Posted on: Sep 27, 2008 12:55 PM, edited 21 hours ago by Moderators
I just got my port placed yesterday and I had such a hard time finding a detailed description of the procedure, so I thought I would share this for anyone who is apprehensive or likes to know exactly what they are going to do to you:
1. I arrived at the hospital and registered. I was then taken back to the outpatient surgery/recovery area, got undressed from the waist up and took off my shoes, IV started, EKG hooked up, blood pressure and blood oxygen meter hooked up, and paperwork completed. A small bag of Levaquin antibiotic was hooked up to my IV.
2. I was taken back to a holding area outside the OR where they were going to place the port and the procedure was explained to me. It takes about 1/2 hour to actually place the port. They don't completely put you under for this procedure - they give you a sedative of morphine and fentanyl so that you "don't care" what they're doing, but you are awake and able to respond if they speak to you. The sedative is the reason why you have to stop eating 6-12 hours before the procedure, and the reason why you have to wait an hour after the procedure before you can leave. In addition to this sedative, they give you several local numbing injections in the areas where they are working in your upper chest below the collarbone and the base of your neck.
3. I rejected the sedative and did this procedure with locals only. Being able to go home quickly appealed to me, and I'm just the kind of person who feels like I'm not in control when I am sedated but not completely under - either put me completely under or nothing! So this worked well for me. (I asked the nurse if every man they worked on today had the "happy juice" and she emphatically stated, "you got THAT right!" - LOL)
4. They transferred me to the operating table from my gurney bed; actually, I transferred myself by sliding over. They gave me a warm blanket, took my right arm out of my hospital gown and gave me a small pillow for my head. They also pulled and taped my skin down on the right side to simulate where the skin would be when sitting up for chemotherapy. I was reconnected to the EKG, blood pressure and oxygen monitors too, and my hair covered with a surgical cap. An imaging device was placed over my chest so they could check the final position of the catheter above my heart to be sure it was correctly placed. They cleaned my skin in the surgical area with a strong blue solution and then draped my entire body and head in a blue surgical blanket. They had a frame under the blanket where my head was and made a "window" on the side so I could look out. A lovely nurse stood right by my head to soothe and talk to me throughout the procedure. I was awake and alert, and curious and continued to talk to the surgical team, asking questions about the process.
5. When I was prepped and ready, the surgeon came in. The first local injections were in the base of my neck on the lower right side, where they begin the process by threading the catheter into a large vein, and pushing it in until it rests just above your heart. The local injections sting and burn just like at the dentist, but once they take effect you are numb. Any discomfort comes from the pushing sensation in your neck and you can feel pressure in the side of your throat, but it's not painful, just uncomfortable and strange. The team kept me informed about what they were doing throughout and I kept them laughing with a funny story about a recent visit to the dentist which involved injections to the roof of my mouth - which was WAY more painful than this, I might add!
6. When they finished with the neck part, the doctor gave me several more numbing injections in the chest for the actually port placement part of this procedure. More stings and burns, but totally tolerable. In this part of the procedure, they make an incision in your chest for the port which is about the size of a quarter, placing it under the skin below your collarbone, and then they make a tunnel for the catheter sticking out of your neck (at this point), push it under the skin down to the port, and connect the two. There is a fair amount of pulling, pushing and tugging in this part of the process but it wasn't painful - again, just strange and uncomfortable. It doesn't last long, and then they begin to stitch you up. The subdermal layers are stitched with dissolving stitches and the top layer is glued with steristrips placed over the incisions. You will have one tegaderm dressing over a small gauze pad a the base of your neck, and another on your chest below your collarbone.
7. I was instructed to change the dressings every 2 or 3 days, and to keep the dressing on the neck wound for 5--7 days, and the chest wound for 10-14 days. I was given supplies for 3 rounds of dressing changes. I was told it was okay to shower by wrapping the site in saran wrap but no soaking baths and ensure the area is kept dry. The port can be used immediately, and does not need to heal before it can be accessed.
8. Because I didn't have the happy juice cocktail, I was able to get dressed and leave right away! A big plus to me. Last night, the surgical areas were numb, and really didn't completely wear off until the wee hours of the morning - about 10 hours later. There is very little pain involved, but it is uncomfortable to turn your head too much, and I am definitely favoring the area. I also could not sleep on my right side last night, but was able to sleep on my left side just fine. I don't plan on doing any housework today, but I'm able to do light cooking, work on the computer, etc.
9. There are very good pictures of what the placed port and scars look like on this site: diehlmartin.com/infusion/.
I hope this is helpful. I was searching high and low for this kind of detail prior to the procedure, but couldn't find it. I wish us all the very best of health,
Posts 421 - 450 (493 total)
Jun 10, 2012 03:35 AM CatFromFL wrote:
Just FYI there are Ports called "Power ports" that are compatible with CT and MRI ( up to 3Tesla) as I have one. Not all ports are Compatible but the newer ones seem like they are designed to interfere less with tests and are able to be used for other tests.
I was an IV nurse ( Held an advanced INtravenous certification- CRNI) for part of my RN career. So when I got my port there were a few things I considered. Would I merely have it during my treatment phase and then have it removed or would I get it flushed monthly and keep it until I decide its value used up or flush it myself and maintain it forever? The port needs to be flushed monthly with a small amount of saline and heparin in most cases.
I had taught a few patients that had ports "self flushing " over the years. Its not a difficult thing for those that want to learn self port care and are motivated. You do need an IV nurse to teach you though.
The flushing techniques are not something that a person cannot learn to do.
A special " non- coring (huber) needle is needed and skin prep and flush supplies.
Non- coring needles come in 2 shapes - straight and L ( huber).
There are home IV nurses that can teach how to do it. Many IV port patients or their family/ caregivers learn how to do this skill all over the country. Including children and diagnoses other than cancer.
Some insurance will have a homecare RN come flush your port or an IV nurse at the physicians office do it. Each case of what your insurance covers may be diferent. And some of us " take charge" wanting to do it ourselves yet others want someone else to do the flush or they want that port out as soon as treatment is over.
Personally I have had 2 primary breast cancers so I am thinking I just may keep this port....
Mine doesn't bother me at all, is low profile, doesn't hurt, isn't ugly, etc.
I just wanted folks to know that these are options. You can discuss your options with your chemo nurses or your insurance carrier. The insurance carrier can tell you what home IV nurses can assist you.
Jun 10, 2012 04:39 AM exbrnxgrl wrote:
Thanks Cat! I think many of us have the Bard power ports. Like yours, mine doesn't bother me, is low profile and due to it's placement, can only be seen if I wear a top with very thin straps. Even if you saw the 3 little bumps,most people would have no idea what it was. I am still using it for tx but will probably keep it in since I'm stage IV. As for the flushing, I'll gladly let the infusion nurses do that since I'm a terrible needle phobe. Kudos to the brave who can do it themselves! Caryn
Jun 14, 2012 03:36 PM penny4cats wrote:
had two blood draws off new port ok but today could get return but no blood to withdraw other than measly 4cc for cbc. severely anemic and almost to the point of transfusion. questionning internal bleeding if port or catherter part was partially thru a bv could this be a cause?
Jun 15, 2012 11:14 AM PixieNel wrote:
Had my port-a- cath insertion yesterday. I was under GA during the 45 mins procedure. When I woke up, blood was oozing out from the wound but my doctor said thats very normal. So they apply pressure bandage on it to be removed the next day noontime.
Soreness is felt after the anesthesia wore off. Even there are painkillers, the pain is still there whenever i moved my left shoulder. At least , I can freely turn my neck with no discomfort.
I was in the recovery room for 3 hours.They did chest xray for evaluation. The result is my port is placed properly. Then i was discharged.
This afternoon i received a call from my OR nurse to follow up on the removal of the pressure bandage. I just told her the waterproof dressing is soaked with dried blood. She told me to immediately replace it with another dressing it to prevent infection.
When i removed the bandage, i can't see the port but i just saw the suture made on the skin. Its a little bit sore but manageable. I just prevent the left arm from being too mobile for faster healing of the wound.
in addition to my antibiotic and painkillers, i chewed on my Vitamin C supplement to maximise the healing.
Aug 11, 2012 01:21 AM sas-schatzi wrote:
Bump-----if you post and need help You can PM me . I'm a retired nurse. Help where I can or guide you to a source. I don't check in regularly. Tbird 57 wrote the header along time ago. She did an excellent job. Her info still is the standard of care that you should expect This thread tends to go inactive. I bump it when I review my favorites. PixieNel sorry missed contact. sas
Aug 21, 2012 10:25 AM mom22ja wrote:
Please be aware that almost 4 years after your post it is still helping some of us immensely. Thank you for taking the time to post this!!
Aug 21, 2012 06:45 PM sas-schatzi wrote:
Mom22ja-- I have tried to locate tbird57. There is no posting after Jan 20 2009. AND she is not in the Angels list. Her description is as good now as it was in 2008. Please, put it in your favs and bump it every so often, I try to do the same. From the beginning it has very good advice. Thanks sheila
Sep 12, 2012 12:20 AM, edited Sep 12, 2012 12:32 AM by sas-schatzi
kNITTERKJV--look in the forum section for a group starting chemo now. Also look for a group that has the sane type of path report predominantly as yours. These two groups will be immensely helpful in getting you started. I'll give you some links to sone other helpful sites.
to help you get organized
Sep 28, 2012 11:51 AM halfcan wrote:
My port goes in this afternoon ... 3 hours actually. In reading the posts I am wondering which side might be better to get the port on. Mastectomy side or the other? Anybody think it makes a difference? Thanks...hoping for a quick response. lol
Sep 28, 2012 11:57 AM marianelizabeth wrote:
halfcan another shared thread! keep us all posted on the whole thing!
Sep 28, 2012 11:58 AM marianelizabeth wrote:
PS halfcan, another you just gave me another question to put on my list.
Sep 29, 2012 04:22 PM halfcan wrote:
I'm answering my own question....opposite side of mastectomy. Not given choice....was told same reason as no BP or blood draw on mast. side to minimize lymphedema risk.
Sep 29, 2012 09:15 PM susan3 wrote:
dont know if this was posted yet, but when you go for scans or any kind of test let them know you have a port when you make your appointment. my pet scan nurse had to use the vein cause a port nurse wasnt available..you do need to keep a sense of humor. and i did let them know, it is not a perfect science, i do laugh a lot, for me its a better option then crying. or maybe i should write a book .lol
Oct 1, 2012 11:21 AM halfcan wrote:
Thanks susan3. I wouldn't have thought to mention that in advance. I got my port placement on Friday and took off the bandages last night. It is not a pretty site, still sore and there is considerable swelling where the port is. My first chemo is on Thursday and I can't imagine them sticking me there!
Oct 9, 2012 09:03 PM marianelizabeth wrote:
Since I just got mine on Friday I am not sure but I took a look at mine and it does not seem right for it to actually move. Let's hope someone with more experience chimes in soon. When did you have yours implanted?
Oct 9, 2012 09:08 PM exbrnxgrl wrote:
Was it placed recently? If so, maybe it seems to have shifted as swelling goes down. As always, call your doc to be on the safe side.
Oct 9, 2012 09:15 PM marianelizabeth wrote:
Then I think calling the doctor is a good idea.
Oct 9, 2012 09:19 PM spiney wrote:
I guess so. This is so frustrating. I had a pic line 7 years ago from breast cancer and it blew. I just hate having to think about even a minor surgical thing. At least the chemo isn't like tomorrow. Hopefully, there won't be any surprises. Thanks for responding so quickly. I also have TE in both sides. This port is on my left and I do have a left branch bundle block.
Oct 30, 2012 07:43 PM S1SSY wrote:
Too late for me, but I am a PICC nurse and I really wanted a PICC line. My onc refused to even discuss it so I had a Bard placed and have awful bilateral pain. It is much worse than either lumpectomy or sentinel node biopsy. Surgeon first tried to place the line on the right side --my unaffected breast-- but after 20 minutes of digging and yanking he gave up and repeated the whole process in my poor lumpectomy/sentinel node biopsy breast instead. Only disadvantage to the PICC is its relatively shorter life, but PICCs are readily replaced. With my TNBC diagnosis and its risk of early metastasis, I figure the Bard is with me either five years or till death do us part...
Nov 27, 2012 10:55 AM, edited Dec 31, 2012 07:03 AM by sas-schatzi
The following RANT was written on a different thread, in response to several members that were told by nurses that ports were for convenience versus medical neccessity. Hope you find it helpful.
Okay I'll be on a rant. Hit a true nerve and I'm pissed.
Those nurses have their collective heads up their ass. Hmmm was that strong enough. Anyone espousing this garbage was never trained properly regarding IV therapy and the indications, contraindications(not to be used), and complications of there use. I would consider them not only improperly trained , but lazy. Because any true attempt at reading/studying the subject, they wouldn't say something ssssssssssooooooo STUPID. Very scary b/c this is entry level nursing knowledge. So, what else did they not bother to learn !!!
Ports were developed because veins were getting fried by chemo. Tissue that is infiltrated with some chemo's dies and sloughs off. Chemo that doesn't cause tissue death, can discolor the tissue for a very long time. Back to fried veins. You may get through a course of chemo, but the internal vessel damage is being done. Long term affects may NOT be seen for awhile. What it means longterm is that one may NOT have veins available for fututre use, thus putting one at risk in lifethreatening situations for no immediate access. In this situation, those idiot nurses, wouldn't see you dead from a preventable reason had the veins not been fried. This is the worst case scenario. Other non-emergent situations, that are situational dependent, you will end up with a PICC line, Central line, or Port anyway b/c arm veins aren't available.
Reason for PICC's, Centrals, and Ports is they access veins that are larger in diameter, thus the medication administered is diluted in the blood quicker. The faster the dilution takes place, the less internal vessel damage. Less damage to the vessel less likeihood of long term negative consequences.
Anesthesia risk: Docs or CRNA's,prefer arm veins, in administering anesthesia drugs thye will only use Ports, centrals or PICC's as a very, very last resort. They will go to leg veins first if an arm vein not available. Leg vein usage for IV's, puts you at risk for thrombophelbitis or embolism. Not likely while under anesthesia, but can happen. Risk is predominantly after surgery. Even after removal of the IV. Leg veins don't respond well at all to IV therapy.
The peripheral IV access of choice for anesthesia is the arm veins b/c the drugs used are administrered at a slower rate in a smaller diameter vein to prevent the drugs from entering the central circulation too fast. Too fast of arriving at the heart or central nervous system control center in this scenario can cause the heart to NOT work right. HMMM need a further description of what can happen then? Google "speed shock when administering drugs". Plus with the arm veins , the patient is positioned so that anesthesia Docs/CRNA"S can visualize the insertion site. Some drugs administered in this situation that infiltrate can cause serious consequences for the tissues i.e death of the tissue. Besides if they infiltrate, the drug can't accomplish the expected response for administration.
Wasn't too hard was it. Now you know more than the STUPIDS. ERGHHH. Hate it when medical professionals don't learn what they should.
In answer to convenience of use of centrals/ports/piccs ---yes, they are incredibly convenient.
When they are ordered by the Doc, it is b/c of what I have written above. The first consideration for choice of route of administartion of an IV therapy drug is SAFETY of route. NOT CONVENIENCE.
Dec 20, 2012 09:48 PM PixieNel wrote:
The port placement is a blessing for me. Since I have very fine veins, the nurses finds me a challenge for blood draw until now. Some said my veins are playing hide and seek.
With the port , its a breeze for chemo/herceptin poke.
After Herceptin treatments, my port will be removed. My doctor said it will done under local A.
@ sas-schatzi, how is port removal done?
Thanks and Merry CHristmas all.
Dec 21, 2012 08:49 AM laurie2025 wrote:
I just had a port installed yesterday, on my right side. I have 2 incisions; a tiny one just below my collarbone and a longer one underneath it. No dressings, just the glue.
The pain is really really bad, I barely slept at all last night. Swallowing hurts and if I have to cough - oh my, unbelievable pain. There is swelling as well. I am going to call my surgeons office and see about getting some pain medication that is stronger than what was prescribed, as this is pretty rough going right now.