Today was porta-cath day. This proved to be quicker and easier than I thought it would be.
I arrived on the Oncology floor at about ten ’til eight, shortly after my visit to the lab for blood work and a quick breakfast courtesy of the VA’s coffee shop. After checking in and having my vitals taken, a nurse showed me to a room with several wheeled recliners (all teal, all ugly, all with mini tables on their armrests) which is typically used for flu shots—I know this ’cause I’ve seen the “Flu Shots Here” signs on the door previously, and the receptionist had directed a woman down to our end of the hall for one. Nurse Mary passed me a hospital gown and robe, told me to take off my shirt and bra, and to put the gown on the proper way so it was open in the back—the first time since starting this trek through cancer care I’ve been specifically told to don the gown that way. So I did, not wishing to upset her. Once I’d changed, she returned and put an IV line in my left hand; this wasn’t a full IV with the stand and all, but a shorter line which would later be attached to various things on such a stand. After checking to make sure it would flush okay, she told me to hold my hand slightly bent in so I wouldn’t kink the line and sent me down to Angio.
The trip to Angio involved a walk to the elevator, going a floor down, and following a blue line all the way around back of the radiation section. There, in a cool room with a table which had an X-Ray panel above it, I was prepped for the insertion of the porta-cath.
First, they had me take off my necklace, then had me lay on the padded table below the X-Ray panel. This table had controls they could use to move it lengthwise up and down, or vertically up and down. I got up on the table with little difficulty (even at its lowest point, it was still fairly high) and laid down, scooting up the table until my head was on the pillow. They put my arms on plastic armrests they had to attach to the table, and I told the nurse on my left side about the requirements for enabling my IV line to work and he made sure I held my hand properly. They had me remove my right arm from my hospital gown, and attached a blood pressure cuff to my right arm and an oxygen reader to my right index finger.
They did not sedate me. The nurse on my left started a line of liquid antibiotic in my IV and the lady nurse ensured my right breast was at least partially covered then, upon realizing its size (DDD at least), suggested they tape it down. I still chuckle over this, because they did indeed tape it down, using three long strips of tape crossing my body from the right arm support to the left arm support. They had to do this so the doctors would be able to access the location they needed to place the catheter line under my skin.
Sometime around this point I suggested they take my glasses, and one of the nurses told me to turn my head to the left. The nurse who’d managed my IV line fetched my glasses from my face and I obeyed the command while someone scrubbed my skin and neck with antiseptic—I forget what it was. While she did this, one of the doctors came in with music and set it up to play. After washing my skin, two of the nurses covered my body in blue surgical slips, one of which completely covered my head; the nurse who was still on my IV lines hooked it up to the IV stand so I could “see” out. Without my glasses, I didn’t see a whole hell of a lot. (LOL)
Now the Doctor and a Fellow came to my side. My right side. I asked why it was so important they put the cath in my right side, and one of them explained it was because the vein is straighter on the right. Then he told me what they were going to do was inject a numbing agent in my neck and in a line down my chest to where the port was being inserted. This involved much use of an ultrasound machine and a couple flickers of the lights to use the X-Ray panel above me.
They explained what they were doing before and during the procedure, but what basically happened was they nicked my neck—and blood ran around the back of my neck, into my hair—did their line of numbness from there to the insertion point, which felt like a series of bee stings, and . . . pushed the porta-cath up that path they’d designated, over my clavicle, and inserted it into my vein. The catheter developed a kink, so throughout a series of lowering the lights to use the X-Ray panel, they got the kink out and the Doc left the Fellow to suture my wounds. He did two layers of sutures on my breast wound, where the port is, and one or two stitches in the wound on my neck.
Someone did their best to mop up the blood which had run around the back of my neck and detached the blood pressure cuff and oxygen monitor. Then one of the nurses peeled the tape off. That hurt worse than anything else. They righted my garments, disconnected my IV line from the bags on the stand, and helped me get to my feet, passing back my glasses and the necklace they’d had me remove prior to the procedure. Quite alert and able to take care of myself, I refused the offer of a wheelchair trip back to Oncology and walked out to pick up my mom on the way.
Back in Oncology, Nurse Mary removed the IV line and had me get dressed, which I did quickly, spending a couple minutes to rub as much of the blood off my neck as I could. The Angio Fellow and Doc had told me I’m not to shower for two days, at which time I can remove the dressings. I’m also not to soak in a tub of water, which I don’t do anyway.
I left the hospital around ten thirty in the morning, and now, at about three thirty, long after the numbness has worn off, I’m experiencing discomfort. There’s a bit of sharp pain which isn’t bothersome around the point of the port, which is right above my breast, just where the flesh begins to rise for it. My neck has some dull pain, and since it tenses the muscles there to swallow, eating and drinking causes some minor discomfort, but it’s not so great it’s prevented me eating or having anything to drink. The muscle on the back of my head where it connects to the back of the skull got slightly pulled with me keeping my head facing left during the procedure, so that causes some discomfort as well, but, again, it’s not enough to stop me doing anything. It hurts my neck slightly to turn my head either way, though it’s not excruciating—again, level of discomfort mostly; kind of like waking up with a kink in the neck and not being able to turn your head too far, though the “stopping point” in this is not nearly as painful as it can be with a kinked neck. The entire line from port to cath in my neck is tender—yet not so bothersome I’m screaming in pain. (LOL)
I expect to regain full, painless freedom of movement within a few days—a week at most as Nurse Mary and the team who inserted the porta-cath seemed to think the procedure wasn’t too difficult to manage or deal with. The Doc and Fellow told me to take Tylenol or ibuprofen to alleviate the pain which was a relief. I don’t know what I’d do with another scrip medication! (LOL)