PORT PLACEMENT - Detailed description of process
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Good luck, April
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No vaccines were mentioned... but I had pneumonia last year.. I think. Had flu this year. And saw my GP/internist and asked for a shingles shot because I heard that shingles risk will be greater with chemo . So I've already had to be very proactive from the get-go.
I had my port procedure yesterday.
I had to call up the day before to get the pre-procedure info because firt call was when I was on the line with another doctor and they never called me back. I still got conflicting info as to whether I can take my diabetes metformin for DAYS after or not!!!! This is a bit important!
I arrive and talk with the surgeon. I ask if they have bard mini power ports but he says they dont, only regular sized one and has big spiel about how small one block up or are hard for techs to find. I tell him I dont have a lot of fat but he says that I could get fatter!!!
I get prepped by one guy and say that I'm disappointed in not getting a mini port. He mumbles that they tried ordering them but the front office (of my large hmo-like all in one place provider DENIED them!!
... I am SO glad I'm switching healthcare providers in January! !!!
They leave me alonebefore giving me sedation and paper and oxygen tube are rubbing on my nose and driving me crazy. I start shifting around to try and rub it on something. They come over and tell me to stop moving. I tell the I have an itch and finally one guy gets some gauze and rubs it under my nose. Theu have to re-do the papers covering my face just in case... this time they use a bar to lift it a little off my face, which is a lot better. I tell them I'd probably be less twitchy if they started the sedation instead of letting me just lie there. I can usually stay stillfor hours.. but they really left me alone for a bit too long with paper, tubes and my hair tickling me!
So... sedation doesnt really affect me and I'm chatting all through the procedure. I feel all the pricks and burns but I have a decent pain threshold. Its nothing too painful... but I asked why I was totally out during my colonoscopy with twilight sedation and they said, "oh, they use a LOT more sedation than we do!"
I was fine after the colonoscopy andwouldn't have minded being out... particular when I felt a HUGE gush of warm blood! No one said anything and it stopped right away... but I found my hair all stuck together at the back of my head when I woke up this morning! NOT easy getting all that blood out with a sponge bath!
They had to call surgeon out to re-bandage me in recovery because I was bleeding. But got sent home after standard hour or two of recovery. I never was asleep, even though I had to get up early after 3 hours of sleep he night before. And no coffee or food either!
I went to sleep last night at 7pm because I had been up since 5am. I took a tylenol just in case, but was so exhausted that I slept all the way to 7am this morning.
I forgot to bring more tylenol with me today, but didnt really need it. I've big bandages on my neck and upper chest because of the bleeding thru thefirst bandages. Its tender and pulls a bit at neck and shoulder, but not painful. I feel a heat and a throb there now and then... hopefully its not all red and nasty under there! But I have first chemo tomorrow so hopefully they will use the port (surgeon said some tchs are afraid to use newly placed port! I hope I wnt have that problem!). They will also change bandages then and hopefully check to see if it's healing ok!
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PET SCAN... did it out of pocket today. My provider was saying.. oh we cant fit you in or we don't do PETS right after a port... etc. But since they haven't given me any MRIs or bone or brain scans ... and no SNB.... 2nd opinion onco. said IMPERATIVE and he's a top UCLA-trained onco. who also teaches part time as clinical professor at the med school AND he is who I am switching to the moment my new insurance starts in January! !!
He calls me up rigt after the PET. Good news: Looks like no organ involvement. Bad surprise: coronary artery calcification! I need to see a cardiologist!
*sigh*
They need to get in line...
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April,
Glad to hear from you and that you are recovering from the port installation. I must say that I am happy you are switching providers too as your experience has been very different than mine. I know there are different health plans through Kaiser, so I'm guessing mine plan covers more than yours. I have never been denied any treatment or test (and I have no deductible, minimal co-pays and have no co-pays for scans). Like all teachers, I complain about low pay, but I guess I can't complain about health insurance. I hope all goes well with your chemo and you have an easy time of it.
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Yeah--the plans are all different. I'm actually paying a LOT because it's Individual and pre-Obamacare and I was older and had Type 2 Diabetes. I was coming off COBRA and many bad HMOs through work, so KP was an improvement.
I should have re-vised my plan when Obamacare started up, but I didn't, so my plan is old and grandfathered in...
I switched to a Platinum Plan with a PPO and am actually paying LESS. It's kind of crazy!
I'm wondering if my current provider is cutting back a bit because of the obamacare changes...? Insurers have to take anyone without knowing if they have pre-existing conditions and that can be expensive...!
I had/have $10 - $25 copays, no deductibles, pharmacy copays and but only certain drugs covered partially. I've been with them since 2008.
They are very friendly and try to help, but I'm really discovering a lot of short-comings with the BC diagnosis... Hopefully things will be a bit smoother with my new MO in January! So far I've totally agreed with his recs, and he got me the PET within days, and not even at the center where he's at, but at a less expensive place because he knew it was out of pocket. He also will see me again before Jan. and my new insurance, to make sure the transition is good. I was going to over-lap and pay my current insurance for a month just in case but I'm getting so annoyed, I'm not sure I will now...!
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The world of medical insurance is more puzzling than airline fares!
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A friend of a friend had bc and stuck with (same provider as I had/have) because she had it through being a teacher, too. She said they were great... Only bad thing was that the reconstruction surgeon made a mistake that messed things up. She said he even called her up and apologised for the mistake. So she's a bit yes/no regarding them. Of course, mistakes can be made under any plan!
I'm just lucky that there's an open enrollment and I was paying for individual anyway... I'm self-employed, (illustration/art free-lance), since my days in-house, so I haven't had job insurance since 2008 and my current provider... They were fine all those years. But then I was a bit lower-maintenence.
Now I've got bc, a thyroid multi-nodule goiter that needs taking out, and just found out about the coronary artery calcification! Talk about a lot happening at once! Before I got older I'd never had ANY medical procedures and never been in a hospital. Oh, well! At least I can get to a care without breaking the bank (so far!).
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I'm getting my first chemo now. The port is working. They gave me some lidocaine cream but waited less than an hour... but I didn't feel a thing! Yay!
I have bruising around the port but it's not swollen. They told me that a big swollen hematoma formed over the port would make it impossibe to use util it went down, but that is rare.
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For me, the EMLA/generic cream is working fair after 20 mins. 30 - 60 works max and after 60 it starts lessening.
See - it's not bad!
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So, so much better than accessing a vein!
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Yes, better than a vein. The PET required interven8us stuff and the guy used a vein on my right wrist and I could ony scribble badly on the forms they had me fill out and sign... my poor veins are getting a workout even with the port.. so at least they don't have to deal wih chemo as well!
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if you ever have PET again, they can use the port
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IF it is a Power Port, they have an RN with experience with using a port and if they have heparin to replace it. I had a CT done at the local hospital instead of where the other scans had been done. It was a 'Comedy of Errors' or the 'Keystone Kops'. They had no numbing spray or cream. They didn't know that the heparin had to be flushed on through before starting 'anything'. They didn't know that the heparin had to be replaced. BUT they wanted to use it as 'training'. I have great veins so the easiest would have been to just use a vein. Thankfully, my Cancer Center is adjacent to the hospital and they did finally call the Center. I was scheduled for my last Taxol as soon as the CT was finished so they were told to put some saline in, leave the needle to in and for me to come directly to them without any stops on the way (it was an elevator ride down 3 floors and probably 500 ft walk. One of the Chemo RNs was in the CCI waiting room, waiting to grab me and get me in immediately. Apparently a lot of 'Kim Chee' came down and education was done in the hospital.
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Yes, true on all counts. I have no verification, but I'm told that most cancer patients get power ports these days. My nuclear med dept. sends me an email reminder a few days before a scan and asks if I need my port accessed so I'm good. My blood draws are done at the infusion center so the port can be used.
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It is my understanding too that most ports are Power Ports but need to be sure what 'you' have. I have never been asked if I needed an access to port for scans - other than the Keystone Kops at the hospital who wanted to access it. I still have great veins, thanks to my port, so it's easier to just use vein for me - not true for all though. I've only had one draw done via port as had draw scheduled for the same day as port flush so RN went ahead and did the draw at the same time.
Got a question for those who get flushes - what 'bandage' do you need after the flush? I get a bandaid and only have a small 'dot' on it when I pull it off when I get out to the truck.
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Band aids irritate my skin so they put gauze and paper tape over my port after it's been accessed. But if not for the irritation, band aids would be used.
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At the infusion clinic they covered my port with gauze and paper tape because I only had my Port put in 2 days ago, so it's still healing. I have no idea what they will use later.
When I asked what kinds of ports were available they told me they were all Power Ports (Bard)(but no mini, only some low profile at my healthcare place)... so I guess that's what's mostly used these days.
I think there are some scanner fluids that are radioactive or something like that, which shouldn't go through ports--I THINK the guy doing my CT said that, because I mentioned I was GOING to have a port put in, but he said they wouldn't use it anyway. Not sure if he really knew what he was saying... I often get conflicting information!
The guys who put the port in said that there were some people who were just unfamiliar with ports and wouldn't use them. Infusion center people know, but not everyone else. Haven't tried that out to see if it's true or not.
Is it somewhere in the Port literature--what Ports can be used for and what they can't?
Ports are OK for MRIs, right? They say no pacemakers or any metal... but I know people get MRIs with ports. The metal is different? If so, why don't they use it for pacemakers?
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The radioactive trace material that is used for PET scans can most definitely be given through a port. That is the only way mine has ever been done, but, as mentioned earlier only nurses trained to access ports can do it. I am always asked if I will need port access so that the properly trained person is available (same reason I have blood draws in the infusion center, not the lab). So yes, it is true that those who don't know, don't know. Techs, be they in the lab or those doing scans, cannot access ports.
Your port is mostly titanium so there is no issue with MRI's , nor going through airport scanners. I was given a small card stating I have an implanted medical device to carry in my wallet, but no one has ever asked me for it. Go to the Bard site for complete info.
PS: the bard slim is the petite model!
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OH! I should have insisted on the slim model, then. But the surgeon kept saying that ports could get lost in some people and make those accessing them nervous... but it sounded a bit like a line to me. I told him I'm not exactly fat in that area. But he said he usually only put the slim ports in super skinny women. I guess I was too tubby for him!
Anyway, my sister said the port doesn't look bad... but it's newly in and I'm sure I'm swollen in that area. Oh, well. It's not like I'm posing topless for magazines! I can live with it. At least my bra strap isn't hitting it! And so far it's not painful and is working, so it's all good.
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April,
The decision as to what type of port to use is up to the surgeon, not the patient. They have the knowledge and experience to decide what will work best for you. When you originally asked about ports, myself and others simply responded with info about our own ports. We did not choose which one we got! I know that I would not have wanted to choose nor "insisted" on a particular port, as that is not my field of expertise. It's not like picking out options on a new car:)
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exbrnxgirl -- Yeah. I let him put in the port he thought was best. But I'm still in full-on paranoid mode after my recent experiences, so I'm still double-checking on everything, JUST IN CASE. And I'm being a bit of a pest in asking for as much info as possible. But I do see that they aren't all incompetent people--I trust them to some extent. But I just like to be sure I'm getting what works for me.
Anyway, the port is in. It works. It doesn't hit my bra strap--although the seat-belt hits it a bit--I'll have to buy one of those straps to keep the shoulder strap more towards my shoulder--no problem. It seems to be healing well--I'm just waiting until I can shower again!
I didn't throw up after chemo... so far! But Neupogen shots start tomorrow... that will be interesting! I've got stuff on hand to help me if I get any aches and pains, so hopefully that won't be bad. And keeping white blood cell counts up is the important part! I'm happy so far that I haven't had a terrible reaction to chemo, since I'm going to be having 5 more cycles...!
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April,
It's good to double check things, ask questions and gather info. Just keep in mind that there aredifferent approaches, no one "right" approach and lots of things still unknown about bc. So, while one doc may recommend xyz, another might not. And my personal mantra, more is not always better!
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Well, the port's in and works, so that's the important thing, I think. I'm definitely glad to have it, even though it's weird to have something implanted in my body. It is still a little bruised and sore, but it didn't hurt at all putting all that chemo through it. I'm totally grateful for that!
I'll settle down a bit, as far as second-guessing doctors, now that things are rolling along and I have other things to worry about, like getting through chemo!
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so far I've had a ton of blood draws and IVs ...but no one outside he infusion clinic uses the port. I mention that I have it but they keep saying they aren't supposed to use it.
Is this common? The guy who did my port placement said most people weren't used to ports and just use the veins instead.
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April , The doc that did your port placement was correct. But if you are in a hospital or multi- use facility ask for1. someone from the IV team be requested
2. That a port certified nurse from the oncology unit be requested
If they have these folks present in the building you are in be insistent. Myself, I have very few arm veins that are accessible. For you this is the beginning.
Others may have a different opinion. wait and see if someone pops in
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April,
I agree with sas. Anyone with a port needs to understand that only those trained to access it may do so. At my facility that would be only nurses certified to do so, no lab techs, imaging techs etc. Because of this, I notify nuclear medicine before scans so a certified person is available. I also have my blood draws done at the infusion center, where all the nurses are port certified. Hope this helps
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thanks.... I am being poked full of holes and currently have a painful potassium drip going into my arm... agh.
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april - it is less critical to have your port used for routine stuff because you have not had surgery yet that increases risk of lymphedema. Many who want their port used for scans and IVs have already had breast surgery and lymph node removal so are trying to minimize that risk.
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okay. But my veins are pretty sucky. I only have one easy arm vein. The others people need to hunt for and end up on hands. I mm just concerned about the one vein going bad... but so far haven't kicked up a fuss... although I'm just a floor up from the infusion clinic...
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April,
If you are a tough stick, have them access your port in infusion and then go to where you need to be. This is easily done. My feeling is that if you've got a port, use it!
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