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Hepatic Artery Infusion Pump Placement: What to Expect at Home

Your Recovery

A hepatic artery infusion pump is a way to put chemotherapy medicine directly into the liver. The pump is used to treat colorectal cancer that has spread to the liver. The pump is a small metal container that holds medicine. A thin, plastic tube called a catheter carries medicine from the pump into a blood vessel that goes to your liver. The blood vessel is called the hepatic artery. The doctor made a cut (incision) in the right side of your belly to put the pump under your skin.

The incision may be sore at first. Your belly may be sore and swollen where the pump and the catheter were placed. This usually gets better in 1 to 4 weeks. You will probably need to take at least 2 to 6 weeks off work.

You will probably be able to see or feel the shape of the pump under your skin. With time, you may not feel the pump as much. It may be more comfortable to wear loose clothing over the pump while you are getting used to it.

Your doctor probably will fill your pump with chemotherapy medicine at your first follow-up visit. The pump probably will need to be refilled every 2 to 4 weeks. Your doctor will tell you more about your pump and how often you'll need to have it refilled.

The pump will release medicine at a set rate. An increase in your body temperature can make the pump release medicine at a faster rate. This can cause your liver to get too much medicine at once. So it's important to avoid strenuous activity, hot tubs, and other things that may raise your body temperature.

This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to get better as quickly as possible.

How can you care for yourself at home?

Activity

Rest when you feel tired. Getting enough sleep will help you recover.
Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, until your doctor says it is okay.
Try not to bend or twist at the waist a lot. These movements can cause the catheter to come loose.
Check with your doctor before you use a hot tub, sauna, steam room, tanning bed, or other things that may raise your body temperature. Do not place a heating pad on your stomach.
Hold a pillow over your incision when you cough or take deep breaths. This will support your belly and decrease your pain.
Ask your doctor when you can drive again.
You will probably need to take at least 2 to 6 weeks off from work. It depends on the type of work you do and how you feel.
You may shower, if your doctor okays it. Pat the incision dry. Do not take a bath until your doctor tells you it is okay.

Diet

You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
Drink plenty of fluids (unless your doctor tells you not to).
You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fibre supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.
If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
Take pain medicines exactly as directed.
- If the doctor gave you a prescription medicine for pain, take it as prescribed.
- If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
If you think your pain medicine is making you sick to your stomach:
- Take your medicine after meals (unless your doctor has told you not to).
- Ask your doctor for a different pain medicine.
If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

If you have strips of tape on the incision, leave the tape on for a week or until it falls off.
Wash the area daily with warm, soapy water, and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.
Keep the area clean and dry.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

You passed out (lost consciousness).
You have chest pain, are short of breath, or cough up blood.

Call your doctor or nurse advice line now or seek immediate medical care if:

You have pain that does not get better after you take pain medicine.
You have loose stitches, or your incision comes open.
You are bleeding from the incision.
You have signs of infection, such as:
- Increased pain, swelling, warmth, or redness.
- Red streaks leading from the area.
- Pus draining from the area.
- A fever.
You are unable to urinate.
You have symptoms of a urinary tract infection. These may include:
- Pain or burning when you urinate.
- A frequent need to urinate without being able to pass much urine.
- Pain in the flank, which is just below the rib cage and above the waist on either side of the back.
- Blood in your urine.
- A fever.
You are sick to your stomach or cannot drink fluids.
You have signs of a blood clot in your leg (called a deep vein thrombosis), such as:
- Pain in your calf, back of the knee, thigh, or groin.
- Redness or swelling in your leg.

Watch closely for any changes in your health, and be sure to contact your doctor or nurse advice line if you have any problems.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

Enter E804 in the search box to learn more about "Hepatic Artery Infusion Pump Placement: What to Expect at Home".

Care instructions adapted under license by your healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.