We had our clinic day today. Nearly ran over two deer (I swear, coming around the corner, the first one looked like a giant muskrat and I was so flummoxed by this, I didn’t see the second one until it was nearly too late). Had trouble staying awake driving there. Not doing 8:45 appts any more.
His new PowerPort won’t draw. It flushes OK, doesn’t draw. We were hoping it would be better today (it didn’t draw well last week, either), but it wasn’t. So he had a line study done (X-Ray #867)
(This is the restraint they use for flouroscopy for him)
This is an image from the line study. You can see the big port there (the big rounded triangle), then the line that comes out of it and runs across his chest to the left (his right). It goes into his heart.
The report says: Findings: A subclavian port catheter is in place, and the distal tip is pointing laterally at the superior vena cava without a caudal turn.
It should have a caudal turn (it should turn down to follow the vena cava). It doesn’t. It’s actually resting against the vessel wall. That’s bad. That’s why it will flush but not draw. It will erode the vessel if left there.
So, plans are kind of up in the air, but it’ll likely have to come out (surgically). May or may not be replaced. And his BUN is up again (mid-50s) this week, so he may start dialysis soon (yeah, we say that a lot, but it’s true a lot, too) and that will sort of make the decision on a port for us.