• Ambulatory pumps Small portable pumps that deliver chemotherapy while you go about your normal
  activities are called ambulatory pumps. ("Ambulatory" just means you can walk around.)
      These devices are often about the size of a deck of cards. They hold the drug supply, a mechanism for
  injecting it slowly and smoothly into an attached catheter , a battery to power the mechanism and controls for
  regulating the rate of drug delivery. Many of the pumps have become very sophisticated. Some have alarms to
  alert you to problems. One of the newer systems can deliver four separate drugs in a preset time sequence.
      Several types are available. The balloon pump is the cheapest and simplest, consisting basically of a large
  plastic reservoir. The pump is filled, then attached to a port or catheter. The pump empties automatically
  when it's connected.
• Central nervous system delivery Some patients, such as those with acute leukemia, need chemotherapy drugs
  injected into the spinal fluid. This can be done by repeated lumbar punctures (spinal taps), but the preferred
  method is to use an Ommaya reservoir. This is a rubber bulb usually placed under the scalp. A tiny tube
  connects the reservoir to the spinal fluid compartment. This requires a minor operation for placement of the
  reservoir and tube. Drugs are injected through the skin into the reservoir. Infection in the reservoir area is a
  possibility, so patients are usually monitored for side effects such as tenderness, inflammation , fever, stiff
  neck and headaches.