Friday, July 1, 2011

Port-a-Cath

Maybe you didn't know this about me, but I'm a surgery/medical buff.   There used to be a surgery channel, do you remember that? They'd just show surgery after surgery: heart surgeries, colon surgeries, amputations, etc - just a camera in an operating room with the doctor narrating what he was doing.  I could watch that all day.

Eventually, the channel morphed into Discovery Health.  At at first, they still showed surgeries, but then they started focusing on medical curiosities, like the woman with the 300 pound tumor.  Then, they got away from medical stuff altogether and started airing shows like World's Worst Teens or My Monkey Baby, which is about, you know, a lady who treats a monkey like a baby.

At least, I think it's a lady.

Discovery Health became a Carnival Freak show, which, by the way, I adore.  But, I missed my pure surgery.

Maybe I'm the best possible person to get a disease like cancer because I find a lot of this stuff really interesting, even when it's happening to me and hey, at least I don't have a 300 pound tumor.

Or a monkey baby.  Or a bad teen.

Once I accepted (after the pain of Navelbine) that I was getting a port, my goal was to get it in my arm and not my chest.  Nobody seemed to think that was possible but I've read enough to know that many people do have it placed in their arm, and I was determined I would too.

Why did I want it in my arm, you are wondering?  Well, first of all, every single very skinny person I've talked to who has a port in their chest finds it uncomfortable.  Many have said it's the worst part of their chemo experience, and they can't wait to get it out.  (Stage IV alert: I probably won't be getting mine out). It also gets in the way of seatbelts, bra straps and clothing.  Plus, I have always had a phobia about stuff touching my neck and so I wear lower-cut shirts and it will always show - marking me as a cancer patient.  I sleep on my stomach (at least, I hope to again some day) and I don't want anything rubbing against that port.

I felt a port in the arm would be easier to hide with sleeves, and would be more comfortable and finally, others who had it in their arm preferred it and recommended it to me.

So, when I made the port appointment, I made sure to mention I wanted arm placement, and asked her to write that on my paperwork.

When they confirmed the appointment, I again mentioned I wanted it in my arm.  I was, at that time, told no, it would be in my chest.  I again asked her to write down that I wanted it in my arm.

When I went in for the appointment and the nurse did the workup, she told me I would be getting it in my chest.  I told her I wanted it in my arm.  She said they didn't do it that way.  Not to be deterred,  I told her I have seen them in the arm and had requested it.  She said she'd check with the doctor.  When she came back in, I was told that yes, it had been written down and the doctor would be putting it in my arm.

Success!

I was given my IV, put in a waiting room and the doctor came in to talk to me.

(Why are doctors these days all so cute?  When I was young enough to snag myself a doctor, they were all old grey-haired dudes, and who was interested?  Now it seems that every doctor I encounter should star in his own TV show - and are young enough to give me grandchildren.)




Anyway, he showed me the device he was inserting into me, and he explained that he would put the port anywhere I wanted.  But, the reason they do it in the chest is there is a slightly higher risk of thrombosis  when placed in the arm.  He also said that the tube has longer to travel in the body to get to the Vena Cava and so the risks of kinking might be increased.    But, he said, in Cleveland where he is from, he's done hundreds of them in the arm, and I'd be fine.  I considered changing my mind - but I asked him to show me on my chest where the port would be and he hit a spot I knew would be trouble, so I said "put it in the arm."

I always was a risk taker.  Anyway, it would go on the left side, opposite the mastectomy side.

As he explained the surgery to me, he unconsciously tied the port he was holding into little knots, and I sincerely hoped that was not the same one he'd be putting in me.

Anyway, he left and they prepped me.  I put on a gown, they gave me a surgical hat, put an oxygen nasal cannula on me, and wheeled me into the operating room.





I was so thrilled!  I was going to be awake for a real life operation!

On me!

I was positioned on a table under a fluoroscope.   There were two nurses in there, and they took my arm and washed it with some very cold cleansing solution - it was blue so I assume it wasn't betadine.  Then they draped me with a blue tent, with a plastic viewing port in it that was way over to my right side.

I complained.  I couldn't see anything but the wall, and I wanted to watch the operation.  They nurses told me that the doctor wouldn't like that but they moved the drape and my viewing port so that I could at least see the image on the fluroscope, and explained what would happen with that.  Apparently, it's operated by a foot pedal and when he needed to see where the tube was going he'd hit the pedal, just like an old singer sewing machine, and the image would be displayed.

They gave me antibiotics via IV, finished up, and called in the doctor.   He came over and sat on my left side where I couldn't see him and told the nurses to drug me up with the conscious sedation, which is Versed and Fentynl, which has never worked for me.  And, it didn't this time either.  They asked me if I could feel it and I said no.  Then they gave me another dose, and I guess that was all they give because the doctor said, "Okay, I'm going to numb up your arm, little prick."

No, he wasn't calling me a prick.

They all say that. It must be medical school/nursing school 101. When inserting a needle into somebody, you are required to say, "little prick." Some people branch out and say, "little stick" or "little pinch" but it's always, universally - little.

Anyway, I could feel the little prick but that was all.  Nothing hurt but I could hear him talking about accessing the proper vein and then checking as it went through my body into the large vein.  And, I could see my heart and lungs and the thing threading through on the x-ray machine, which was very cool. I could hear him sewing me up and deciding it needed one more stitch and it was just like my old surgery channel days.  All I needed was popcorn.

And, I told them how much I enjoyed it too, and thanked them.

I highly recommend that everybody be awake for surgery, it's much more fun.

I had no pain that day and we went out to dinner.  But, in the middle of the night, I woke up in agony.  Bad, bad pain.  The local must have worn off.  I really thought something was wrong and maybe it was getting infected.  They had told me it might be "sore" and to take some tylenol but this was real, post-surgical pain.

I took something a teeny bit stronger than tylenol because I had a busy day. Two doctor's appointments and a business meeting. But, I skipped going to work in the morning, I needed time to get the pain under control.  The next day, the pain had subsided to expected sore levels and I'm on day three now.  It itches, which means it's healing.  And, that port feels heavy in my arm.   I go in for a "port-check" today and get the bandage off and I can finally shower.

I had Navelbine through the port the next day and my arm didn't end up with that deep ache as it did after the last infusion, so I guess the port is doing its job.

More importantly, I was the star of the infusion room - all the nurses and even a couple of patients crowded around to see the oddball with the port in her arm instead of her chest.

Maybe Discovery Health will do a show about me.

.

14 comments:

  1. I wish I had known about this when I got my port. Not only does it stick out and is sore (i'm skinny too) but they punctured my lung when they did it through my chest.

    Mine is coming back out on July 29 and I am counting the days.

    But I do wonder why they don't tell women about the port in the arm option... So much easier to hide. Sigh.

    ReplyDelete
  2. Ouch! Punctured lung - that must have been awful!

    It's kind of between my elbow and shoulder so it will show, but it's not as obvious as chest, I don't think. And, in the winter, nobody will know.

    ReplyDelete
  3. That is so awesome! I LOVE my port!

    ReplyDelete
  4. My daughter in law has a port in her chest and hates it! I'm sure she would have jumped at the chance to have it in her arm!

    When/if you feel up to it, would you please post a picture of the port in your arm?

    ReplyDelete
  5. Yes, it still has a bandage on it but I'll post a picture. I'm going to the bandage off today.

    ReplyDelete
  6. This is awesome! I'm glad you were able to get your way!! I loved the surgery channel as well, and drove my husband and surgeons crazy trying to get them to film my surgeries. So I think it's way cool that you got to watch yours!!!! You probably are familiar with this site, it's not the same as the tv channel was, but it's got some cool surgeries to watch as well. I was able to find and see what my surgeries were going to be before I had them, which I found fascinating!!
    http://www.orlive.com/

    ReplyDelete
  7. Hooray for Purple Power Ports! I love mine, no more tears and searching for veins! I only wish it glowed in the dark, and shined through the skin. How cool would that be?

    ReplyDelete
  8. I can't wait to see a picture. I totally wish I knew about the arm one. Bugger. Lol.

    ReplyDelete
  9. I was kept awake when I got mine too. My nurses and doctors though didn't seem to like my commentary and questions. I thought it would be awesome to watch but they wouldn't move the blue curtain for me. I did get to watch it come out though and we even took pictures each step of the way. They were a bit gory to share online but I thought it was cool. I hated the port at first but sure appreciated it during treatment. I kept it as a souvenir.

    ReplyDelete
  10. good for you! way to stand up and take charge!
    I too was a surgery show fan and miss the more straight forward medical stuff. Glad your surgery went well -

    ReplyDelete
  11. THAT was extremely funny ...and interesting!

    ReplyDelete
  12. Okay, so you totally have me beat in the control freak category. When it comes to surgery, I want to see, smell, and hear NOTHING. Wake me up when it's over, I always say. Wimp is my middle name. When (and if) I get my port removed they will do it in office...no sedation. The idea of that makes me queasy. You are one strong woman.

    As another skinny gal I can really appreciate you wanting it someplace other than your chest. You can see every detail of the purple powerport under my skin...color (always looks bruised), cath line and all. The chemo nurses loved it, though, so I guess I do too. It's just freaky looking. I have never had cleavage so I can always tell when the port is showing...eyes tend to drift down...

    I'm very curious about the arm placement. There was a young man (too young) when I was undergoing chemo this past spring who had his in his upper thigh area. It barely showed at all. I think I would've liked that area.

    Patti
    www.pattihatescancer.blogspot.com

    ReplyDelete
  13. HAPPY BELATED INDEPENDENCE DAY!!!

    Oh my, I found your sight yesterday when I was looking for some sort of Independence Day image, that might be cancer related (go figure) for my blog posting: http://debsbreastcancerjourney.blogspot.com/

    My port is in my chest. And while I've stopped wearing necklaces with it there since I don't like a chain rubbing over it, I don't mind it. Much like preferring not to wear a wig, I figure I do have cancer, so why try to hide it. It's not that it is all I am, or that I focus on it, but at least for a few more months, it is a very strong part of me.

    But I'm glad to learn there is another placement. It is interesting how things are done so very different from one place to another. Makes me think of the treatment I recently learned about to save one from losing their nails from chemo. I mean losing my nails was not the end of the world, but what a pain to wear bandages all the time when 1/3 of the nail tips were getting ready to fall off and the fear of bending them back was horrible; not to mention the tenderness of the tips. Anyway, apparently there is a technique of covering the finger tips in ice packs or frozen pea bags, either for the first and last 10 minutes of each chemo, or for the whole treatment (I've read about both). Similar to the cold cap that is being used to prevent hair lose in some places. Of course neither of these are used at my chemo center, maybe for insurance reasons, or because they aren't really tried and true yet. But I thought the nail thing was a no brainer.

    Well, I will close for now but wanted to say how sorry I was to learn of your recurrence. I can't imagine how horrifying it all must be for you - words cannot even express. I look forward to reading more of your blog and learning more about you.

    Hugs,
    Debbie
    Glen Ellen, CA (North Bay Area)
    http://debsbreastcancerjourney.blogspot.com/

    ReplyDelete
  14. My dr only gave me the option of the chest port and she said the arm port will have tgree wires hanging from it. She insisted I have the chest port..my chemo.will onky be for six months( God willing). I am really wanting this arm port! Ugh..what do i do????

    ReplyDelete

Thank you for commenting. If the post is over 14 days old, the comment will be moderated and will approved later. This is a spam prevention technique - but I love to hear from you!