warfarin for portacaths and hickman lines

Evening all,
I went for my regular herceptin today at chemo suite, and we were all told that there’s been new research just published showing that taking warfarin with a central venous line has no measurable effect in terms of preventing clots. So we have been told we can stop taking it as of now! Of course, there’s no need to rush into anything yourselves, but I would ask about it at your next appointment, as it seems to have been a definitive study.
A summary of the research can be seen here:

thelancet.com/journals/lancet/article/PIIS0140-6736(09)60205-1/abstract

all the best
Jacquie

More than interesting since I have a portacath and am not taking warfarin. It’s not even been mentioned. Either my hospital is very up to date with current thinking on that score or they’ve missed a trick! :o

Hi there
I have a Hickman line and taking Warfarin has never been mentioned to me either ! How strange.
Sue

Hi

I have a Portacath, too and I’ve never been given anything like Warfarin (I wasn’t given anything when I had a Grouschon line four years ago, either).

In fact, I’ve had the Portacath for 16 months and apart from the administration of chemotherapy, no-one has touched it at all.

Are there different types of Portacath, does anyone know?

X

S

I’ve had my port for 10 months and didn’t notice until yesterday that what I thought was a flush injected prior to removing the canula was actually Heparin.

I’m waiting for appt to have hickman fitted at the moment…I’m sure I read somewhere that portacaths don’t need flushing etc and you can get them wet can’t you ie with swimming etc?? you can’t with the hickman and picc…

Portacaths need flushing every 4 weeks apparently. Well so I was told last week anyway, I thought you could just leave them if they weren’t being used. I also didn’t know that the stuff they inject at the end is heparin until today when I asked what it was. I guess if that’s done at least every 4 weeks then it removes the need to take any other anti-clotting meds. I don’t know, it does make me worry sometimes and I am still a bit squeamish about it I must say.

Mary - you can get portacaths wet because they are entirely sited under the skin, a Hickman has a tube hanging out doesn’t it?

Just out of interest - why are you having Hickman rather than portacath? I know ports are more expensive, but I wondered if there was any other reason to choose a Hickman over a port? Having said that, accessing the port entails piercing the skin over it with what looks like a big carpet tack and then pushing hard until it clicks into the port. It ain’t comfy. Does anyone else find that? Does it get easier the more it’s used?

Hi,
I had a port for all my chemo as had ‘no veins’ on my first visit. I had it flushed at the end of every treatment but like you thought it was saline again. Not sure now. Anyway just wanted to suggest you ask for Emla cream (or equivalent). It is a local anaesthetic cream that you put over the port area to reduce/prevent the stab as they push the needle in. They gave me a tube and a dressing to take home each time so that I could put it on at home before I arrived.It does not always completely numb it but definitely helps take away that initial stab that used to make me jump and wince in anticipation (low pain threshold). Most units have them in the fridge, do ask it definitely improved my visits.
Lily x

Gennie - they tried a picc line first with me - no good - so said they’d sort appt for hickman - its put in under local and yes has tube/s out and you need to keep it dry - did your portacath need doing under GA gennie? I don’t know too much about them…

No I had it done under local with a bit of sedation. It wasn’t done in a theatre or anything, just on a bed in a room at the chemo unit. Took about 40 minutes.

After reading Ripley’s post I double checked the medication provided by my onc that I take to the District Nurse for my line flush.
Lo and behold one of them is called Heparin sodium flush solution and is an anti coagulant !
Having said that I’m not sure if this is the same as taking full blown Warfarin if you know what I mean ???
Sue

I have heparin injected each time they access my port, AND have been on Warfarin! Interesting that so many of you haven’t ever had it.
I must say I like the sound of the Emla cream, as I hate that moment the needle goes in…
Jacquie x