Getting the port installed in my chest

21810462Yesterday I blogged about learning just how widespread my lymphoma cancer was. My body seemed to look like a fireworks display in the PET scan. Due to the widespread nature of the cancer and other factors it was decided it would start chemo soon. As I continue documenting my cancer experience it is time to write about getting a port installed in my chest to facilitate chemo.

Wednesday, September 5, was the day I had a PET scan performed and was able to see the fireworks. The oncologist said a surgeon would be calling me soon to hopefully get a port installed in my chest on Friday. She explained the port would allow the chemo drugs to go directly into a major vein. If that is installed and if insurance pre-approves the chemo drugs she hoped to start my treatments the next Monday.

On Thursday I got a call from the clinic to set up a consultation appointment with a surgeon late Friday morning. I took the fact that this was a consultation appointment to mean that I would not likely get the port installed on Friday. This kind of annoyed me. But then I should mention at this point everything was annoying me; and my family can probably attest to that fact. My breathing had continued to deteriorate. Even simple things as getting out of a chair or walking across a room were leaving me breathless. The inhalers I had been using to improve my breathing were basically useless at this point.

On Friday morning, prior to my appointment with the surgeon, my oncologist called to ask how I was doing and the status of my port. I let her know I had an appointment later that morning. She said she would work with the surgeon to come up with a plan. Part of me was annoyed she didn’t know the current status; but another part of me was happy with the fact a doctor was calling me instead of having a staff member do it.

The consultation with the surgeon went very well. He is a very likable guy and I could relate with him right away. One thing he did that nobody had done to that point was ask my wife and I “has it hit you yet?” We had to admit it really hadn’t. It seemed everything was going so fast.

During the appointment, the surgeon took the time to explain to me what exactly a port is and why it was important to be installed. Since the chemo drugs have to be injected into the bloodstream intravenously he explained a port makes the whole treatment process go smoother. Receiving chemo drugs the traditional method is very rough on the veins in the arms. As each treatment passes it may be harder for staff to get a good vein.

In order to facilitate the chemo treatment process a port can be surgically installed into the chest, the surgeon explained. What he planned to do was perform a surgery from the front of my shoulder (I believe he said left at the time, I could be remembering wrong.) He would insert a catheter into a vein in my shoulder, which would run to a small device inserted just under the skin in my chest. He would use his finger to actually create a small cavity the port could rest in. When the procedure was complete I would be able to receive injections (or even blood draws) by putting a special needle through my skin into the port. Since the port was always connected to a vein it mean oncology staff wouldn’t have to fight with find a vein every time I had chemo. He showed the type of port he would be installing, it was about the size of a quarter. The type of port I had installed can be viewed on this website.

After explaining the process the surgeon answered all of the question that my wife and I had. Actually he made sure this was something I wanted before proceeding. The he said he will work to figure out when the surgery could be done. Usually he does surgeries on Tuesday, but he understood from talking to the oncologist that we wanted the port on Monday. The surgeon let me know him and his staff would figure out a way to get the port installed on Monday morning and that I would get a call in the afternoon.

That afternoon I did get a call from the hospital to set up the appointment for my surgery early Monday morning. They were able to schedule an operating room with a bit of shuffling. As with most surgeries I was told to fast the morning of the surgery. I was also told not to take any ibuprofen that weekend. It is good that was mentioned. I’ve never really had a lot of surgeries before and I had no idea that ibuprofen is a blood thinner. My back aches so much that taking ibuprofen is almost second nature to me by this point.

The night before the procedure I remember looking forward to getting surgery. I didn’t care about the port at this point. Really all I wanted was to be knocked out so I didn’t have to worry about my breathing problems anymore. By this time I was getting very little sleep and any amount of activity, including talking, would leave me breathless.

In the morning my wife took me to the hospital and I went through the normal check-in process. Before surgery I remember speaking briefly with the surgeon. I also remember being wheeled into the operating room and the surgeon joking around with the OR staff using a quote from The Waterboy (I love that movie). That is the last thing I remember from before the surgery. Those knockout drugs are amazing!

When I woke up I remember speaking to my wife about the procedure. She had been worried during the surgery because it took a lot longer than had been planned. The surgeon had run into multiple problems. He first tried to connect to a vein in one of my shoulders. But there were so many lymph nodes and they were so rock hard that he could not get a clear path. He tried to access a vein from the other shoulder and he ran into the same problem. The front of my two shoulders show the multiple attempts me made to find a vein. It looks like a little mine field had exploded.

Since the surgeon was unable to access a vein from my shoulder he had to access a vein in my neck. The port was installed on my right chest and the catheter runs under my skin to about half way up my neck. The catheter was then surgically installed into a vein running through my neck. The path of the tube can be seen since it is just under my skin. He also said the port is not inserted as deeply as he usually likes due to the problems he ran into. When looking at my chest there is a lump that is actually caused by the port. But even with the problems the port was installed and was ready for use.

After the surgery my wife said the surgeon and the oncologist met with her for about a half hour. They talked about the procedure and what would happen going forward. I really appreciate the fact both doctors took time to speak with her and keep her informed. It was then my wife found out chemo might not happen that day since the insurance had yet to pre-approve all of the chemo drugs. But that is a story for the next post.

At discharge I was given a prescription for some of the good painkillers, which I only used for a day. I really don’t like the way those painkiller make me feel so I use them only as necessary. I was also told not to lift anything for a few days and to take it easy.  Since I still had my  breathing problems I found it unlikely I would have the urge to do anything stupid like lift heavy objects.

I’ll end this part of my cancer documentation here. In this post I blogged about meeting the surgeon and getting a port installed in my chest. I’m thankful I had a surgeon that was good enough to deal with unexpected barriers and come up with alternatives in order to get my port installed. In the next post I will blog about my chemo experience, which I was starting to get nervous about.