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Port vs PICC

karenlas
0 Recommendations

Trevor may be starting TPN in the near future. He's an 11 yr old whose very active, when feeling well. He had a picc in May, had an infection and it was pulled. He's also got an immune deficiency so any thing in him is a risk. He wants a port so he can swim and be active without having a purple thing hanging out of his arm. I'm not crazy about TPN, but at this point his gut is giving him fits, somethings got to be done.
I need some input on the pros and cons of both...

Karen
www.caringbridge.org/visit/trevorlasure

8 replies

danfitzner

I was on tpn from the age of six and had hicmans, piccs, and ports. I will say that I liked the port the most due to my active life. I was grew up on a ranch and farm and was in the dirt all the time. I would really tell you to go with the port. you may be shocked to hear may main reason way. I know as a young main the problem you have with your imaige of your body with a tube hanging out of it. I alwaysed told my parents it did not bother but trust me it does. The main thing to remember of the port is it is more work for accessing and coming off in the morining. you really have to be on your game. As for infections I have a thing that worked for me. The surgical soap with chorahexadine in it when used almost stoped all my infections. shower before hook up and use lots of it on the skin of the hands and in a huge area over the port or cath. also placement of the port is very important. Your child when he gets to the point were he can help with the care need to be able to see it and get both hands to it. For me the best spot was on the front of the chest and one to two inches below the nipple line

happyone

My son, same age, has had picc lines in the past and has hated it. He wanted to swim, wear short sleeves without advertising his line, and do sports. We put in a Port and he's thrilled!! He de-accesses for swimming, can do just about anything his friends do, and it's working really well.
He is immune deficient and prone to infection, we use Vanco Locks which protects his line well.

karenlas

We saw the gi today. He will be getting a port in the next week or so. We're waiting to see when the surgeon can fit him in. He was thrilled he'll be able to continue playing football and taking PE. As sad as it sounds, he's happy he doesn't need to worry about eating and making his stomach hurt. The gi is trying to get him to Ohio to see Dr. DiLorenzo before our scheduled visit in Jan.

prettykitty

I am not on TPN, but have a Power Port in my chest, because my veins are so scared up that its VERY hard to draw blood from them. All I can say is that I love my port! It is very conveient, hardly noticible when not acessed, doesn't hurt, and I have not had an infection since getting my port last year in September. The Bard Power Port is a good one, because it can be acessed for CT contrast dyes. The only drawback to a port is that they can't be used for a PT/INR blood test, due to the heparin they inject into the port after its been acessed to prevent blood clotting.
As far as the procedure for the port, it was realtively easy. They just numb you up really good and have you turn your head to one side. They also sedate you, but I found that the sedation drugs didn't kick in until the doc was almost done implanting the device (I just talked to the nurse beside me the whole time to distract myself).

Hope this helps!!

Jessie

karenlas

Some how I missed this post. Happyone, does your son use the port for tpn only? The docs are telling me tpn will leave sludge in the port. ALL the docs have changed there minds regarding the port and want a broviac. We're leaving on a road trip in a week, the surgeon didn't want to do the broviac until we come home. Trevor ended up with a picc for now. Hoping and praying for no infection.

Karen
www.caringbridge.org/visit/trevorlasure

momto2girls

I posted something last Saturday or Sunday about the port vs hickman/broviac issue. The docs had all agreed, so I thought to do the port for my daughter who is now requiring TPN (should be temporary, but likely the need will come back intermittently). I had done my research and all, but left DD with her dad at the hospital the evening before the placement, so I could sleep at home and see my other daughter for 24 hrs........came back and they had placed a hickman, same argument from the docs, port not good for TPN. I got a LOT of great replies here about people who have used ports for many years and been on TPN. I will find my post and link to it here.
Good luck, he wants the port for good reasons, so did we, we managed to make our case and DD will be getting a port during the next procedure where she needs to be sedated, so there will be no extra sedations, she's had enough!

happyone

Yes, karenlas, my son uses his line for TPN, iv antibiotics when necessary, and extra fluids when needed.
Thank G-d it's working well for us. Good luck with your child, hope you find it works well.
Regarding the sludge you mentioned of TPN, as long as you flush your lines properly prior and after using, you should not have a problem.

Also, many docs don't recommend Heparin anymore, they rely only on normal saline for flushing, but I wouldnt take the chance and take the risk of it clotting.

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