Your doctor or nurse has recommended that you have a venous access device or port placed in order to administer your treatment. The port is implanted under the skin, usually in the upper arm, under sterile conditions. It is designed to remain in place for long periods of time and is made of materials that are long lasting and safe when placed in the body.

The procedure to place the port is scheduled by our office and is done in radiology. The area will be thoroughly cleaned and anesthetized. One end of the catheter is inserted into a vein through a small incision in your upper arm, and the other end is connected to the port underneath the skin. When the incision has healed only a small raised area will remain.

Ports require very little care. If you are not regularly receiving treatment through your port, the nurses in the clinic will need to "flush" it with saline and a heparin solution every 4-6 weeks. This helps to prevent clots from forming in and around the catheter.

As with any procedure, there is a risk of infection and bleeding. There may be some swelling, bruising, and discomfort in the arm. This generally lasts about 2 weeks.

As long as the port is in place there is a small risk of infection developing in the area. There is also a small risk of clot formation in the vein around the catheter. Your doctor may prescribe a very low dose of Coumadin to prevent this. If you develop pain or swelling in your arm notify the office staff.

If you have any questions or concerns, your doctor or nurse will be happy to talk with you.

Coumadin Therapy for Access Devices

Because there is a small risk of clot formation in the vein around the catheter, your doctor has prescribed an anticoagulant called Coumadin that prevents clots from forming.

The dose of Coumadin that your doctor has prescribed for you is very low, 1 mg per day, but research has shown that it is effective for preventing clot formation in patients with access devices. Even though the dose is low, there are several things that we would like you to know about therapy with Coumadin.

1. Take the exact amount of Coumadin prescribed by our office.
2. Take your dose at the same time each day, usually in the evening.
3. If you miss a dose of Coumadin, resume the next day. It is not necessary to make up the dose.
4. If you are going to have any dental, medical, or surgical procedures done, be sure to let the physician know 7-10 days before. Coumadin may need to be stopped for a period of time before the procedure.
5. You will have a blood test called an INR done about 7-10 days after you begin this medication. This is usually done only once. Our office will let you know if there are any changes that you need to make in your dose or if you need to have your blood drawn again.
6. Let all of your physicians know of any medications that you are taking as Coumadin interacts with many drugs

Call our office if any of the following occur. We can be reached by calling 734-712-1000 at any time. If after hours or a weekend, the physician on call will return your call. If you call during business hours, one of our nurses will call you back.

1. A serious fall or if you hit your head.
2. Bleeding or oozing from a wound or cut.
3. Bleeding from your nose, vomiting or coughing up blood, more bleeding than usual from your period or brushing your teeth, or blood in the urine or stool.
4. Any unusual bruising for unknown reasons.
5. Rashes.
6. Pain or swelling in legs or feet.
7. Confusion, dizziness, numbness, tingling, rapid or unusual heartbeat, chest pain or shortness of breath.
8. Fever, sickness, nausea, vomiting or diarrhea.
9. If you begin any new medications.

Ann Arbor Hematology Oncology Associates, P.C.
734-712-1000
Saint Joseph Mercy Cancer Center
Ypsilanti, Michigan

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