Thursday, July 8, 2010

Port installation

If you are undergoing long-term chemotherapy like I am, it will be necessary to have a port (or port-a-cath) installed. Chemo drugs are highly toxic and damaging to veins and tissue, so long-term treatment is very hard on these parts of your body. Ports allow health care providers to administer drugs more efficiently by tapping almost directly into the heart - drugs are flushed quickly and efficiently through the circulatory system with little chance for damage to your veins.

A port is a small disc made of plastic or metal roughly the size of a bottle cap that is placed beneath your skin. It is usually implanted in the area just below the collar bone on the side opposite the breast with cancer. A soft thin catheter extends from the port to a large vein near your heart. Nurses will administer your chemotherapy medicines by inserting a needle right into the port and then connecting an IV line to your pouch of drugs. When all your cycles of chemotherapy are done, the port is removed during another short outpatient procedure.Click here to find out more about ports.

My port is a power port. The nurses love my power port. It has three little bumps on it that help them easily locate the injectionable area. But I really wish someone had told me about the bumps soon after the port was inplanted. I didn't notice them until several weeks after I'd had it - at about the time the swelling was starting to go down. But, of course, I didn't occur to me that the bumps were there intentionally. I don't know about other cancer patients, but my experience has been that I no longer give anything the benefit of the doubt. Every itch, twinge, tickle and creak in my body is directly related to SOMETHING VERY VERY BAD!!!

Me: WTF are those bumps? Come feel this! Jon, WTF are these bumps? Is it broken?! Where did they come from? They weren't there yesterday!!!!! WTF? WTF? WTF? WTF? (insert sound of my voice steadily getting higher and more screechy)
Jon: It's probably nothing. Let's ask the doctor. 
 Me: Probably nothing? Probably nothing?! How do you know that? This doesn't feel normal. WTF? Feel them! They weren't here yesterday! They're wiggly. It must be BROKEN! They must be poking out because something has come undone! Oh, god. What happened? How did it break?

...ok - I'll save you the whole freak-out session. But I seriously put the freak in freak out. Turns out, the bumps are a good thing. Who knew? Note to self - stop imagining the worst.

Ports are installed in simple day surgery. Mine was installed in the same exam room in which I had my surgical biopsy - just a wee room with a nurse, a bed and some tools. Warning - I received no sedation. The area was numbed very nicely with a local but I was just as aware for this procedure as I was for the biopsy. Now, it wasn't as stressful - 'cause, like at this point I know that I have cancer so I've already sort of gone to 11 on my stress meter - but it was disconcerting. There was no real pain, but the feeling of my surgeon making a pocket for the port using his thumbs was, um, gross. But get this - when he was finished he smiled and had the nurse confirm how long it had taken (I forget now but it was mere minutes). And....YES...he installed it in record time! Apparently the day before the same procedure had taken much, much longer; the patient was larger and that makes the procedure more challenging. Surgeons like it when they can be in and out fast. And, let's face it, he's a guy so he likes the competition, even if it's against himself.

After he was finished, he gave me some instructions for care and signs to watch for that would indicate infection. Then he smiled :-) and said, "You can manage the pain with Tylenol."  Now according to the link I gave you above, it seems to be standard in the States to manage the pain with a narcotic like Demerol. But you have to love Canada. So, in the days following implantation, I can best describe the pain as being akin to having been punched repeatedly in the same spot on my chest by someone wearing a cocktail ring. Or maybe being pummelled again and again by a seven year old with a mittful of Lego. You get the idea. So, he's right - I was able to manage the pain with Extra-Strength Tylenol - it sort of took the edge off.  And the pain started to subside after a week or so.

The port has been great. I was worried at the beginning that it would be difficult to manage seatbelt or purse straps, but I now no longer even notice it is there. Unless, of course, one of my kids gets overzealous and smacks me on it. (Are you starting to wonder about what goes on in my household yet?) The nurses flush it regularly and it has never given me a moment's pause.

Plus, it gives me that cool cyborg look that I just know is going to be the next big thing. Watch for Lady GaGa to be sporting one in her next music video.


  1. I had a love/hate relationship with my port. I hated the damn thing and couldn't wait to get it out of my body but was so glad I had it as it saved my veins. Good luck to you!

  2. Thanks, Caroline. I wish much luck and happiness to you, as well.