Nora’s port definitely has some issues but they are manageable for now and we’ll just keep using it as it is until it stops working which hopefully wont be anytime soon. The first issue is that her port is not flat against her chest but is in at an angle, so now we know to put the needle in at that same angle instead of straight on and that explains why getting it in has been an issue. After the initial x-ray was taken showing how the port was laying, we put a needle in and injected some dye to see what the catheter was doing. The catheter had recoiled back up the artery a good bit so instead of being at a gradual arch from her port over to her heart it’s at a sharp turn. So just like with a water hose things don’t flow as smoothly as they would if it were at a straighter angle. Anther thing going on with the catheter is since it’s recoiled and not hanging down in the big artery right above her heart, it’s now in a smaller artery and the end of it is up against the artery wall, so that explains why we can’t get blood return sometimes because it’s making a vacuum against the wall. But it does move around in the vein a bit so moving Nora’s position should move it off the wall enough to be able to pull blood. Thankfully Nora only gets labs drawn monthly so drawing blood wont be a weekly issue. Lastly, it looked like there was a bit of fibrous clot forming at the end of the catheter causing even more blockage issues. But the clot is still small and if it gets bigger it can be easily be broken up by injecting a certain solution.
So it’s far from perfect but it still works and no surgery was needed and that makes us all sigh a big sigh of relief. Dr. Crooms was with us every step of the way this morning and left it up to us whether to go in and straighten out the catheter now but we don’t want to put Nora through even a minor surgery unless absolutely necessary. He agreed with our decision and as long as Nora’s TPN can infuse with out occluding than that’s the most important thing. And now that we have a clear picture of what’s going on inside working her port should be much easier from now on, and less stressful. Even though there are multiple issues going on none of them are putting Nora in any danger, especially since we’ll continue to go by the golden port rule of not forcing anything in or out. If it doesn’t come with gentle pressure then we’ll know to give it a rest and try again later.
Since I know I’ll get fussed at if I make two posts in a row with no pics I’ll wrap this up with some funny pictures of our silly girl that have been taken over the past few weeks.
