Port Line

Hi Wonderful Ladies,

Do any of you know where I can find a thread on here about people with Port Lines fitted. When mum went for her CT scan and her treatment last thursday they had difficulty getting blood and finding good viens they mentioned about having a Port Line fitted?

Any views on this?

Many Thanks

Love to all Jenna

Hi Jenna, I have a port fitted as they can only use one of my arms for bloods/treatment due to surgery. I am not sure that all hospitals have this facility and it is very expensive, but as your mum has problems with veins, try pushing. A lot of people seem to have these PICC lines. Port is a little disc under my skin on upper chest and a little wire goes into my neck. I know its there and apart from that it seems ok. It will be taken out once treatment is over. I will have a small scar I presume. Good luck Adi

As I understand it, there are three general types of line, which all end up at the superior vena cava, a large blood vessel near the heart. A PICC line, standing for Peripherally Inserted Central Catheter (“central” referring to the large blood vessel) has the open end coming out in the upper arm. The line has to be kept tidy when it’s not in use so is usually stuck to your arm with dressings (I think) and you can get a sleeve or use a loose tubigrip bandage to cover it up so it doesn’t catch on clothes.

A central line comes in a couple of flavours which are slightly different, there’s the Hickman line which a lot of ladies on here have, and a Groeschung line. There is a minor difference to do with valves or something similar (not quite sure) but the principle is that where the PICC comes out in your upper arm, the central line comes out in the upper chest. To keep it tidy, the external part is taped to your chest with dressings.

Both lines are usually inserted under local anaesthetic, perhaps with additional sedation. It’s uncomfortable but not painful, according to the ladies on here who’ve had it.

A portacath is a subcutaneous line, where instead of having the end of the line protruding from the body, the port is under the skin. To access the port they need to use a special needle, and not everyone knows how to use this, so you might find blood tests and any emergency procedure still has to be done in the normal fashion. It is inserted either under general anaesthetic or local plus sedation. Again it’s uncomfortable but not painful, and sedation is pretty hefty so you don’t actually care!

Both the PICC and central lines need to be flushed weekly with saline and anti-clotting stuff, to keep the line clear, the Portacath needs to be flushed once a month.

One benefit of the chemo being delivered into a large blood vessel rather than a scrawny little vein in your hand is the volume of blood quickly dilutes the chemo and so you don’t end up with veins getting very painful and possibly breaking down, and Epirubicin, the E in FEC, can often cause vein problems. It also means, particularly with the PICC and Hickman lines, that it’s very easy to take blood for tests and so on, so if you have a needle phobia it can be a complete godsend to have a central line.

I have a portacath and I’m very glad of it, I really hate them digging around for blood vessels and find that very distressing. I think everyone who’s had a line inserted prefers it to having to put up with having a cannula inserted.

Good luck to your mum, and hope the information helps. If you want more detail, give the helpline a ring, they’re very good and really know their onions.

Jenna, I think CM’s pretty much said it all really!

From a personal point of view, I have a Hickman line fitted. I had it done before my third chemo as my veins had gone by then. They were finding it almost impossible to get any blood and chemo had become very painful.

The insertion of the line took longer than expected (and to be honest wasn’t a very pleasant experience!) because apparently I have very small veins, which was probably why they’d given up during chemo. If I’d known that I’d have had the line in before I ever started chemo.

I’m so glad I’ve got the line. I haven’t had any problems with it at all (they do get infected quite easily so good hygiene is vital). Giving blood is a dream and having chemo is so easy and painless and is over more quickly.

I have a small scar on my neck where it was inserted (usually they try to do that lower down, below the clavicle if possible, but my veins were all wrong for that!) and the line comes out at the top of my breast with a clear dressing over where it comes out to keep it clean and dry. I can shower as normal and just change the dressing if I think it needs it. I tuck the long loose end in my bra.

I have to go to hospital once a week to have it flushed out with saline and have some anti-clotting agent put in to stop it from getting blocked. Some places will teach your partner or a friend to do that for you but mine doesn’t do that.

I had it put in about four weeks ago now - it was used for chemo the very next day - and I hardly notice it now. I was a bit scared of rolling on the line in the night and pulling it so I decided to wear a Mothercare sleep bra (haven’t worn one of those for 17 years!!) to keep it safe. I could have taped it down with surgical tape but I’m allergic to a lot of dressings and tapes so try to keep them to a minimum.

I’d recommend your mum should go ahead with a line or port, whichever is thought best for her. It’ll make having chemo and giving blood (which she’ll have to do very frequently) painless and an awful lot easier and faster.

Jane xxx

Hi, can I just say that I thought chocciemuffin’s description of the different lines really helpful. I shall be pushing for a portacath when my time comes
Alison x

Depending on where you are you might have a bit of a fight, because a portacath is more expensive than other central lines to insert. I had to push because I really didn’t think I could stand the cannulas (three people had independently commented that I have tiny veins) but I didn’t want to have to have dressings stuck to my skin for the guts of 18 months, seeing as the dressing following surgery that was only there for a week left my skin flaky and peeling.

Regarding the cost, things to bear in mind (and to remind your health care professionals) is that although the insertion cost might be more, it works out a good bit cheaper in use, particularly for those who have to have Herceptin for a year, on top of being MUCH less of an intrusion in the life of the person having it.

External central lines like PICC and Hickman have to be flushed weekly, usually by a district nurse. (Wonder how much that costs.) Portacath needs to be flushed monthly, but as it’s used more often than that, it doesn’t need any intervention from nursing staff over and above the usual chemo unit staff.

There are significantly fewer infections in subcutaneous ports than in external ports. I did find a bit of research that showed this, I’m sure you could find it with a bit of googling but I’m afraid I didn’t save the link.

ANY central line is preferable to being cannulated every time they need to stab us!

I’m not having Herceptin so a Portacath wasn’t really necessary for me as I’ll only have it in for a couple of months. I’ll have used my Hickman for the last three chemos and they’ve told me it’ll be taken out three weeks after my last chemo, so just before I start rads.

I’m allergic to the white dressings and micropore they usually use for operation wounds (and for the Hickman sites when it was first inserted) so I was dreading that bit, but once the first dressings were changed they’ve used some very thin clear ones that I don’t react to at all (quite a nice surprise!) They have some sort of clear gel pad on them in the centre that I think has antibacterial properties and the nurse told me they cost about £5 each. They’ve been excellent.

I have to go into the chemo unit at the hospital to get my line flushed, but as the hospital is in Bedford I usually manage to combine it with a trip into town or to the supermarket so it’s not too much of a problem.

I completely agree with CM, if you need it in for longer then a Portacath is the way to go if you can get it.

My chemo nurse thinks that everyone having chemo should have a line put in before they start because it just makes the whole experience of giving blood and having intravenous chemo so much quicker and less stressful for everyone. I think that says a lot!

Jane xxx

Hi I too have a portacath it’s brilliant. Would definitely advise this, can be uncomfortable having it fitted, but after that, fantastic.

Thank you so much for all your comments, everything is much more clearer than when I first come on here, Ive printed everything off for mum to read.

Thank you so much ladies

Jenna x x x