Saturday, February 20, 2010

Vampire Diaries

I am a small person with bird bones.  My wrist is five inches around; I wear a size 4 1/2 ring.  I can't purchase a watch without a picture of Hannah Montana on it, and I buy bracelets to use as anklets.

I have correspondingly small veins.  Watching people draw my blood has always amused me, because I have a strong sadistic streak and no needle phobia whatsoever.  I like seeing sweat on the brow of the phlebotomist responsible for getting blood out of me and into that vial.  It just doesn't happen without hard work.

Typically, the way it goes is the first tech pokes around a while, moving the needle in and out, muttering about tiny veins until she either pops one or freaks out.  She then calls the specialist with the butterfly needle who has the finesse to start the flow. Even when I try to make it easy - drink lots of water and wear warm clothing to "plump the veins," it's never enough to get the well pumping.

I'm so dry if I was Bella, Edward would leave me.  

Back in November when I went in for my initial chemo consultation, I was quite surprised to find out that they weren't planning to put a port in.  (For those who don't know, a port is small appliance installed surgically under the skin near your collarbone. It connects to a vein which allows them to administer chemo drugs without sticking you.)

Because I had lymph nodes on the right side removed,  there is only my left arm available for sticking.  I was certain that with a year of infusions ahead of me and only one arm to use, they were going to insist on a port.  I was relieved when they said it wasn't necessary, but still, I mentioned that medical professionals in the past had difficulty getting blood from me. They all seemed convinced that they were expert enough to handle it, so who am I to argue?  Maybe getting blood out and pushing chemo drugs in are two vastly different things.   I had no desire for yet another surgery and subsequent scar so I wasn't going to argue to get a port.

To be clear: their plan was for me to have a year of weekly infusions in my left arm only, an arm with tiny veins, using no port.

Unsurprisingly, after 2 1/2 months, it has become increasingly difficult for the chemo nurses to access my veins.  They can't seem to get the ones down near my wrist at all anymore since they "roll," and so can only use the area in my elbow, which is becoming deeply scarred.

Last week when one of my nurses spent ten minutes getting the canula in, she said, irritated,  "So, what's the plan for when we can't do it anymore?"

I looked at her, surprised.  I have to come up with a plan?  My plan was to get a port before all of this started.  Their plan was for me not to.

At this point, I intend to stick with their plan.

But, I am not one to leave people without hope.  I said, "Well, when chemo is done maybe I'll try an every three week herceptin schedule and see if I have any side effects.  Hopefully, that will give everything time to heal."

That leaves her six weeks to, as Tim Gunn would say,  "make it work."  

I watch Intervention.  If a brain-dead junkie can figure out a way to inject chemicals into his veins every couple of hours for 20 years, surely a smart chemo nurse can figure it out for six more weeks? 

If I really have to come up with a new plan:  the space between my toes is available.


  1. I'm really surprised too that they didn't give you a port. That's insane when you are having infusions for a year. I didn't have a choice but I'm sure it's because I had a bilateral mastectomy. I sure wasn't going to let them use the space between MY toes! =)

    They still have to stick a needle thru your skin to get to the port. It actually hurts (the needle is thicker) if I forget to put lidocaine cream on an hour prior.

  2. Ann,
    I can't believe you didn't get a port in the first place, especially getting Herceptin for a year.
    My port is awesome - doesn't hurt a bit and very convienent. Perhaps you will end up with one if they can't get anymore veins.
    Take care,

  3. I initially thought that I could "go without a port" for the chemo and Herceptin. After 4 or 5 rounds of chemo, however, my veins were shot, so the port became my next best friend. As long as I applied the numbing cream prior to the needle stick, the pain was minimal.

    Even now, years later, the techs still have trouble finding a "good" vein in my arms (the port is out, obviously). If I had known better, I would have had the port inserted prior to the very first chemo dose. Had I done that, my veins would have been spared, and simple blood draws would be a piece of cake these days!

    Now, the butterfly needle is my next best friend :)

    Enjoying your blog!

  4. What were they thinking not encouraging you to get a port? Do get one if you can. I was able to get my treatment only a couple of days after getting my port and I'm told you can get it the same day. It really makes getting treatment easier. Oh yes, you get another 2" scar and a button size bump (the port), but mine doesn't bother me and tucks nicely under bra/neckline lines so having it show is a non issue. There is a bit of a tiny "pinch" going in but being able to have the use of both arms during treatment to fuss read and move about is great. Take care.

  5. I'm not worried about pain of putting it in, but I am worried about the placement. I have a thing about my neck - nothing can touch it - so I can't stand having any clothes anywhere near it. That means the port will show in all my clothing, and right before summer is not when I want to get it. Plus the scar. :) Also, I'm extremely thin and I hear that it's uncomfortable for skinny people - although I've heard a lot of things that haven't panned out and that is a small consideration.

    I think to be honest, I am a little annoyed at the original "oh, we don't do ports" attitude, even though I reminding them how long my infusions were and told them how hard it is to get my veins. Now that it's inconvenient for them to access my vein, they are implying I should get one? And, not nicely.

    I heard them complaining about another woman who refused to get a port and I can see why she isn't. If they tell you that you aren't going to need one, asking you to do it right before your chemo is over is frustrating.

    If there is no other way then I'll have no choice but for's their problem, not mine. :)

  6. it's not that uncomfortable, but it does look like i have a soda cap under my skin. and fwiw, it does hurt when they stick it - i smear it with lidocaine and cover with tegederm about 30 min. beforehand 'cause otherwise it burns like a mofo. can't believe they didn't give you one, tho - only one arm? you're a trooper.

  7. Man! I can't believe it either, I have only had one infusion and I have a port. I didn't put lidocaine on it because I thought they were going to do it later than they did. They just sprayed it with freeze stuff which actually stung, when they accessed the port it was not big deal. I also like being able to use both hands. I won't say I am skinny, but I'm not big either. It does show if I wore clothes that showed it. Right now it isn't an issue because of the weather. I don't really care if it does show tho. It is a little uncomfortable if I am laying on that side. I AM squeamish and would not put up with them digging in my veins so I'm glad I have a port. I have a friend who had hers put in and was on the way out of the hospital and they stopped her; the surgeon had put it in an artery as opposed to a vein, oops.

    I'm about 2 months behind you in chemo, my hair just started falling out.

  8. Hello. I was 42 when diagnosed her+, stage 2 cancer. I had a single mastectomy with no reconstruction ( wanted to deal with the Cancer first and then put myself back together) and had a port put in my remaining breast. Sounds weird, but the breast was a size D and the surgeon put in about an inch to the inside of my nipple. A little awkward when they accessed it, but I didn't flash anyone either. At the time, I didn't see the advantage, but like you, I am very small and he thought it would drive me crazy and and show terribly under my bony collarbone. I ended up with a fabulous reconstruction.....way better than my saggy, trice nursed old ones. The PS removed the healthy breast for better results and my peace of mind....I know perhaps false, but some nonetheless. I now have no scar from the port since it was "blended" into the mastectomy scar. I just though I would pass along to you that there are other places to place the port. My breast surgeon even places them in the arm! I can't imagine not having had had a port.

  9. Thanks Kim, and everybody. I'll keep that in mind. Somebody else told me about having it in the arm, although I'm pretty small for that too, I would think. I had no idea they could put it anywhere but the collar bone - it's good information to have.

    I am very glad you got a good reconstruction!


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