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PORT PLACEMENT - Detailed description of process

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  • katinsak69
    katinsak69 Member Posts: 1
    edited April 2010
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    I just had my port placed today.  They put me in a twilight sleep which is not really a sleep at all.  The procedure was no big deal until I got home.  God....I hurt so bad...more than with the mastectomy.  Before I left the place where they placed it I has the Dr for some Vicondin for possible pain.  They wouldn't give me any and said "just take tylenol", "you'll only be a little sore".  I have a high pain tolerance.  This has incapacitated me.  I am on the verge of tears, and it takes alot for me to cry.  Fortunately, I had 3 Vicodin pills left.  Left a message with my Plastic Surgeon to see if he would refill his prescription for me after I explained the circumstances.  I am livid that the pain this port causes was treated so casually.  I am having my entire family for Easter because I start chemo on Monday after.  I'm not sure I can even clean my house at this point. I know I won't be able to wear a bra.  No one thought to tell me I wouldn't be able to put a bra on.  Plus, I am not to shower for a week (oh...that wasn't mentioned prior to the placement)  I am so angry.  I went back to work a 2 weeks ago.  Now, I wish I had stayed on disability for awhile longer.  I am in a commissioned job and now wondering how the hell I'm going to be able to drive to appointments and with no bra.  I am definitely reporting this to my Onc.  I am second guessing recommendations to have a port placed.  Based on what I have read in these posts, I am not the only one who was blindsided by the effects of port placement.  Having a port in sure better be worth it.  I am so not happy now. 

  • Julia123
    Julia123 Member Posts: 1
    edited April 2010
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    Good description! I had mine done yesterday, and generally I would say the procedure was very similar to yours. Like you, I was anxious to get home. I hadn't really researched it prior, and though I wouldn't say it was "bad", it was a little more than I was expecting (closer to surgery, however minor). I have been surprised at the level of pain/soreness so far though. Not so much the area itself, though it is certainly sore, but mostly my left shoulder/neck/back. Of course, I've had issues off and on with my left side for years to a herniated disc (car accident years ago), so I can only think that the process just irritated that pre-existing condition.

     I asked for a pain script to take home though, because as soon as I woke up I was feeling the significant shoulder/neck pain, and that has helped immensely.

    Sort of a shame...I'm roughly 3 weeks out from a bilateral mast with tissue expanders, and positive lymph nodes were taken from the right (hence the need for the chemo), so now, my previously "good" side on the left is messed up! Ha! Oh well, this too shall pass....

  • ThereIsHope
    ThereIsHope Member Posts: 18
    edited April 2010
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    I just want to say that I am very thankful to have my port.  I began chemo this past Tuesday.  My veins are always a problem to find and the process was so much easier.  Just a slight pinch and the needle was placed in the port!  I did have a little discomfort during the healing process after surgical placement, but that is to be expected.  No pain meds needed. Now, three weeks later, I hardly notice it and can even sleep on my chest.  I am so glad that my onco had my surgeon give me a port.  Anything to make this journey a bit easier is welcome!  I need to add, however, that everyone's experience with this disease and the associated treatment is different.  It is no comfort to have someone tell you how wonderful something has been for them when your personal experience has been pain and problems.  For those who have had that happen, I hope your recovery is better each day and that you will soon be without discomfort.  Thank the Lord for medications in these instances! 

  • forestladybc
    forestladybc Member Posts: 1
    edited April 2010
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    Here in Kamloops BC  it is day surgery to have the port put in.  Mine was put in March 23 had my first chemo treatment on March 26th.  I can feel the port and the tube if I stretch , cough or sneeze. Tis a tight feeling.  No pain just like a pulled muscle as some have said.  I thank goodness for these boards so I can see how others are fairing with the same treatments I am getting.

  • Terry731
    Terry731 Member Posts: 3
    edited April 2010
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    Apparently my port was placed a little too deep and the onc nurse is having much difficulty connecting to it. The first time she poked around a few times and then gave up and used my veins after seeing the look on my face. Last week she said she needed to use a bigger and longer needle (I envision a biopsy-sized needle but I cant bring myself to look at it!), which hurt like hell (BTW ice doesnt really numb the skin too well) and then she moved it around until she finally connected with the right spot. Thank goodness because I wanted to just smack her! Poor thing, I think she was more upset than I was. She;s really a pretty good nurse and felt bad that she was hurting me. Next time I have some numbing cream to use and I pray that it will all work out better! Maybe I should take a sedative!! lol

    I have to go through this weekly with my Herceptin treatments and every 21 days with the chemo. I can tolerate the treatment itself pretty well, but the whole needle in the chest thing really makes me want to scream! I would take the veins any day but apparently it would be too much stress for them. I hate it!

  • juli0212
    juli0212 Member Posts: 801
    edited June 2010
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    I had my port implanted during my second cancer surgery (tumor had not fully been removed), and it was a port-a-cath.  That was in 2006, it stopped working ( a sheath had developed ) in December, we put in mega-blood-thinners, had it tested at the hospital, and it worked at that time, then stopped working again.  Because I have lots of testing done, we opted to take that port out and implant the 'power-port'.  The original port-a-cath was placed in the LEFT clavicle area (cancer was in right breast).  This time, power-port was placed on right side, as described by first post above.  I will ALWAYS want the port, and will replace it if this one starts to fail also.

    Due to vascular constrictors I take for other health issues, I have no veins to choose from, and having had lymph disease, we only have one arm to choose from when I had to have the MRI/CT/BoneScan/Bloodwork taken.  It would take basically an hour to find a vein after the hot packs, running arm under hot water, etc...me drinking mega-water ahead of time, etc.

    The port is a blessing to me, I want it ALWAYs, and the power-port will now allow them to use it for the CTs, MRIs, Bone Scans, blood labs, it's awesome!   One of the bright spots of having it implanted for the chemo treatments I had for 5 months!   :)    ~juli

  • Eileen101
    Eileen101 Member Posts: 9
    edited June 2010
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    Great idea about the vertical placement. I wear tank tops all summer. I'm getting my port soon. Thanks for the suggestion.

  • hmh23
    hmh23 Member Posts: 50
    edited June 2010
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    I'm here for the first time and thought I'd pass along a suggestion that was given to my prior to my port surgery.   The surgeon and nurses both thought it was a great idea.  Using a permanent marker, trace an outline where your bra strap is located and the doctor can then avoid placing the port along that area.  Some doctors really don't take your bra into consdieration and put the port wherever it is easiest for them...by doing this you can avoid a port placement/bra strap problem.  Heather

  • mammons
    mammons Member Posts: 3
    edited June 2010
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    I am new-lumpectomy w/ removal of 8 lymph nodes on April 23, 2010.  Stage III Her2+.  That's all I know right now.  So much of the lingo is new to me, still learning it.  I had my first onco visit last Tuesday and had port inserted today.  The procedure was not too bad, just took a long time due to a backlog at the hospital.  It's a little tender tonight and my surgeon gave me Hydrocodone just in case-only 12 so he obviously thinks I won't need much.  I have a pretty high tolerance for pain, so he's probably right.  I took one tonight so I can sleep but I plan on going to work tomorrow, so nothing stronger than Aleve.  I do appreciate all the posts here. Being a newby, it is helping me to learn so much.  Yes, I'm scared, but I have a strong faith in God which has helped me cope with this.  I'm rambling and I'm sorry about that, but I have so much going through my head, that it is difficult to produce a cohesive post.  Thank you all who have shared your experiences-it helps a lot.

  • kira1234
    kira1234 Member Posts: 754
    edited July 2010
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    I'm not sure this is the right place to ask this, but here goes.  I just got a call from the hospital in preperation for my surgery  next week.. I was told the the BS has ordered a port to possible be placed at the time of lumpectomy with sentenal biopsy.  Has anyone else had this done at the same time as this surgery? He never told me this was being considered.  I'm afraid it put me into tears.  The last he told me he was considering the Mammasite radiation and more than likely would not need cemo. Plus the hospital new nothing about the Mammsite plan. The lady new I was at my wits end so she asked me if the BS has given me anything for my nurves, I said no so she told me to call him.  When I did his idea of something to calm me down was take Benadryl.  I almost shouted at the poor nurse.  I have high blood pressure and she wants me to take Benadryl.  Finally he said he would order something, not sure what.

     Karen

  • coss
    coss Member Posts: 8
    edited July 2010
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    Sounds like they're jumping the gun on this one.  Do you even know for sure you need chemo? And you're Her2- so won't need Herceptin - - that was the only reason I had a port put in since it entails a year of infusions. They can't put in a port without getting your informed consent. I'd be calling the BS office for clarification. And yes, they should give you something stronger than Benadryl if you need it. It's stories like this that make me embarrassed to be a nurse.  The hospital was out of line in discussing this with you. I had my port put in 2 weeks after my lumpectomy when we were sure I'd need chemo and Herceptin.  Most people can get through just chemo without a port. 

  • kira1234
    kira1234 Member Posts: 754
    edited July 2010
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    I have no idea if I need cemo, the last I knew he didn't seem to feel I would need it.  I know he ran some additional tests on my biopsy hoping I could be part of a study he is in,which I was unable to be a part of.  Is it possible something showed up in those tests?  I haven't talked to him except for the first visit.  I do have a meeting with him on Tuesday, and you can be sure I will be asking many questions.

    Thanks Coss.

    karen

  • coss
    coss Member Posts: 8
    edited July 2010
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    He might be referring to the Oncotype test which helps determine if chemo would be of benefit to you. With a small ER+/PR+/Her2- tumor, I would definitely ask if that's been done. You may be able to get away with just radiation.  Good luck.

  • MaryNY
    MaryNY Member Posts: 486
    edited July 2010
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    If I knew then what I know now, I would have chosen the option to have a port installed at the time of the lumpectomy, thus killing two birds with one stone and having one less round of anesthesia and recovery from it. I have difficult veins and having a port that was one less thing to stress over each time I had chemo. The port was used for blood draws too. I was really grateful to have a port.

    However, in your case where your tumor is so small, they probably aren't even sure that you will need chemo, so it does seem like the BS is getting ahead of himself.

  • kira1234
    kira1234 Member Posts: 754
    edited July 2010
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    Is it possible he will make the decision to use the port if some of my lymphnodes a positive.  I know the nurse told me if the sentinal lymphnode comes back positive he plans to remove them all what ever that means. I plan to ask him about that as well.  I sort of feel I would like to have the choice to have that done later, plus I somehow feel if it has spread I would like to at least discuss having a  mastectomy and if I do go that way the lympnodes can be taken at that time.

  • coss
    coss Member Posts: 8
    edited July 2010
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    There are two separate issues here. It is standard of care to remove more lymph nodes if the sentinal node is positive. Usually they'll send the sentinal node to the lab while you're under so they can take all the nodes in one surgery. You can read more about it on this site. The port is placed by a surgeon but chemotherapy decisions, including whether or not you'll need a port are normally made with a medical oncologist. It sounds like you need to clarify these issues with your BS.

  • kira1234
    kira1234 Member Posts: 754
    edited July 2010
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    Coss,

    Thanks for all the info, it sort of makes sense to me what he is doing.  He is a BS/Oncologist.  Should I also talk to an oncologist as well when he has both knowledges? 

    karen

  • coss
    coss Member Posts: 8
    edited July 2010
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    I've never heard of a breast surgeon also being an oncologist.  They are both subspecialties of medicine. Most of us had a BS, a medical oncologist for chemo and hormone therapy if needed, and a radiation oncologist if we had rads. I'd look for a regional cancer center in your area to get a referral if your BS office is not doing this for you.  They should have done this already so I'm a little confused. I met with all 3 docs before doing anything.     

  • kira1234
    kira1234 Member Posts: 754
    edited July 2010
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    Ivorymom and Coss, thanks so much for the info.  I am going to a Dr. right near Moffit in Florida.  I think I will give them a call to ask for the name of a good Oncoligist and the name of a radiolisgist.  I spoke with my kids and husband last night after your email Coss and we have decided if he fights my choices we will walk.  As many people have been saying my breast cancer has been more than likely growing here for years so I should have another couple of weeks to research if uncomfortable with this man.

    I know some of my problems have been coming to turms with my own fears and unreasolved feelings about my own mothers death from breast cancer 5 years ago.  She suffered more than I even want to remember.  I thought I had handled it but now realize I never evened cried for her and now I am crying for her and for me as well.

    Karen

  • kira1234
    kira1234 Member Posts: 754
    edited July 2010
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    I have to say you ladies have been so helpful to me these last few days. I am SO GLAD I got on this discussion board before I spoke to the Dr. next week.  You have really opened my eyes.  I'm not sure why I have just let him decide what should be done without questioning him.  It really isn't like me at all. It's almost like I've become the child in this situation, and I don't like it.

    I checked out some local Radiation Drs.  and have found 1 who is listed with Moffit who works with my insurance company. He has a good rating from what I could find.  I live in a very small town so I am very limited in my choices.  That is why I ended up driving 3 hours to the Dr. I am using. That being said I will find another if I don't get the answers I want.

    In a way I'm glad the nurse brought up the port and the fact he will do a complete lymphnode retrievel if any nodes come back positive with the first procedure it woke me up and got me asking questions I should have asked long ago.  I wasn't even set up to have a visit with him before the operation till those "pesky" little things came up.

    Again I am SO GREATFUL for your help.

    Karen

  • imbell
    imbell Member Posts: 61
    edited July 2010
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    LOL. Thank you for the info. I went in at 6:30 A.M. today.. Got changed. Wheeled me to the operating room. No IV yet cause the nurses tried 4 times and couldn't find a vein. Thank god for the port. Got my IV placed in the operating room by a ICU nurse. Last thing I remember was "I am going to give you a shot. You may require another". Out like a light for an hour. Had my husband stop at Wendy's. Home by noon. A little more sore than the last time. I am running out of chest.

  • MaryNY
    MaryNY Member Posts: 486
    edited July 2010
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    immarybell: Was that visit for port removal? I'm having mine removed in two weeks and although I had sedation when it was being put in, they told me they would just use a local anesthetic for removal. And that I could drive myself there an back. It seems they knocked you out completely. Sorry to hear you are more sore than the last time.

    Karen: I hope you get all your questions answered before you proceed. If possible, you should try and get a second opinion from a BS. I know if you live in a rural area this might be difficult but would be worth it for your peace of mind.

  • Ondagrow
    Ondagrow Member Posts: 133
    edited July 2010
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    My port was inserted Monday when I woke up I had two incisions covered with gauze...  I wrote in a previous post that they tried to put it in my neck and then decided on chest (I initially thought the neck rejected the device)...  I now know they begin the process by threading the catheter into a large vein in my neck... and then pushed it in above my heart... (Just like you wrote in your post TBIRD)

    That is why my neck hurts and there is some bruising...  My neck is so stiff...  I just put a heating pad on neck area and I have found relief...

    The actual site where port is... does not really bother me...  I am ready for chemo... 

     

  • myesan22
    myesan22 Member Posts: 5
    edited August 2010
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    Thank you for this information. I am going to have my port placement tomorrow and this is really helpful. Glad you came through o.k. and wish you well through your treatment!

  • MaryNY
    MaryNY Member Posts: 486
    edited August 2010
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    myesan: good luck with the port placement tomorrow. I had mine placed in October of last year and had it removed three weeks ago. I was so glad to have the port during treatments as having them stick me in an effort to find veins was one less thing to worrry about. Make sure your onc gives you a prescription for lidocaine cream. Each time you go for treatment, put a dab of the cream on the skin above the port, cover it with a little piece of plastic film and you won't feel a thing when they access the port. That stuff is magic!

  • MStrance
    MStrance Member Posts: 2
    edited August 2010
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    I wish I had been offered the oppurtunity to have my port placed at the time of surgery.  Just when you are beginning to heal from one set of scars, you have to go thru another.  I knew ahead of time that I would be needing chemo.  My worst complaint about the whole process, I can feel the tubing in the vein in my neck when I sleep on belly, so I don't sleep on my belly anymore.

    Kira - My best advise to you is get second, third, and maybe even fourth opinions!! This is a traumatic enough experience w/o having faith and confidence in your surgeon.  I live in the Chicagoland area and my surgeon is from one medical practice about an hour away from my home, my oncologist is from another practice about 10 minutes from home - shop around for the people that make you comfortable, you will need to have a relationship with these people that extends beyond your initial surgery. 

    Another bit of advise, bring someone with you to every appointment.  They can be your "slightly less emotional" set of ears.  I didn't remember half of what the doctors told me in the appointments and it was so helpful to have that second set of ears to discuss options with when I was less emotional and ready to listen.  You might want to bring a girlfriend, cousin, or (in my case) sister in law, rather than husband since he is likely to be just as emotional as you are in his own way.

  • nanabanana
    nanabanana Member Posts: 2
    edited August 2010
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    I will have my port put in Aug. 24th and this is very helpful to know what to expect. I really don't want to have a port but the nurses say it is neccessaryFrown
  • artemis
    artemis Member Posts: 105
    edited August 2010
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    nanabanana ~ *hugs*  Some chemos are very hard on the veins, so having a port helps protect you.  And it's also good to know that you'll have only one stick to start your IV:  no looking for veins, no poking around...one stick, and that's it!  Smile

    That said, my port did sort of creep me out.  For a long time, I couldn't stand to look at the site much less touch it...ewwwwww!!  But after a while, it was no big deal.

    Hang in there, sister.  You can do this.  *hugs, hugs, hugs*

  • kira1234
    kira1234 Member Posts: 754
    edited August 2010
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    Well I had the surgery and a 2nd to correct the margins. No port placed Dr. was "sure" I would not need chemo! Wrong, my oncotype test came back 24, so here we come. I guess 57 is young in the breast cancer world. I'm doing TC 4 times. So your opinion guys, do I need a port or not. I talk to the oncologist on the 22nd, and will have a better idea what all is going to happen and when.

    Karen

  • coss
    coss Member Posts: 8
    edited August 2010
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    I'd vote no.  I had one because I was getting weekly Taxol and a year of Herceptin.  With just 4 doses I don't think it's worth it, assuming your veins are okay.