Whoever wrote this won the internet today.

hands (veins) heal? They obviously can't use his feet, given how swollen and probably want to preserve his median cubital vein (top of the arm at the elbow) for blood draws.

A PICC line (peripherally inserted central catheter) would have a visible tube, though hidden under long sleeves. But, given what appears to be advancing dementia, he might well catch the PICC line on something and pull it out).

So, that (primarily) leaves a port--tunneled under the skin at the chest, with the least infection risk, non-visible--requiring only monthly checks and flushes when not in regular use. It COULD be placed in the White House clinic, despite requiring some light sedation and local anesthetic-- and about 60 minutes of time to place. Or, of course another trip to Walter Reed if they feel it necessary for the placement. It can remain in place for years if necessary.

If, as I suspect he is getting regular fluids administered--delivering an experimental dementia medication (likely immune therapy), I doubt this regimen is going to stop any time soon, so a port might be advisable.

There are couple of other options, but I just don't see continuing the use the veins of his hands, given how readily they bruise, extravasate (blow up), and never seemingly get a chance to heal.

His left hand has the recent puncture wound fairly pathognomonic for a needle stick.

FWIW, Gemini's take on it. Note it even mentions hand shaking. Who knows, maybe it's multiple factors.

1. Senile Purpura (Actinic Purpura)

Medical experts note that the most probable culprit for recurrent bruising on the back of the hands in older adults is senile purpura.  
As people age, the skin and the connective tissues supporting the blood vessels thin out, and the blood vessels themselves become fragile.  

Combined with cumulative sun damage (common in avid golfers), even microscopic, unnoticed trauma can cause these fragile capillaries to rupture, leaking blood under the skin and creating prominent, long-lasting purple bruises.  

2. High-Dose Aspirin or Anticoagulants
The White House medical staff has publicly stated that Trump takes 325 mg of aspirin daily as part of a standard cardiovascular prevention regimen.  

Aspirin irreversibly inhibits platelet activation, meaning blood does not clot as quickly.  

At 325 mg (which is higher than a standard 81 mg "baby" aspirin), the risk of easy, pronounced bruising from minor bumps is significantly amplified.

3. Vigorous Handshaking
Both Trump and White House medical statements have explicitly attributed the bruising to "soft tissue irritation from frequent handshaking." For someone on daily blood thinners with thinning skin, shaking hands firmly with hundreds or thousands of people can cause enough minor, repetitive pressure to trigger localized bleeding on the hand.  

4. Minor Sports Trauma
As an avid golfer, grabbing tightly packed clubs out of a bag, minor mis-hits, or the repeated friction and pressure of gripping a golf club can easily cause superficial bruising when combined with the thinning skin and aspirin use mentioned above.  

5. Chronic Venous Insufficiency (CVI)
Official statements have also referenced Chronic Venous Insufficiency, a circulatory condition where vein valves (typically in the legs) weaken, causing blood pooling, swelling, and increased venous pressure. While CVI primarily causes swelling in the lower extremities, it reflects a broader fragility in the vascular system that contributes to easy bruising and skin discoloration.

Yes. he has fragility and ready extravasation/bruising with manipulation--such as regular intravenous infiltration using butterfly catheters on his hands. Undoubtedly more so than a 40 year old, for example, though even they would likely show bruising not unlike this if they had regular intravenous injections/fluids via butterfly catheters in their hands. Even the most cautious phlebotomy can result in such outcomes.

Still, Trump has had regular periods where he was very unlikely to have had a lot of "hand-shaking" going on--particularly during his disappearance periods--of which he has several the past 18 months. Can I be sure? Of course not, but unlikely.

That he has signs of progressive dementia with cognitive disabilities and right-sided intermittent facial droop and rt leg ataxia (separate but along with his lower leg venous insufficiency and swelling of ankles), is widely accepted in the medical community watching him-- the constant video available daily makes this expressed armchair diagnostic suspicion not out of bound sans examination--unlike in prior times in my opinion. That FTD (frontotemporal dementia) is a leading rule/out, along with other types of progressive dementia make the potential for currently studied experimental immune therapies not unlikely. Despite their having progressed through Phase II and III (for some) clinical trials, he would not normally be eligible--though of course he would be given access. He's the "President' after all.

As to a simple senile purpura diagnosis with blood thinners explanation, he does not appear to have dramatically thinning skin as is seen with elderly people experience that in his hands nor extending to his arms. Close up photos of his hands seem to suggest pretty average--looking hands and wrists/upper arms when exposed on the golf course. Given he does continue to golf and apparently has a pretty strong swing, one might expect more trauma to the hands extending into the lower arms if he were experiencing senile purpura, exacerbated by blood thinners. Yet we've never seen (or at least I haven't) photos of him showing that. And we have seen plenty of photos of him coming and going on the golf course with rolled-up or short sleeves--sans any makeup at all. He does have rosacea on his face which is treated, but no obvious skin-thinning on his face along with it. So, I'd bet his skin is average for a man his age and unlikely to be experiencing severe senile purpura, though he may be beginning to demonstrate it. AND, of course his legs may be demonstrating it along with the swelling of venous insufficiency. But, we don't ever see that, so...? Periodically, we have seen what really appears to be injection punctures (left hand) and possibly on the right, but it is regularly too bruised to be certain. So that really doesn't suggest simple fragility and hand-shaking trauma consistent with senile purpura.

Not to mention if senile purpura was his valid diagnosis, it was not entered into his last physical diagnoses (though rosacea was). Of course he might have objected to the word "senile," so who knows? LOL

All who follow him can believe what they will, but I have lots of company in the medical community sharing my assessment. We shall see.

And use the same hole.

My veins are squirrely. Circles, squiggly... Crazy. I literally have Circles and weird stuff in all my veins. So, when I go in for a procedure, like my last hernia mishap. Ultrasound machine I think was brought in? To find where they could put the initial IV, for starters. My main veins are blocked with balls of scar tissue. Hard marbles.
I don't know what orange guy has going on, but I know after my trauma and a year in hospital...any my messed up veins, I know what goes on with me, just getting a blood draw. Guaranteed at least one blown vein 🤣

But my port made my cancer treatment much more comfortable and easier

Awesome medical technology, I got to keep it, showed my kids and tossed it

Call me when he's gone.