Installing a Port-a-cath for chemotherapy infusion

My daughter, Meaghan, is at the University of New Mexico Outpatient Treatment Center (OTC) today for her first dose of two for the second round infusions of Rituximab (Rituxan).

Rituxan Official FDA information, side effects and uses.
http://www.drugs.com/pro/rituxan.html

This Rituxan medication is the next step in efforts to achieve remission with her Churg-Strauss Syndrom (CSS) vasculitis. She was taking Methotrexate and Prednisone for the past eighteen months with some success at controlling symptoms, but no remission. She flared last March, and started Rituxan in May. Since then, she has been able to taper completely off the Methotrexate, and lower her Prednisone dosage.

The numerous negative side effects associated with both Methotrexate and Prednisone make lower dosages a significant improvement. The documented side effects of Rituxan are neligible compared to Methotrexate and Prednisone, so we hope this will not only control her CSS, but also improve her long term prognosis by reducing the risks of other diseases related to side effects.

Because she has become a long-term infusion patient, her doctor recommends she have a port-a-cath installed. This will make bloodwork and other infusions requiring a vein puncture easier and safer.

Today was a case in point. For whatever reason, her veins were not cooperative, and it took several attempts before the nurses gave up, and eventually a paramedic was called in to find a vein with the assistance of an ultrasonic imaging scanner. This process of enduring nine or tens IV attempts delayed her infusion by almost four hours, and caused her a lot of suffering.

The doctors talk about this "port" as if it were no big deal. It is fairly common and they see few incidents of complications. They described to her what those complications can be. My research seems to indicate that the rate of complications is something like 1.04/1000 (0.01%).

The complications range from a minor site infection that is treatable, to blockage of the port. Certain more serious complications require removal of the port. These are all rare, and the more serious are the most rare.

That information correlates with a summary web page I found on this topic that I think details the entire issue pretty well according to what the doctors tell me and from what I have been able to research myself:

Portacath Insertion
http://www.sir.net.au/portacath_pi.html

After researching this fairly comprehensively, it seems the Port-a-Cath method of installing a permanent catheter is cheaper and safer than most other choices.

This is not really "permanent" in the traditional usage of the word. When she is successfully in remission, then the Port-a-Cath will be removed.

Big news, but it will make blood draws easier, and it will certainly be more comfortable than the peripheral IV method of administering infusion therapy. The other benefit to this will be that emergency medical personnel will have an easy method for administering medications should she ever have an neeed for urgent care.

So it seems this Port-a-Cath will be more efficient and more economical in the long run. Plus this promises to be more comfortable for the patient, who in this case is my daughter. I am all for sparing her additional pain and suffering.

: Joseph

To other vasculitis patients:
So, what's your story? Let me know how you are doing. You can send me Email.

Joseph W. Carpenter
Email