Wednesday, February 08, 2006
Almost Enough to Make Me Superstitious
The root of all superstition is that men observe when a thing hits,
but not when it misses.
--Francis Bacon
but not when it misses.
--Francis Bacon
Ever since I learned how to access and flush my port-a-cath by myself, I have been diligent in flushing it on a monthly basis. To keep things simple, I would typically do this on the 1st day of the month.
This month seemed to start without me. Not only did I forget to change my calendar to February until last Sunday afternoon, I failed to flush my port according to plan. I realized this breach in protocol in the middle of the night a couple nights ago. "Better late than never," I told myself, and began to to gather the necessary supplies. 1-inch Huber needle; dressing change kit; saline syringe; heparin syringe; all was set. I prepped the needle and it worked just fine. When the reddish orange betadine had dried to a sickly yellow, I proceeded to insert the needle.
It felt like it went in fine. I purposefully had aimed for an area that had as little scar tissue as possible. When I attempted to flush the line with the saline, the plunger was met with lots of resistance. I tried rotating the needle slightly. I tried raising my arm over my head (for some reason this helps sometimes). Still no luck. No blood return in the line either. Just a sinking feeling in my gut that this was going to take a bit longer than expected. Nearly half a dozen times I tried backing the needle out just enough to try to reinsert. All the while I was blaming myself for having waited to flush it. I was convinced that I'd let the line become blocked due to my negligence.
I didn't want to waste any needles if I didn't have to. Nothing was working, so I pulled out the needle and tried another one. The new needle went in fine, flushed smoothly and I got good blood return when I drew back on the plunger.
When all was said and done I examined the first needle. I tried flushing it and had just as much resistance as I had felt when it was inside me. Out of curiosity, I connected a new saline syringe to it and pushed down on the plunger as hard and fast as I dared. A very small piece of something peeked out of the needle as the saline sprayed from around it as though I was holding my thumb over the nozzle of a garden hose. Apparently, I hadn't aimed for a spot that was free enough of scar tissue, and as I pierced my skin, a tiny chunk managed to become wedged into the needle, preventing it from being used.
I was relieved to find out that waiting a few days to flush my port didn't cause any harm. I've had my port for about 9 years, and I'm told that it's amazing to have one last that long. The whole episode from the other night got me wondering though whether it may be time to replace/relocate it so that the buildup of scar tissue doesn't cause problems. Of course, replacement would involve surgery, and anesthesia isn't always the greatest thing for people with CF, so I'd like to avoid it if at all possible. For now, I'll keep flushing my port and treating it well, and maybe I can get several more years out of it.
This month seemed to start without me. Not only did I forget to change my calendar to February until last Sunday afternoon, I failed to flush my port according to plan. I realized this breach in protocol in the middle of the night a couple nights ago. "Better late than never," I told myself, and began to to gather the necessary supplies. 1-inch Huber needle; dressing change kit; saline syringe; heparin syringe; all was set. I prepped the needle and it worked just fine. When the reddish orange betadine had dried to a sickly yellow, I proceeded to insert the needle.
It felt like it went in fine. I purposefully had aimed for an area that had as little scar tissue as possible. When I attempted to flush the line with the saline, the plunger was met with lots of resistance. I tried rotating the needle slightly. I tried raising my arm over my head (for some reason this helps sometimes). Still no luck. No blood return in the line either. Just a sinking feeling in my gut that this was going to take a bit longer than expected. Nearly half a dozen times I tried backing the needle out just enough to try to reinsert. All the while I was blaming myself for having waited to flush it. I was convinced that I'd let the line become blocked due to my negligence.
I didn't want to waste any needles if I didn't have to. Nothing was working, so I pulled out the needle and tried another one. The new needle went in fine, flushed smoothly and I got good blood return when I drew back on the plunger.
When all was said and done I examined the first needle. I tried flushing it and had just as much resistance as I had felt when it was inside me. Out of curiosity, I connected a new saline syringe to it and pushed down on the plunger as hard and fast as I dared. A very small piece of something peeked out of the needle as the saline sprayed from around it as though I was holding my thumb over the nozzle of a garden hose. Apparently, I hadn't aimed for a spot that was free enough of scar tissue, and as I pierced my skin, a tiny chunk managed to become wedged into the needle, preventing it from being used.
I was relieved to find out that waiting a few days to flush my port didn't cause any harm. I've had my port for about 9 years, and I'm told that it's amazing to have one last that long. The whole episode from the other night got me wondering though whether it may be time to replace/relocate it so that the buildup of scar tissue doesn't cause problems. Of course, replacement would involve surgery, and anesthesia isn't always the greatest thing for people with CF, so I'd like to avoid it if at all possible. For now, I'll keep flushing my port and treating it well, and maybe I can get several more years out of it.
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I too have gotten into a routine of changing my tracheotomy tube out every 72 hours.
I take the one in my neck out and soak it in hydrogen peroxide and take the one that was in the peroxide and scrub it again before soaking it with rubbing alcohol to make sure that any nasties that are left after the scrubbing are sufficiantly dead. I then clean the area around the tracheotomy with hydrogen peroxide and coat it with vitamin E oil -- it helps to make the scar tissue not hurt so bad (after having a tracheotomy done three different times there's a lot of scar tissue... after all there's only one place where they can do that procedure).
Then the tube that has just been cleaned goes back into my neck. Wait 72 hours and repeat again. It's amazing how those of us who have serious medical problems get into habits. We have our way that we HAVE to do things because in many cases our lives depend on it. Oh for simpler days...
I take the one in my neck out and soak it in hydrogen peroxide and take the one that was in the peroxide and scrub it again before soaking it with rubbing alcohol to make sure that any nasties that are left after the scrubbing are sufficiantly dead. I then clean the area around the tracheotomy with hydrogen peroxide and coat it with vitamin E oil -- it helps to make the scar tissue not hurt so bad (after having a tracheotomy done three different times there's a lot of scar tissue... after all there's only one place where they can do that procedure).
Then the tube that has just been cleaned goes back into my neck. Wait 72 hours and repeat again. It's amazing how those of us who have serious medical problems get into habits. We have our way that we HAVE to do things because in many cases our lives depend on it. Oh for simpler days...
Lauren, thanks for sharing about flushing your port. Neither of the girls have a port, although every time they are hospitalized the doctors really push to put one in. I would rather wait until they are older to get one. Once they have one, it's just there and needs continuous care. I'm glad yours has lasted for such a long time.
i wouldn't worry about the portacath its done every six weeks at my practice.
what i do find odd is that the needle is able to core things - done you use needles with the hole on the side? rather than in a tubular format.
what i do find odd is that the needle is able to core things - done you use needles with the hole on the side? rather than in a tubular format.
Sounds Painful...I have managed to not get one yet & I am 22, and still no one has pushed or even mentioned it to me. What a blessing.
Actually, it's not very painful at all. To me it almost seems like putting in an earring. The spot is already primed for it, I just have to slide the needle in.
I consider it a blessing to have a port. I can see how it would be a pain in the neck for someone who isn't on IVs regularly to have a port, but for me, life is MUCH simpler with the port. It give me a lot more freedom when I do tune-ups.
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I consider it a blessing to have a port. I can see how it would be a pain in the neck for someone who isn't on IVs regularly to have a port, but for me, life is MUCH simpler with the port. It give me a lot more freedom when I do tune-ups.
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