Port Question

[fumaros]

I still have my port in my chest, but it hasn't been used since the end of November, 2016. Should it be undergoing periodic maintenance like regular flushing so it doesn't get clogged? How did you decide if and when to have it removed?

[NedPlease]

Yes, you MUST maintain the port with routine flushes. Frequency of those flushes varies a bit but monthly-ish is generally the norm.
Removal will likely be brought up by your onc. I chose to keep mine a bit longer just because I expected to need it again plus handy for bloodwork. Karma may have been a factor too.

Best to you,
N

[fumaros]

Thanks alot NedPlease, i will certainly bring up getting it flushed next time I go for a check up. My onc says removal is totally up to me, so for now, perhaps I will wait.
wishing you all health and NED

[Soccermom2boys]

Wow, I am surprised no one at your onc office ever mentioned the importance of getting your port flushed regularly? I was told that I need to have it flushed every 4-6 weeks. I always schedule the next appt on my wait out from the office so that I make sure it is on my calendar and hopefully somewhere in my brain so that I don't forget to go. It truly takes about a minute or two to get done, they just want to check the blood flow and cleanse it out so that if needed it is in good shape. I had my last chemo in late May/early June and have been going to get the port flushed every ~5 weeks since. My onc said she wanted me to wait until after my one year post chemo scans before I had it removed. I know many want to rush to get it out which I completely understand why, I hate seeing the alien looking bump under my skin, but I also don't want to rush and then need to have another one put back in, that was not high on my list of fun things to experience. Because the flush is such a quick in and out appointment I am guessing they can squeeze you in as soon as you want, but as it has been over six weeks now since your last treatment, I would call them up this week to get in there for it. Good luck!

[fumaros]

Thanks Soccermom2boys. Port maintenance was not brought up after my last treatment, in fact my onc was just ready to take it out; I had to tell her I wasn't ready yet. I will definitely bring up doing a flush during my next visit (i still have my novocaine).
The port bump is a reminder of a really rough time in my life, and it does make hugging a little awkward, but you make a good point, especially since mine was really tough to install.

[teri3]

I'd think about keeping it in a while. I had mine out 3 months after finishing chemo and was declared NED. 9 months later I my scan showed lung mets and I had to have another put in and this 2ND one just isn't as good as my first. It more painful and hasn't worked as well as my first. But that is just my experience. Good luck.
Teri

[horizon]

I'm shocked they didn't bring up maintenance. I was told the longest I should go without flushing it was 6 weeks. Get that thing flushed!

The port bump is a reminder of a really rough time in my life, and it does make hugging a little awkward, but you make a good point, especially since mine was really tough to install.

Been there done that. I had mine in much longer than I expected. I know exactly how you feel. Sometimes I would blissfully not be thinking of cancer, take off my shirt, and bam. Constant reminder. I did love that little bugger for blood draws and IV contrast though.

[cecioboe]

Jim kept his for 4 years "just in case" he said. He would get it flushed every couple of months. It always worked perfectly. Had it out a few months ago.

[fumaros]

Thanks all, especially keeping it for IV contrast for CT scans. I have teeny tiny veins, it took 5 attempts to get the catheter in for the IV dye the last time, yeah that was miserable.

[horizon]

Thanks all, especially keeping it for IV contrast for CT scans. I have teeny tiny veins, it took 5 attempts to get the catheter in for the IV dye the last time, yeah that was miserable.

If I remember correctly it's a power port that supports IV contrast. Hopefully you have one. My first chemo was in my arm and it took about 5 attempts for the IV and I *despise* needles (still). That's when I broke down and got a port. No regrets.

[LPL]

fumaros,
Thank you for posting this question.
It is the same for my husband - No info about flushing the port. Last time his port was used was Feb 18 !!
This rutin/recommendation can not be different if you live in Europe (as we do) can it ?
Are there different kinds of ports ?
I find it frightening that we have not gotten any info about this
Does anyone have a link to some 'official' recommendations/info about flushing of ports ? I would like to print it out and bring to his Onc later this week when husband has a control ultrasound and an Onc appointment.
Kind Regards /L

[horizon]

fumaros,
Thank you for posting this question.
It is the same for my husband - No info about flushing the port. Last time his port was used was Feb 18 !!
This rutin/recommendation can not be different if you live in Europe (as we do) can it ?
Are there different kinds of ports ?
I find it frightening that we have not gotten any info about this
Does anyone have a link to some 'official' recommendations/info about flushing of ports ? I would like to print it out and bring to his Onc later this week when husband has a control ultrasound and an Onc appointment.
Kind Regards /L

I just did some quick Google searches.

This powerport documentation says flush it every 4 weeks.

http://www.bardaccess.com/assets/litera ... de_web.pdf

This site says once per month.

http://nursinglink.monster.com/training ... ss-devices

This says every four weeks:

https://www.drugs.com/cg/how-to-care-fo ... -port.html

[LPL]

Thank you horizon for trying to help.

I searched some more..
and have calmed down a bit,
because I found these studies:

(2010) https://www.ncbi.nlm.nih.gov/m/pubmed/20224280/
Interval between Port Catheter Flushing Can Be Extended to Four Months
"Abstract
Background: Little is known about proper interval periods between the flushings of totally implantable access ports after completion of chemotherapy. Manufacturer guidelines recommend flushing catheters every 4 weeks. Methods: This retrospective study examined whether flushing less than every 4 weeks conferred any benefit. Results: 349 totally implanted access ports were divided into four groups based on the different durations of the intervals between flushings. Sixteen (4.6%) complications were observed in the study population. Conclusion: Our results demonstrate that extending the flushing interval to up to 4 months remains medically safe and drastically reduces the costs."

(2013)
http://file.scirp.org/pdf/MC_2013041514133207.pdf
Extending the interval for port-a-cath maintenance
"Our initial and now follow-up data suggest that ex- tending the interval of PAC accession to every 3 months, rather than monthly, is safe, effective and convenient in maintaining PAC patency in this patient population. Fur- thermore, more frequent flushing can reach the limit of maximum accessions of a PAC device if the maintenance period is prolonged in cases where malignancy does not recur. Accessing the device too frequently can potentially cause more residual blood in the catheter and further limit the successful blood return during the flushing.
Furthermore, catheter maintenance is associated with significant costs, which primarily affect the patients and the healthcare system. Although cost was not considered in this analysis, it can be assumed that more frequent flushing is more costly and burdensome not only to the medical system, but for patient transportation and com- pliance. Indeed, for women who have completed their therapy, monthly visits to the doctor’s office for PAC flush have resulted in poor patient compliance, as it is invasive, inconvenient and expensive. Thus, extending the interval for PAC maintenance period is feasible, safe, convenient and cost effective. It will facilitate patient’s follow up and compliance. A three-month catheter main- tenance schedule would also coincide with patient’s re- quired clinical cancer follow up office visits and may improve their compliance and satisfaction, while de- creasing healthcare costs."

(2016) http://ascopubs.org/doi/abs/10.1200/JOP.2016.010843
Phase II Trial on Extending the Maintenance Flushing Interval of Implanted Ports
"Conclusion: Extending the maintenance flushes of implanted ports in adult oncologic patients to once every 3 months is safe, effective, and likely to increase patient adherence and satisfaction while decreasing the associated cost."

[TXLiz]

Yes, get it flushed. My onc says every 6 weeks.

I finished chemo in March and had my first flush in June, just a few days ago.

It flushed, but they couldn't get a blood return and think a flap of fibrin grew to block a blood return.

I have to go back in and get injected with medication to try to disolve the fibrin. If that fails,I will need an ultrasound study of my port to assess it and its function.

I am a bit ticked off because I called them a few times and they said they'd get me on the schedule for flushing.

They didn't, and I finally had to go in and insist I need a flush.

Ugh.