Wednesday, May 14, 2008

Ports of Call


For the uninitiated, I have what's called a porta-cath in my upper chest. It's a Power Port, specifically, implanted under my skin just beneath my clavicle. My surgeon did it in January so I could start my treatment. I really hated this idea desperately. But the surgery was no big deal — I was eating potato, egg, and cheese tacos at Loca Maria's by 11 am the day of the procedure, and the pain management from the incision was minimal. Here's what it looks like.

About an hour or 45 minutes before each infusion, I apply a thick layer of numbing cream over the spot and cover it with a small piece of Saran Wrap. When I go get my treatments, the infusion nurse (or more recently, the lab tech) feels the spot where the port is and pushes into it a short needle that resembles a push pin. That's what starts the "line," as opposed to an IV in the arm. The reason for the port is, the chemotherapy medications are very scarring to tissues and having a direct path into the body's biggest vein is better. You don't want your arm veins to get scarred. They're small.

Overall, I've been pleased with this arrangement. The port rarely bothers me and I don't feel it all — unless some joker decides she's gonna push on it. Somewhere down the line I must have heard some wisdom about never letting the lab techs touch your port, only let the infusion nurses start the line. So until recently I had the lab techs do their blood draw out of my good arm and the chemo nurses access the port. But one nurse once told me, "Oh, no, the lab accesses most of the ports, we don't do that many. But we'll do them, it's good to keep up our skills." Huh, I thought. I thought you guys had the mad skills.

Week before last I let the lab tech start the line in my port and it was fine. Last week, it was not fine. One tech began to really push on the spot, hard. I winced. She still couldn't figure out where the hell she was supposed to jab me with that fancy push pin. Finally she gave up and punted to another tech, who seemed similarly uncertain and not gentle, either. He put the needle in — oops. Not the right spot. He took it out and tried again. This time it worked. I had to go into my doctor's appointment with my chest irritated like this. I ended up with a bruise there.

I still had this contraption taped to me when, an hour later, I was downstairs for an ultrasound. I have been having a swollen feeling in my tissues, especially in my armpits and chest, so they checked for a blood clot. I don't have a blood clot. But at least I got in a nap while I laid in that dark room, getting probed with that warm goo on me. I'm going to go back to my first tack today, and get my favorite nurse to deal with my port.

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