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.

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