PORT PLACEMENT - Detailed description of process

sas-schatzi

All after this, TB57 wrote such an accurate description, all that has been here has been written with good questions and answers, I'm leaving. I've bumped this thread many a time to keep it going. I think it's time for me to move on. Please, someone take the responsibility to bump it every week or so. The info here is to valuable to let go. Thanks. and good luck L&H&P's Edit not leaving

sas-schatzi

Bump

Dreadlx

Thank you for thinking of this! I'm scared about EVERYTHING! Never needed support before... I was always the one giving support. I'm just trying to prepare myself for any & everything.

sas-schatzi

Dread, going to PM you b/c it's been a few days and I wasn't watching.

aaoaao

My port was placed just under my collarbone on my right side.  I was completely knocked out so I didn't feel a thing.  My healing was pretty quick and actually painless for the most part.  I love my port because I HATE IVs.  Always have and always will have a big fear of them, especially when they try to put them in my hands.  I was going to have my port removed when I finished chemo over 3 years ago but never got around to it.  My cancer has come back and I'm so happy that I kept it.  But if I had removed it I would definitely have had it reimplanted.  I have such a good experience with it but I understand some haven't. 

aaoaao

Bump

aaoaao

Some people wonder how long you can keep and use a port.  My port has been with me for nearly 4 years.  It is similar to a pacemaker in that you don't HAVE to remove it.  You are suppose to go in every 6 weeks to get it flushed but I (bad me) have gone 3 months without a flush and it still could be used for pulling blood out for tests.  Sometimes it might act like it won't give the blood up but they have some type of injection (into the port) that opens up any blockage.  Even if it doesn't give up blood they can still use it for infusion as long as you can taste the saline flush.  This lets them know that the port is still working.  My ONC nurse told me that ports were designed more for infusion than for blood draws which is why sometimes they can be more difficult to obtain a sample. Also you don't have to worry about MRIs with the ports since there is no metal in a port at all.

exbrnxgrl

I concur! I am about to have my last two Aredia infusions but since I'm stage IV, I'm leaving it in indefinitely. Mine is a petite Bard power port and is placed in the hollow between my shoulder and top of my chest, below the collar bone. I have a strapless long, cotton summer dress and I wear it without concern. All that is visible is 3 tiny bumps in a triangular arrangement.

Caryn

sas-schatzi

So, pleased, aaoaao has promised to watch this thread to make sure it's bumped for anyone needing port support. She will keep it from falling out of site.

aaoaao remember to pass it on to someone else when it's your turn to move on Bless you sassy

aaoaao

No problem Sassy.  I will be around for a long while since I am early Stage IV with a single bone met.  I definitely will find a replacement when I can no longer watch this thread.  It's information for newbies is to vital to let it disappear.

Mellie289

This is a very informative thread! So many wonderful contributions.

I want to see now about getting a port in my arm. I'm curious if that's something only particular surgeons do? My oncologist only brought up about having it placed in my chest and that made me cringe, particularly if it restricts my movement (as he said it could). I have good veins but now that I've been reading up on the damage that can be done by all the needle pokes, I've come around to the idea of one in the arm. 

I'll ask tomorrow about the arm port when I visit with a surgeon (a new one at the cancer center who didn't do my lumpectomy/ALND) and with the oncologists on Tuesday. If anyone has any thoughts though on arm ports (types of ports, placement, whether the surgeon needs to be specialized for that particular surgery), I'd be interested since I like to go into these appointments informed.

exbrnxgrl

Hi Mellie,

A few women on this forum have had ports placed in their arms and, hopefully, they will weigh in soon. If you read my earlier posts you'll see that where I had my port placed doesn't restrict my move movements at all. I rarely even notice that it's there. I am petite and was able to get the Bard power port petite size. Three small bumps under my skin are all that shows and it has worked very well both in and out. If an arm port is not possible, you might want to speak to the surgeon about placement on the chest. Mine is so far over toward my shoulder that I would hardly say it's on my chest.

Caryn

aaoaao

Due to many port questions in other threads, I feel this thread needs to be bumped to make it easier to find.

lark

Thanks for your responses. I had the surgeon try to put the port in last week, but she couldn't get it threaded through the vein. Had to close up and refer me to Intervention Radiology. So I guess I should have gone to them to start with. The nurses told me after the fact that its best for very thin women to use IR. Wish they would have told me that before and avoided an extra surgery. Today I had IR place the port with no problem. They just used a local and twilight so I was awake, but very sleepy. The worst part was nausea and a headache. Very sore tonight and have first chemo tomorrow. Will definitely ask for a numbing agent.

sas-schatzi

AAO Hi you lovely person, I have confidence you will keep the thread going , but i'll pop in where I think it can help.

MY OPINION: ports should be done in Intervenional Radiology Units or OR's that can do Fluroscopy. Because they use a system called RealTime Imaging.  If RTI is used in the operating room good. In a previous time before RTI gained it's reputaion of accuracy, the surgeon was  diving for a vessel blind, but with skill. BUT== with skill is an important concept. Surgeons go through such extensive training..  In the early days of Interventional Raidiolgy the application to procedures that could be done in the radiology unit were unknown.   Now there are soooooo many. Many other disciplines that previously only did things in the OR have changed venues-----i.e. to the interventional radiology room within the department of---whatever we ar calling radiology/diagnostic imaginging this year.

If I had a choice, this is what I'd ask for: The most practiced person(done lots), done under real time fluroscopy.

aaoaao

Thanks for the complement.  I agree we have to demand better treatment.  Sometimes doctors forget we are still human beings and not just a group of organs and cells to be manipulated.  I'm suppose to be scheduled for endometrial biopsy...my doctor told me to just take a few motrin before the procedure.  But after reading about how painful many women found the procedure to be...I'm demanding some pain killers before the procedure.  They're not going in unless I get them.  It's still MY body and I have the right to not be tortured for their convenience.  So I agree with you tell them the way YOU want the procedure done.

sas-schatzi

Go get'em AAo.....sassy.

KellyBee

Wow, thank you so much for this information! I was just recently diagnosed and start my first treatment next week. Thanks to your info and the advice of all the wonderful ladies on this forum I have decided to get the port. Thanks again!

Mellie289

This thread has been great with lots of info about the procedure, although I haven't read all 18 pages.

I have an important questions that is going to seem extremely silly and bizarre, but is a sensitive topic with me and my boyfriend. Does the procedure (with local anesthetic) require that the breast is exposed while the surgeon puts the port in? 

exbrnxgrl

Because I was having something else done at the same time, my port was put in under general anesthesia. I would guess that exposing the breast area might occur but can't say for sure, but since this a procedure being done by a medical professional, what would your concerns be?

wyllikers

Mellie, this procedure is done naked from the waist up with a drape covering the areas unneeded for the port placement.  It is possible that part of your breast will be exposed during the procedure.  I had already had mine removed when I had my port placed, but the side of my chest where they put the port was exposed.  If it makes you uncomfortable, be sure to talk to your surgeon beforehand and let him/her know of your concerns.

Mellie289

exbrnxgrl - I don't really have a concern, but my SO knows a retired doctor who has poisoned his opinion of doctors who view women's breasts as being "professional" about it. My surgery caused friction because I had a male general surgeon. I was shocked. I really don't want to rock the boat any further as I need his support through chemo. To me, it's a small thing and a battle I don't think is worth fighting considering how important our relationship is and the other things he's so great on (like moving in with me to help me through chemo). Where my port placement was scheduled has only male doctors. I could ask my new female BS to do it possibly, but at this point, I'm trying to just go without it since I have good veins and will only have 6 infusions. I'd prefer IV. Knowing the details of the procedure is important so I can avoid further conflict.

wylikers - the information you provided was really helpful. I suppose if my MO makes me do this, I can see about discussing the procedure with the doctor who's supposed to do it. It would be only local anesthetic, so I'd be alert for everything.

aaoaao

I'm sorry but I think your SO should be understanding that you have bigger fish to fry than worry about a chance of an exposed breast during an operation.  The surgeon wouldn't be the only person in the room.  There would be nurses, a doctor to monitor your breathing and other vitals.  They usually don't do it under local because it is unsettling to have someone making an incision into your chest close to your face and what if the breast does become exposed..they wouldn't want you to move to recover it.  However, if YOU would rather have it done through an IV that is fine but if you would rather have a port it is your body and your decision. Some chemo drugs aren't recommended through IVs due to possible damage to the veins in the arm.  I don't know if that is a concern of you MO or not. He'll probably advise you if this is the case or not.  Your SO support during your chemo should include your choice of how to administer the drugs.  Again this is just my opinion.

Mellie289

aaoaao - I agree with your points of what his support "should" be like during this, but his feelings on this are pretty hard-wired now. It is what it is and I can't change it. I thought it was pretty ridiculous when he first brought it up and didn't take him seriously. Likewise, a couple friends I told laughed like it was a joke at first until I could convey how serious this was. If I can work around this issue, it will make my life a lot easier. My MO's office has arranged for port placement next week with only local anesthetic, so it seems they aren't concerned about how unsettling it could be at this hospital.

There has to be a female doctor who places these things somewhere! I'm waiting to hear back from my MO and hoping she says I don't really need it though. The thought of having a port in my chest makes me feel like I can't breathe.

aaoaao

Of course you should do whatever is best for you.  I understand this is a stressful time for both you and your SO.  Fortunately the port more or less is inserted just under the skin so the incision isn't to deep.  I wish you the best, if you need any support this is a great place to get it from others fighting this battle.  Please keep in touch.

exbrnxgrl

I had a female general surgeon place my port but I didn't seek one out, she was just available at the time. My port is not smack in the middle of my chest but up toward my shoulder. I rarely notice it and it doesn't show in most clothing, though I don't care if it does. I know that you are taking your SO's feelings in to consideration, but you have bc. BC involves breasts. I don't care what this doctor told him. You have to trust that YOUR doctors are professionals. Most importantly, he needs to put your needs above his hang ups.

aaoaao

If it makes things easier for her not to upset her SO she should do what she wants.  But I agree that BC involves breasts.  Where does it end..him telling you what gyno you can use.  Who he will allow to do a colonopscopy (spelling wrong) if you need one?  If you ever need any kind of chest surgery it can only be a female even if a male doctor is better at the procedure.  If you need rads is he going to determine who does that procedure too. Would he accept you telling him who can treat him if he needed medical treatment?  I guess I wouldn't feel supported if during this already stressful period that he makes demands about YOUR health care.  That is trying to control someone and I guess I don't work like that.  I found that with Stage IV cancer I don't want other people determining how I am going to live my life and deal with my disease.  I'd tell him if he gets testicular cancer than he can decide if he wants a male or female doctor but since they're your breasts not his he should let it be.  I wouldn't do a procedure normally done under general being done using a local because my small minded SO can't handle it.  He should be more worried about the stress the procedure is already having on you and not add to that stress. His main concern should be how YOU will come through the surgery and relieving your concerns/pain instead of focusing on HIS needs. It would make me wonder how supportive he will be along your entire treatment if he is already bullying you about this.  He's not the surgeon and his trying to orchestra how it is done is ridiculous. Sorry but I think he's self-centered and insensiitive.  But you know him and if you think he's worth letting him decide what treatment you get then that is up to you.  I really do wish you the best and hope he helps you get through the difficult time.

aaoaao

Mellie, I want you to feel like you can come here for support.  Yes, we may have differences of opinion but we are all going through this awful disease and very few people can understand the stresses both physically and emotionally.  I hope I didn't make you feel judged because that wasn't my intentions.  There are a lot of great and supportive women here and they have helped me a lot by relieving some of my fears and answering questions I might have.  I hope you get the same benefit too.  Take care of yourself, you deserve it. 

jnprsn

So glad to find this thread. I have port surgery today, and as with all of my "unknowns", I panic. Anxiety issues my whole life. The step by step description was ever so helpful. Chemo starts Monday the 22nd.

Mellie289

aaoaao - It's all good! LOL! I don't feel judged. As I kind of said already, I think his thinking on this is ridiculous, but I can't change it. He admits it's irrational and selfish, but the solution is that we break up and he supports me through this as just a friend if I feel like his needs in making doctor choices are in the way of me getting treated properly for this disease. I normally have a female doctor and gyno anyway - I feel more comfortable with one. I can certainly extend my preferences for female doctors into other areas if it makes him happy. Having already switched to a female surgeon for follow-up, I can see that she would have been a better choice from the outset and I'm sorry I didn't find her earlier and went on my PCP's referral to the general surgeon who did my lumpo/ALND, so I don't feel like this is choosing substandard care.

This is one thing I am conceding to my SO and to me it's a small thing as the cancer center has female surgeons, oncologists and radiologists. The port is a bit of an issue because there aren't any female doctors in the area who place them, but I have been opposed to the idea of getting one in my chest since my first onc told me about it. I said right off the bat - No, I don't want that! - and that was before I knew about this female doctor issue. I could see about the surgeon doing it possibly if necessary, but I'm waiting on hearing from my onc to see about changing to order for the arm.

I know this makes my SO sound very self-centered, but keep in mind that he gave up his appartment, in which he was a bit entrenched, and moved in with me to take care of me during chemo. He helped me out so much when I was recovering from surgery and is telling me he doesn't care about things like me losing all my hair from chemo. He is prepared to take over all the cooking and dishes if I'm too fatigued to do anything. If the only thing I need to compromise on is my doctor selection based on gender, that's a small thing to me. It's a hassle right now to research and find them, but once I'm set up, I'll just keep going back to the same doctor's year after year and it won't even be something we think about.

And, yes... I would need to find a female doctor for a colonoscopy too! LOL!