Port Removal

At the very end of my last meeting with my oncologist, I remembered to bring up the subject of my port. A port, or Portacath, is a surgically implanted device used to provide long-term access to a central vein for treatments like chemotherapy, blood draws, and infusions. It consists of a small, sealed chamber (the port) placed under the skin, connected to a catheter that runs into a large vein near the heart.

I had one put in about two weeks after my diagnosis. Between the immunotherapy treatments and blood tests, I knew I would soon look like a heroine addict if I relied on IVs. Plus I react badly to IVs. I have little roly-poly veins and technicians often hit valves that blow out the IV and make me extremely nauseous. Once at the cardiologist for a stress test, the nurse botched the IV and I threw up so violently that I wet my pants. That's definitely not the normal procedure for inducing stress. this would be my most embarrassing medical moment except for the time I threw up at the pediatrist --- not because they were doing anything to me -- but because the doctor was describing the draining of my wife's blood blister in too much detail. Needless to say I'm a bit squeamish when it comes to blood and guts.

The oncologist said I would not have a lot of use for the port moving forward. My colitis and pancreatitis had wiped out immunotherapy as a treatment option. She said that if the cancer returns, the next line of treatment would be in a pill form. This puts me officially on my second line of treatment once this returns. there are people on their fourth and fifth lines still pushing back the cancer. I'm amazingly lucky to have reached remission with only one line of treatment (well, also with some help from surgery and radiation.) I should shut up and be grateful, but I still feel anxious about how the next round will go. I also feel anxious not knowing when that next round will start -- will it be next month?, two years? ten years?

If I decided to keep the port, I would likely have to make appointments to get it flushed every six weeks. Unfortunately, most doctors offices and CT and MRI facilities do not have the equipment or staff to access a port and require and IV . The only place that will use my port is the oncologist. This has been frustrating because accessing the port is so much easier and less painful. The port creates a dime sized lump under the skin and the needle head just presses into place with a tiny pinch. On days when I was getting a blood draw and then going upstairs for treatment, they would leave the hook up and a foot of tubing attached. They would tape it to my shirt and I'd walk around the cancer center with a tube hanging off me. I felt very sci-fi and the whole thing was very easy and efficient

On the other hand, the memory of the procedure to insert the port still makes me shutter, but it was totally my own damn fault. They said no food or drink before the procedure and I had a cup of coffee. This apparently made the sedation less effective and I woke up while they were still inserting the port. I was awake enough to feel their actions but too out of it to move or speak. They had numbed the area, so it was only mildly painful, but the sensations of the instruments and my imagination made it a waking nightmare. So I wasn't particularly excited about the procedure to remove the port, especially when I learned that you are awake the whole time and they only use local anesthetic.

But all in all, I decided it would be the best move to remove the port. I got an appointment for this past Monday. It surprised me how casual the whole thing was. I had to remove my shirt, but kept on my bra. They took a quick X-ray, scrubbed down a 3" by 3" area, and put a cover over my face and the rest of me. They gave me a warm blanket. I waited about 15 minutes for the physicians assistant performing the procedure to arrive. They said the numbing agent was going to hurt for about thirty seconds and it did. It blocked the sharp pains, but not the sensation of digging and pulling and sewing up. I became really nauseous. For a minute I tried not to say anything, but it was becoming clear that I was potentially going to throw up. They waived an alcohol swab under my nose and when that didn't help, put a cold rag on my head and oxygen tubes on my nostrils. That did help. I focused on my breathing and kicked my feet during the most uncomfortable sensations. The word "uncomfortable" seems insufficient to describe the feeling. A better word would be wrong. My body did not want its integrity intruded upon and it set off alarms of wrongness.

They patched me up, sat me up, and sent me on my way. My arms would not stop shaking for at least a half and hour.

I know I must come off as skeptical and maybe even a little pessimistic because I can't really ever forget about the fact that the cancer will return. But when I was sitting in the chair getting the treatment, I would lean back, put on my chemo playlist, and try and fill my veins with positivity. I would send out the drugs with peace and love and an assurance that they would do there thing and super charge my white blood cells to destroy the cancer cells. I can't say scientifically that it worked, but it definitely didn't hurt. And I felt better and my body felt better about the intrusion.

I have to keep the bandage on for another day. I want to see the scar. The insertion left very little scar so hopefully the extraction scar will also be slight. . Regardless, I would like to cover the area with an orange butterfly tattoo. Orange is the color for kidney cancer and I've always loved butterflies for their ability to transform. To me, they symbolize hope. So it feels like the perfect tribute to the port and the treatment it carried.