Port Installation

[raneyf]

Can anyone describe what it's like to get and have a port for me? I'm wondering if I'm out of commmission for the whole day I get it. Also, how secure is it inside of you? Will hugging and playing with my kids bother it? Thanks for any information.

Raney

[Don Wood]

My wife had a port for almost 4 years, and really liked having it because her veins were small and hard to access. it is an outpatient operation -- really no down time. And it is placed under the skin. You have to be sure it is flushed with saline and heparin once a month when it is not being used, and it is a good idea to use it only for the chemo, to keep it clean. Don

[Cindy RN]

I had one put in 2/01 while I was under having biopsies done. It still flushes and I would NEVER let them take it out!!

I have not needed it since Aug 2003-last chemo dose-but if this thing ever comes back I have it in place and ready to go!

I don't hardly notice it. it is under the skin right below your collar bone and does not move around.

Cindy

[trish2418]

Hi Raney,

I had my port installed in August '05. I finished chemo in March '06 but I'm not planning to have it removed any time soon. I barely notice its there until its time to have it flushed. Hope the procedure goes well and good luck with chemo.

Trish

[recce101]

Hi, Raney:

I had my port installed in late September, a few days before my first scheduled chemo session. It was a quick procedure, though I was at the hospital 4 or 5 hours to go through all the administrative, pre-op, and post-op routines. The standard plan at that hospital is to use general anesthesia for port installation, but I told the surgeon and anesthesiologist that I preferred a local anesthetic if that was possible, and they agreed. This allowed me to hear what was going on, which I always find interesting, and to trade fighter pilot jokes with the anesthesiologist and others before the surgeon started his part. Example: "What's the difference between God and a fighter pilot?" "God doesn't think he's a fighter pilot."

The recovery room stay was short since I was already awake -- while there I received a mobile unit chest x-ray (to verify positioning of the port catheter) and had to wait a few minutes more until they called back saying the film was good. I was sent home with instructions to keep the area dry for 2 days and see the surgeon in a week for follow-up. There were no specific restrictions on activity, but common sense would dictate being careful with the area for several days. I don't think you would want your 4-year-old pounding on your chest right away, but some nice hugging shouldn't be a problem (a good question for your surgeon in your pre-op discussion). There was very little discomfort, and any residual soreness was gone within a week.

One question I did ask was whether it was okay to include Avastin in the first chemo cycle since the port incision was going to be fresh, and was told that in my case the concern with Avastin and wound separation involved only the thoracotomy incision, and since that was more than 28 days old I was good to go. Nevertheless, the port incision did take several weeks to heal, and I was prescribed oral antibiotics a couple of times to guard against infection.

Another potential problem is that drawing blood from my port (as for a blood test) has always been an iffy proposition, and I've learned that this is a common occurrence with my type of port. There has never been any trouble getting solutions IN via the port, and since my arm veins are still okay for blood tests, it's not an issue for me. But for someone with poor veins who is depending on the port for blood draws as well as chemo infusions, it's something to pursue. Perhaps a different type of port or some modification to the implanting procedure would make blood draws more reliable.

There's one other thing, again not an issue for me at this point. Hospital techs seem unwilling to use the port for contrast dye injections prior to scans, and this presents a major problem for people whose arm veins are in bad shape. Out of curiosity I've asked this question when being prepared for scans and have received a couple of different answers. One is that the hospital's imaging department has no one trained to use a port. Another is that the contrast dye is injected under pressure that would "blow out" the port. I was dubious of this answer, and asked my oncologist's head chemo nurse for her opinion during a recent infusion. She didn't buy that story either, and having been a chemo nurse for 20 years with good contacts in the major hospitals here, she called around to get a consensus. Their answer: most hospitals do have people trained to access ports, though they may not be routinely available in the imaging department. If the oncologist wants the contrast dye to be injected via the port, that should be included in the scan order and the hospital will ensure a trained person is available at the proper time. At least that's the situation in Honolulu.

Three cheers for ports! Aloha,

Ned