Wednesday, July 18, 2012

The Port: He Love-Hates It

One of the bits of information I went looking for but had trouble finding at the beginning of this cancer journey was documented personal experience with “the port.” It’s such a generic phrase and there are lots of different kinds of ports with different purposes. I understood the idea, but I didn’t satisfy my curiosity about it until Dave actually had his put in and the nurse put the owner’s manual in my hands. Finally, I had information to devour.

I suspect that not many people write about it or post pictures of it because... well, because of a lot of reasons. I obtained Dave’s permission to write this post about it so that information will be out there for the next person who needs it. He told me I could include pictures from the manufacturer’s website, but I am forbidden to post a picture of it in his body because it is too personal.

Dave has a Bard PowerPort that looks like this. This picture is enlarged to show detail; it’s actually about the size of a quarter.
I don't know why they make them purple.
It lives in the right side of his chest. If you put your left thumb in the dip between your collar bones and spread your fingers comfortably on the right side of your chest, the port would be between your pinky and ring fingers. Outpatient surgery with twilight drugs is required to put it in (mainly to keep everything sterile but also for the good drugs), and it requires a 2 inch incision where the actual port goes in and another centimeter length incision a couple of inches above that to help guide it into position. I think Dave’s procedure took about thirty minutes.

This is what it looks like inside the body.

The port goes right under the skin and the catheter is threaded into a blood vessel. He had soreness in his shoulder for a couple of days after the surgery, but it didn’t require narcotics. I don’t think he even took ibuprofen.

The little incision was closed with a dissolvable stitch and the 2 inch incision was closed with steri-tapes, because the oncology nurses would have to access it two days later for chemo. He had to keep it dry for 7 days, so we bought those giant square Band-Aids to put over it while he showered. For a couple of weeks, it was swollen so it just looked like a knot under his skin. Now, you can see the three little palpation bumps through his skin when he’s not wearing a shirt. Otherwise, you don’t even know it’s there when he’s wearing his usual t-shirt / dress shirt combo. This is the benefit of being a man. If it were in my body, you would be able to see it at the necklines of some of my shirts.

It eliminates the need to start an IV line for each chemo session and eliminates the need to draw blood from a vein in his arm. I believe they might also be able to access it to inject the radio-active glucose for the PET scan; we’ll find out about that in a few weeks. They spray the skin with Dermaplast, or something like it, to numb it before they stick him so he never has to feel the stick. That is how they draw blood to check his counts and how they hook up the IV for the chemo.

They use a special needle (a Huber needle) to access the port and it looks like this when it’s ready to be hooked up to the IV.

Obviously the "tag" is the only part you see.

Ella would have called this part a “tag” when she was younger. All the patients have tags sticking out of their shirts while they are waiting for a chair in the treatment room.

Once the treatment is over, they take it out and stick a cotton ball on top of the prick with a Band-Aid. He has to leave it on for a few hours in case leaks. We haven’t seen it leak, but that’s what the nurse told us after the first treatment.

It has titanium in it so it will show up on an x-ray and possibly set off metal detectors.

Sample X-Ray
For that reason, he carries an identification card in his wallet. He also wears a purple bracelet so that if he has an accident and finds himself unconscious, the medical staff will know that he has a port and what kind it is.

When it’s time to take it out, he’ll schedule an in-office appointment with the surgeon to remove it. He doesn’t have to be in the OR for that part. He’ll probably keep it for at least a year after he finishes chemo, just in case. And because it makes the blood draws so much easier.

He hates it because it is a foreign object in his body that you can see from the outside. He is very aware of it and it feels weird. He also hates the reason he has it. He loves it because it makes the whole experience a little more comfortable for him, needle hater that he is.

The pictures are from the Bard website.

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