Before you receive chemotherapy, there is a very high likelihood that you’ll get a port-a-cath placed in your chest first. There’s also a possibility that you’ll have a PICC line placed in your upper arm, which is another more efficient way to receive chemotherapy and nutrients. Back in the day, patients received chemotherapy intravenously, but eventually the veins get tired of the song and dance and finding a ready spot on the arm or hand becomes quite difficult.
But back to port placement.
It’s a pretty simple procedure, lasting about an hour or so. You are wheeled into a procedure room but you’re not fully anesthetized as you’d be during surgery. Generally, you’ll be put in a state of conscious sedation (the main drugs used to achieve this kind of half asleep/half awake state are Versed and Fentanyl). While you’re relaxing in la-la-land, your surgeon will find a spot on your chest — usually on the right side — where the port will be placed. You may feel a little bit of pressure as the port is actually put under your skin, but you might not. You should not feel any pain and if you do, speak up. This should be a totally painless procedure.
After it’s all over, you’ll have a shiny new port in your chest. Take care of the wounds and expect to be a little sore the next day, but soon you’ll be feeling back to normal. Only now you’ll have a certifiable, physical reminder of your cancer warrior status.
Here’s my dispatch from the front lines regarding my own port placement, via the WunderGlo blog.
Placing the Portacath
The portacath is this medical device that consists of a 1) port, and a 2) catheter that is inserted below my chest — above the boob (of course) and below the collarbone. The catheter connects the port to a vein — usually a major vein located right above the heart. Instead of poking my arms with an IV every time I get chemo, the nurse simply needs to access the port, which can be identified as the slightly raised disc-like area in aforementioned above boob/below collarbone area. Efficient, much more resistant to infection, and easy to use.
I got my portacath in yesterday morning at USC. The fellow who operated on me did a solid job, and the nurses — Veronica and Fiji — were incredibly awesome and fun. They gave me some Versed and Fentanyl, a powerful pain relieving duo, to help bring about my “conscious sedation” during the procedure. They actually gave me three times the amount they usually give folks because my tolerance to these drugs was so high (as in, they could tell I was totally with it during the process). The upped dosage, although administered in an attempt to get me to that lovely “conscious sedation” place, didn’t actually work. Don’t get me wrong — this girl was relaxed and pain-free, but I sure wasn’t sedated. I heard every word spoken in the operating room, felt every tug at my chest, and had the pleasure of listening to the back and forth as the main doctor instructed the fellow on how to close up the incision points. The main doctor definitely talked some smack at the fellow as he dressed my wounds, and in the process, I think she made him so nervous that he added a little too much glue to one wound which has resulted in a silly line of glue running down the right side of my neck. Oh well. I think it’s funny.
Speaking of wounds, I have two — one at the chest and the other at my neck (the catheter had to be snaked up my chest to my neck, then down into the major vein above my heart).
The portacath felt decently sore last night (imagine tweaking your neck really badly and having a foreign object under your skin), and the nurse said that it would be worse on Days 2 and 3 following the procedure. Lo and behold, today is Day 2, and the portacath feels awesome. Soreness is much, much less, and the wounds are healing very well. Man, I love when health professionals make predictions about how things are going to be for me. Crushing those predictions are my new favorite pastime.