Port-o-caths

Notes on port-o-caths:

When I was first diagnosed, a technician warned me that chemotherapy will actually eat away your main arm veins if administered through the arms. The veins will re-grow, but only as a network of thin, "spider" veins. The alternative offered by my oncologist was to have a port surgically implanted into my chest. The port consists of a round metal box (about the size of a small spool of thread) with a special rubber seal on the top, connected to some plastic piping that is threaded up under the skin and hooked into the jugular vein in the neck, just above the heart. This way, the chemo needle is inserted through the skin on my chest, through the rubber seal, and the drugs flow into the bloodstream and drop directly into my heart.

The last time I went in for chemo, there was a tiny blood clot clogging the port so the nurse couldn't get a blood return. They had me do "port calisthenics", hopping up and down and waving my arms over my head, but to no avail. Finally they injected a blood thinning drug to dissolve the clot, and after 45min. the port was open again, so they were able to proceed with chemo. Because some of the drugs are vesicants, which cause terrible tissue damage if they escape the veins and touch any other body tissue, nurses normally won't administer chemo unless they are absolutely sure they are in the vein. (A blood return is the best way to be sure.)

Does port access hurt? Yes, but not too much. They usually use a small shot of lidocaine, which stings, to numb the area before pushing in the larger chemo needle. You can ask for Emblen cream, which will numb the area so that you don't even have to endure the first injection. I recommend the no pain approach, since there are so many other things that hurt in the cancer treatment process that are unavoidable.

After chemo is completed, the port can normally be surgically removed. The surgeries are considered minor and take only an hour or so, and I was able to return home the same day.