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: http://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,
Love, love, love - that is the soul of genius. Mozart
5/2008, IDC, <1cm, Stage IB, Grade 3, 0/2 nodes, ER-/PR-, HER2+
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