Re: - re port-a-cath

[Guest guest]

,

Yes I do have a port-a-cath and it has truly been a blessing. Even before I

ever had the first attack of acute panc (Jan-00) I was a difficult stick. I

had to have a central line for shoulder surgery after two anesthesiologists

tried 14 times to start an IV with no success. I've had the port-a-cath

since Jan 03 and have had no problems with it. I had no idea that I could

get IV fluids and IV meds at home. They have left my port-a-cath acessed

once when I came home from the hospital. I had cellulitis in my left arm

and needed to be on IV antibiotics for another 10 days after I was

discharged from the hospital. They had a home health nursing service

provide the antibiotics, saline and heparin flushes. I did the flushes and

antibiotics three times a day. Home health came out every other day to

change the dressing on my port-a-cath. It worked fine and I was very happy

to continue the IV antibiotics at home once the panc attack had resolved

enough for me to do without IV fluids and IV meds for pain and nausea.

I would love to be able to get the IV fluids and IV meds at home! My GI doc

and rheumatologist worry very much about me being in the hospital because I

am at a higher risk for getting an infection than a 'normal' person. I have

a genetic IgG deficiency, systemic lupus, and am on an immunosuppressant

(Imuran) for my autoimmune liver disease. My 'normal' white count is about

3.0-3.5. Most labs show the normal WBC as 4.5-10.9. We're not really sure

if it is the lupus, liver disease, and/or Imuran that keeps my white count

constantly below normal but whatever the cause, I'm at increased risk for

infections. However, even when I have an infection I don't usually present

with the typical symptoms. When I had the recent bacteremia (bacteria in my

blood), my WBC was only 8.4 - well within the normal range. The only reason

the ER doc even did the blood cultures was because my temp was 102.1. When

he sent me home he told me I probably just had a mild UTI since my WBC was

normal. I didn't bother telling him that I have not had a WBC over 5.0 in

at least 3 years. He did send me home on levaquin and I didn't even find

out the blood cultures were positive until I'd already finished the

levaquin. They called me from the ER and told me I needed to see my local

doctor ASAP and get on more antibiotics.

Anyway, since having the bacteremia the end of June, my doctors have really

been wigging out about putting me in the hospital even though the infectious

disease doc said he is sure the bacteremia did not come from my port-a-cath.

So, in my case, even more so than the case of someone who is 'normal' and

doesn't have all the autoimmune issues and increased risk of infection that

I have, keeping me home during a panc flare would be wonderful! I have an

appt with my GI doc the end of this month so I will definitely talk to him

about whether or not that is a possibility. I think my insurance only pays

for a certain number of home health nurse visits but I haven't had any home

health nursing service this year.

Thank you so much for the suggestion! However, I do SO love going to the ER

and being treated like a liar and a drug addict! I don't know if I really

want to give up all the fun that I have when I go to the ER! Obviously, I'm

being incredibly sarcastic! If I never, ever have to go to the ER or be

admitted to the hospital again, it would still be MUCH too soon!

take care,

W