PORT PLACEMENT - Detailed description of process
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Hi, everyone! I am new to the board and to bc, but like many of you, wondered what I faced with port placement and could find very little about the procedure. Your posts are soooooooo helpful. I am going to the surgeon today for the port placement pre-op visit. I'll get my port sometime later in the week, I think. With EVERYTHING a new experience, it is hard to keep up with it all, and I am the kind who wants to know what will happen beforehand. Thank you!!! Whew! I have started with a DCIS as the initial diagnosis and through the various tests and pathologies have moved right along to between a stage 2 and 3. Had a PET/CT last Friday and am waiting for the results, so a little nervous about where else the cancer might be. (I had a Mastectomy on Oct. 17 with positive lymph involvement) As hard as it is to face this enemy, it is such a blessing, and the fight is made so much easier, with the strength and support shared on this board. I wish the very best to each of you as we stand strong shoulder-to-shoulder through our various battles and set our sights on winning the war. Hugs, K
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I had no experience with cancer and with the type of managed care that goes on up here.
At 3:30 PM, the day before my mastectonmy, the doctor's office still didn't have it straight. They had me down for a lumpectomy.
Before I left the house the morning of my surgery, I took a red marker and wrote "That One", and drew an arrow and
on the breast they weren't doing that day. I showed my surgeon when he came up to see me beforehand because it would be draped by the time he was in the OR. He laughed.My dad's pacemaker was put in on the wrong side at Albany Med. You really have to watch, and be sure to READ YOUR RECORDS.
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Does everyone get a port? I was DX on 10-23 with IDC. I had a bi lat mast on 11-12 don't get my path results until 11-27.
The wait is killing me. I wonder will I have to have a port. They told me to expect at least 6 months chemo. I don't want a port it is the one thing I have an issue with. I just took something foreign out of my body that did not belong there. I have no desire to put something else in. I ahve no isse with gettng needle picks. Do I have to have a port?0 -
Momof4stars,
There are others who know more about it, but my understanding is that not everyone has to have a port. It depends on your veins (are they easy to get a needle in? do they "roll"? are they small?) and on the chemo your're getting, as some of the chemo drugs can be hard on the veins and the port makes that easier (less discomfort). It also may depend on how often you are getting chemo--every week, every 2, every 3?
Ask your onc when you meet with her/him for the first time, and no matter their answer, ask why.
I have a port and while the first five days weren't much fun, I don't even notice it now. And it really does make chemo easier. I've had a lot of IVs in my life, and while I don't mind a needle (shots, blood draws, etc.), I do mind an IV!
Good luck--
Martha
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TorchSong - you are correct -- I am having TC and was told that the cocktail is not hard on the veins, therefore a port isn't required. However, my veins are so inaccessible that I had to get one or be prepared for the torture each time they took blood and did chemo. The description above is really good -- I have two cuts. Got it on Monday and with only a couple Tylenol, no real pain -- just stiffness of my neck. What caught me off guard was the twilight drug - made me so sick to my stomach - spent 24 hours nauseous and vomiting -- worse than the lumpectomy! One week later I have only a bump where it is placed and another small cut in my neck. (and it took 3 nurses about 15 minutes to find a vein to start the IV before the insertion, so I guess it really was needed).
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Momof4stars- I don't have a port. I am having my 4th TCH on Friday. I will continue H for a yr/every 3 wks. They said my veins are great and I would be fine.
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Thanks for the report. My port was placed several months ago and I've finished chemo but keeping it in until the radiation is finished. Before the port was placed, the doc said they wouldn't put me under but I wouldn't remember anything. Since I don't remember anything after going unto the table, guess it worked.
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With all this discussion about ports I feel I have to add something here. I wonder why more cancer treatment centers don't use Picc lines. It does the same job as a port and doesn't need a surgical procedure to put it in or any anesthetic. I had one put in last week. It was done by a trained nurse in the cancer treatment center, took about an hour and the only thing I felt was a small prick when the area was frozen. It is a thin tube in my inner upper arm and has a baby sock around the ends where the drugs will be administered, a firm clear plastic tape over where the tube goes into a vein and then a mesh sleeve to cover it all. It doesn't interfere with any activities, doesn't hurt and I just have to have it flushed out once a week either at the hospital or by a home care nurse. It seems a lot simpler than ports to me.
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Some of us with ports are getting Herceptin for a year. PICC lines generally aren't put in for that long. I think they have a higher risk of infection because the end is exposed while the port is under the skin.
Also, one doesn't have to worry about keeping a port dry when showering, bathing or swimming. Everything I've read has said that bathing and swimming aren't allowed with a port. Again more of an issue for those of us on longer therapies.
Taxotere can be hard on veins so it is a bit of an advantage to have it go into a big vein near the heart where it gets diluted quickly.
My treatments are once every three weeks and my port doesn't have to be flushed between treatments. I'm not sure what the maximum time between flushes is for it.
There is a thread on ports, PICCs and pokes where people talk about the different options and why they chose them.
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Thanks this is a great help, geting mine on1/12.....
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Hello Ladies!
I'm new to the board, so here comes my two cents worth. I just had my port out this morning as I just completed all my chemo: 4 doses AC plus 4 doses Taxol, spanning 4 months as it was every other week (dose dense). The port was the "under the skin" newer type, and my bc surgeon used to be a vascular surgeon in the beginning of his career, so I felt he did a great and delicate job and I had no trouble at any time. He's been specializing in breast surgery for 20 years, and I am sooooo glad I did not go to the general surgeon who also does anal issues. Hmmm...
The main difference with my port experience was the LOCATION. I asked him if it could be HIDDEN IN MY BREAST, just below the top of my bra line and a bit toward my armpit, so that it was entirely covered if I wore the tiniest tank top. The incision is vertical, an inch and a quarter(?) long, and right next to my size A breast so that even a moderate bikini top would cover it in the future.
I am a tango teacher/dancer and I really did not want to see the port bulging out every time I looked in the mirror, and I did not want it disturbing my students dancing close or even standing in front of the group. I am tall and thin, so if this were on top of my uper chest somewhere, it would really be obvious!! Dancing gets hot, even in the briefest "little black dress" and especially now with the lovely hot flashes... We must compromise enough of our feminine appearance as we navigate through this journey. Why not tuck at least one constant reminder out of sight?
My surgeon was a little concerned that the infusion nurses would find this location odd, and joked that I should tell them that it was my idea. It did make for a good conversation starter with the nurses, and they all thought it was a good idea. To access it with a shred of modesty (do we really care?--they are professional nurses) I just pulled my tank strap and bra strap off my arm, folded my bra down to the nipple, where they tucked in a blue paper covering like it was a dinner napkin, and proceeded to poke and begin. I wore a front zip sweater over the tank top, so I could zip back up with the tube sneaking out, open the curtains, and viola!
I should add that it was placed between the skin and the thin fat layer covering the actual breast tissue, and that it was stitched in place so it did not wander, I think this is standard for other locations as well. The surgeon asked me to use a pen and mark the exact location that I wanted it, and also my preferred spot for the incision for the insertion which needed to be only an inch and a half or so away from the port. Also, sometimes a newer black bra would rub a bit of blue-looking dye onto the slight bulge, especially if I used body oil before dressing. At first I thought this was a bruise, but it wiped off.
You know what I REALLY liked about this whole situation was that I advocated for myself, persisted through some eyebrow raising, and thanks in part to my fabulous "I will listen to you surgeon" I got an adjustment for something that mattered to me. In his 20 year bc practice, I am the first that ever asked for this. There were a couple other things I advocated for that I did not get ("Can I take a couple weeks off before Taxol to rebuild a bit?) but usually there was a medical reason.
Next stop--radiation for 7 weeks beginning on the 20th of Jan and ending just prior to my daughter's 18th birthday. Hooray!
Best wishes and prayers to all--very helpful encouragement and information.
PS. When I figure out the best place to put it, I have a lifesaver tip for taking a dose or two of steroids to nearly eliminate my two days on Vicadin for TERRIBLE Neulasta pain which I was plagued with for the first 7 of my 8 treatments.
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I had a PICC line (peripherally inserted central catheter) inserted for IV antibiotics several years ago. It was put in by a specially-trained nurse (in my hospital room) before discharge. There was nothing that looked like a port on my arm, just some clear plastic tubing--what was called a 'hep-lock' that I flushed with heparin before each infusion--and a clamp, looped around. I kept a knit cotton stockinette sleeve on it to keep it from catching on things.
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Hi, AusAla ~
You wrote way back in October:
>>My third one is inside of arm just below the bend of my arm (elbow). I think this is rare placement for port. But I love it! Never even know it is there. >>
Today, my onco was talking about getting my port, and I was sure he said it would be on my arm. Then I started reading here and thought maybe I'd misunderstood him until I saw your encouraging post. Thanks!!
I'm not looking forward to having this done, though, so I'm going to take all the "happy juice" (as tbird57 put it) they will offer me. And then I'll probably ask for more.
I'm to get mine on Jan 22...
Hugs to everyone,
Artemis0 -
I am getting a port Tomorrow Thanks to your great post it helped me make my decesion and not to be worried about it. I am doing 6 rounds every 3 weeks THC then herceptin for the year seemed like the intelligent thing to do the port.
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I had my port surgery today. This post was EXTREMELY helpful to me in the days before my surgery. Thanks so much for taking the time to post all this information.
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Thank you torchsong, I just had my port today and I am in more pain than I was when I had the lumpectomy and the lymphnodes removed. I was beginning to wonder if they broke my collarbone or something. It has been stiff and more painful as the local pain killer wears off. My left arm feels horrible. So I guess this will last a few days? ......Hi everyone I am new here and thank you guys for sharing. I hope in the days to come I get a little more cheery.
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Zoeyetta--Yes the first few days are hard, but it should get better soon. Most people I've talked to who have ports have agreed that once the healing is done, they can pretty much forget about it and ti makes chemo a hundred times (well, a lot, anyway) easier.
Hope you feel better soon!
Gentle hugs
Martha
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Thanks for all the info. I'm having a port put in in 4 days, good to hear the procedure isn't too tough. Hope things are going well for you. suzanne
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Sorry to hear of your discomfort, I'll be going through this in a couple of days. How are you feeling 2 days after your placement? suzanne
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I live in Albany, which hospital did you have your surgery in and where did you do your chemo and radiation? I'm going in on Tues. for a port insertion at St. Peters. Chemo to follow shortly thereafter and then radiation. What was your experience like? How are you doing now? suzanne
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excellent info to know!! My port was placed improperly also. Would've had 1st chemo yesterday 2/4, but couldn't, so back in hospital for replacement. A setback, but according to dr. 1 week missed isn't going to affect further treatment. I was hoping to know how I would've felt
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Thanks, Teena, for the detailed description of the procedure and to everyone for writing about your experiences. I'm having a port placed on Monday. Onc didn't think I needed it, but I have lymphedema in one arm and didn't like the idea of having just one arm for chemo and labs.
Jane
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Thanks again Torchsong, and I now see what you mean... I feel much better now. I get to start chemo this Friday on the 13 of Feb. Still mixed emotions but a little better. It really helps to be have this kind of forum.
Gentle hugs back,
Lynette
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I have to get a port put in again and had one a couple of years ago. It was so uncomfortable that I am not looking forward to it. I saw that someone had it put on her right side, I thought it had to be put on the left side over your heart. I have lymphadema on right arm so I don't know if surgeon will do it on that side. Also, I use to put Emla cream on top before I went for chemo and it really helped. I am wondering if anyone uses the Emla cream.
Take care,
Geech
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Hey Geech!! That's interesting about port on right side. I wonder if that depends on which breast has the cancer-if the port goes on opposite breast affected. I have my port on left breast because right breast is affected. With the lymphedema in right arm, I would say that you should not have BP taken on that arm. I need my pressure taken on my left side, so no lymphedema sets in on right side. What is Emla cream?? never heard of it.
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Hello
I just can't make my mind up. I am scheduled for a PICC on Tuesday I will be having chemo 2 hours every 3 weeks for a total of 4 treatments, The nurse said if it was her she would choose this over the port since its short term, I'm having second thoughts????
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Hi All
I just had my port placement today and it was virtually the same process as outlined by tbird57. I have a Deltec PowerPort-A-Cath, which comes with a small spiral instruction guide and ID tags. The only thing that was different was that I oppted for the happy juice. I got a local anthesia, but then was given a very heavy sedative. One nurse said it would a little bit like dreaming and then you forget the details. For me, it was just like being under general anhesia; one minute I was staring at the ceiling and talking to the nurse, the next I was in recovery. The time it took to get dressed and leave was surped by the prep the nurse need to do for the port - flush, insert needle and dress the site. Although I felt good, I never would have been able to drive away, so my husband was there to escort me to our next appointment - chemo! Having the port (even new and bit sore) was awesome for my first chemo treatment. I have a perscription for pain meds on an as needed basis and I have a bag of ice on my neck where I have the most discomfort. The nurse I saw said that PICC lines are exposed, create more opportunity for infection and are really better for repeated access over 1 week or so, not so well for 9 - 12 weeks of acces. The port needs be flushed every couple of weeks to prevent clots, but I dont know what kind of maintenance the PICC line needs. In addition, the port is completely beneath the skin, so once it is healed, I can take showers, baths, swim etc..no problem.
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I had my port inserted on my right-side yesterday (left breast lumpectomy). My experience with the sedative was much like Ginagina's: one minute I was awake, the next I was in the recovery room. I denied needing any pain medication because the drugs are always too strong for me. By the time I got home, it felt like a horse had kicked me in the shoulder. I took an Alieve and that managed the pain just fine. The drugs, on the other hand, took the better part of the afternoon to wear off. I went to sleep around 7:30PM and easily found comfortable positions on my back and left-side. Today was a great day, virtually no discomfort at all.
Based on some of the comments here, I planned to return to work after the port insertion, but, for me, the drugs were too powerful. Frankly, not being able to return to work was the worst part of the whole procedure.
Cheers!
Cloud
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I got my port on Wednesday of this week. I will be doing taxol and herceptin for 12 weeks and then herceptin every 3 for rest of year so needed a port, especially since it takes at least 2 tries to get a vein each time I have had surgery. This makes the 4th time in 6 weeks. Excisional biopsy on Jan 15. Cancer with no clear margin. Re-biopsy on Jan 29 with SNB. Clear nodes but still not clean margins.l Re-biopsy on Feb. 9 Clean margins!! Her2+ so I need chemo according to onc, so I need port. The hardest thing about any of the surgeries has been that all my lymph nodes have swollen up every time they used sedation and local anesthesia. They hurt worse than the surgery. Same thing happened with the port. I am awake and then wake in recovery to find port in and also the Dr had gone back and drained some fluid off at the BC incision on the other side (I am told port is always the opposite side of your surgery unless you did both sides). Now both sides hurt. Each day the port incision and neck are better but I tend to guard my neck , so those muscles are stiff. They also warned me that since this was my 4th trip in I would not heal quite as fast. Lymph nodes finally went down on Friday. I am still sleeping in a recliner as both sides are too sore yet for sleeping in bed. I can't handle sleeping on my back. Don't feel like you are only ones that have different symptoms. I went home and slept Wednesday and went back to work Thursday for 5 hours before I was too tired and went home. Fortunately I work part time and any time store is open I can work, so I worked part of Saturday to catch up. Annette
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I will add a couple of things here from my personal experience. Each time a vein in your arm is used for blood work or IV, a small scar forms (was told this by several doctors and nurses). If you have lots of these things done, it can make getting a good vein (place the works) harder. Usually they have to go higher and higher up your arm to get a good place. You may have seen some getting an iv on the back of their arm, near the elbow - I have.
As far as flushing - my port needs to be flushed (not by me) once a month. My treatment is every 3 weeks, with occasional tests or blood work in between, so I do not need an extra appointment to have it flushed.
I always ask that they flush it SLOWLY, or there is an awful taste in my mouth that lasts for hours, like licking the bottom of a dumpster. When my port is accessed (needle stuck in it) there is a momentary pinch - no need for a numbing cream. Same momentary pinch when the needle is removed. A small square of gauze and tape are put on after the needle is removed. Ask that they put the tape "north/south" or it may end up in the 'cleavage" area.
If you are concerned where they are going to put the port - draw your bra strap on your chest beforehand. Then it will not rub or irritate after. I had left side dx, port on right side. If they put it IN the breast tissue, I think a mammo would be impossible if it is needed before the port comes out.
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