Of Ports & Blood Cultures

Update, 01/28/10:

I have cellulitis - in layman's terms that is an infection or inflammation around my port.

No definite idea on why this happened - it could be attributed to any number of reasons. One theory is that because my immune system is down due to the prednisone, it may be a contributing factor.

So, for now, we are just going to wait and see. Hopefully the infection clears up on its own (I'm on so many antibiotics that it should). Since I am so close to being done with this round of antibiotics, I elected not to re-access but did change the dressings and clean the site.

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Doing blood cultures on my port.

It's been bothering me since last Friday but I thought it was because the nurse had to manipulate it so much (it also took her 3 sticks to get it reaccessed). There is some bruising, but my whole side is tender to the touch & the dressing had a lovely yellow tinge to it. Have been blaming the soreness / tenderness on Prednisone withdrawal (been dealing with that too), but that's better & my port is still hurting.

GREAT.

Hospital, Day 2

It's official. I'm back in "Club Med" (or "Club Dread," depending on your perspective). After 80 days of freedom, it was time for a tune-up. I accomplished my goal of staying out of the hospital through the end of the year (a challenge that I had with my boss) and even made it almost a week longer.

(80 days?!? I can't believe I made it that long. I should get a gold star.)

In all, I don't feel terrible. I certainly don't feel great and I know it was time to come in, but there have been times that I've been here that I have felt much, much worse. I would love for this to be a 14 day visit rather than my normal 21, but I'm not going to jinx myself by making plans for a 14 day stay. Not yet, at least.

They started me on the same schedule of meds, pending the results of my sputum culture. I've been very tight and most of my congestion seems to be confined to my upper lobes (on both sides). My bases actually sound fairly clear, which is a nice change. I have not had the opportunity to do PFTs yet, so I don't know what my current functions are.

My port went on strike. When I first accessed it, we were able to get a small amount of blood return and it was sent off for labs. By the time the lab received it, the blood was clotted and the sample was useless. When they came back for more, my port decided to have a temper tantrum and wouldn't draw back at all, although it flushes perfectly fine.

In all likelihood, I have a fibrin tail at the end of my catheter. I've had this happen several times before, so I wasn't too surprised or concerned about not being able to get a blood return.

For those of you not familiar with the wide world of ports, fibrin is a fibrous protein involved in the clotting of blood. Fibrin starts to build up on a catheter without completely enclosing it. A small piece of fibrin may hang off the catheter tip. This is known as a fibrin tail, which also represents a persistent withdrawal occlusion. These can sometimes be resolved with an infusion of low-dose alteplase.

Two doses of tPA later, I am the proud owner of a port that flushes with ease and gives a beautiful blood return. Whew!

I think that's about all the new news for now, so I'll sign off.