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Portacath placement was very easy

zsazsa1
Posts: 159
Joined: Oct 2018

I just had a portacath placed today, and I cannot believe how easy it was to have it done!  I was a little bit worried about it, had been considering toughing it out with IV chemo, but my oncologist really encouraged the portacath to prevent extravasation (leakage into surrounding tissue) of the chemo, so I went ahead and did it.

Outpatient procedure, with a little bit of versed and fentanyl.  I also asked them to buffer the lidocaine with sodium bicarb, so it wouldn't sting so badly.  I was awake the whole time, it didn't hurt at all, and it was over very quickly.

It's not painful 4 hrs after placement.  I'm glad I had it done.  For any future readers, it's really a very minor and quick outpatient procedure, nothing to be worried about.

MAbound
Posts: 670
Joined: Jun 2016

Mine was called a mediport, but it was so much easier than having a new IV for each infusion. Chemo drugs are so caustic that having them go into a larger vein makes so much sense. I did find it a bit freaky having three people working on me in different places at the same time when I was awake for the procedure. Made me kind of jumpy.

zsazsa1
Posts: 159
Joined: Oct 2018

Update on port placement.  It was tender for about a week - couldn't sleep on the port side for a few nights - but after a week, a lot of the time I forget it's in there.  First time they will use it will be this Friday when I have my first round of chemo.

abrub's picture
abrub
Posts: 2041
Joined: Mar 2010

It's a prescription numbing cream that you gob over your port about an hour before chemo.  Cover with plastic wrap or a tegaderm.  The nurse will wipe it off. Then you won't feel the needle go in.  Emla is worth its weight in gold.

LadyMox's picture
LadyMox
Posts: 132
Joined: Sep 2018

For some reason I am scared of the idea of the port, though they haven't offered it yet either. Right now I'm only getting chemo every three weeks so I'm willing to endure the pokings. 

ConnieSW's picture
ConnieSW
Posts: 1342
Joined: Jun 2012

about the port before I got it but loved it afterwards. I never gave it a name but felt very affectionate toward it. 

cmb's picture
cmb
Posts: 187
Joined: Jan 2018

I'm normally not interested in actually looking at the medical procedures being performed on me, But I was disappointed when I was asked to keep my head facing left while the doctor installed the port on my right side. There were several large monitors that he used to see what was going on inside me and position the port. I would have liked to watch the process too.

I was awake during the whole procedure, but felt no pain or anxiety (the drugs worked!). The port area was a bit sore for a couple of days and it took me some time to get used to it if I laid on that side at night, But after a while I got used to it and appreciated having it during my chemo sessions.

I was later told by the nurse in recovery that I had the "speedy" doctor who does fast, accurate work. The process did go much faster than I expected.

CheeseQueen57's picture
CheeseQueen57
Posts: 768
Joined: Feb 2016

I love my port. Not only was it convenient during chemo but they use it any time I have blood drawn or contrast for any test. When I’ve gone to the ER they’ve also used it and when I’ve been hospitalized. I‘ve had mine 2 years. Today when I had blood drawn the nurse said she knows patients who have had their ports for 20 years. Not only would I be thrilled to even live 20 more years but I’ll keep my port if I can. 

Northwoodsgirl
Posts: 524
Joined: Oct 2009

I also had a central venous access device (Port-a-Cath) implanted and had it in for a year without problems like occlusion or clot development at the tip is the silacone catheter or the titanium portal with a silacone septum which is the part that the special Port-a-Cath non- coring needle is inserted. This vascular access device was so important in avoiding chemo leaking into my tissue if a peripherally inserted IV catheter lost its patency. Chemo is so toxic to one’s peripheral veins. Once your veins are scarred or damaged by chemo they won’t ever be the same. Highly recommend Port-a-Cath or some other central blood stream implanted access device. Plus the nurses and doctors have a much easier time administering drugs and taking blood for lab tests. 

EZLiving66's picture
EZLiving66
Posts: 1260
Joined: Oct 2015

My doctor put me under for port installation and they used it the next day for my chemo. But that was the only time it could be used. It got horribly infected and they couldn't clear it up. Finally after two months of trying, they took it out. By that time, the skin around it was also degraded so they couldn't stitch the skin back together. After a month of them trying to clear up the hole, they sent me to the wound care clinic. Seven weeks later, they chemically cauterized it. I have a lot of scar tissue there and am thinking of going to a plastic surgeon to cut out the scar. The scar tissue also hurts if I sleep a certain way so I'm thinking my insurance would pay to have it removed. I usually just wear a tank top backward under some of my lower cut blouses to cover it. If it didn't hurt, I wouldn't care.

But....I'm like one in a thousand who ever had trouble with their port. Most women love them! Having chemo the second and third time in the same vein was no picnic and I wish the port would have worked.

Love,

Eldri

zsazsa1
Posts: 159
Joined: Oct 2018

I was the one who brought up inserting a port well ahead of time, because I wanted it to heal in before they started chemo.   Otherwise, I think they would have just tried peripheral veins, and after there was a problem with that, they would have recommended the port.  And once I was in the middle of chemo, I doubt it would have healed.

Going to start tomorrow.  I'm definitely taking Ativan before I leave the house, to try to stay calm.  I tried out frozen pea bags, but I didn't feel as if it got my hands cold enough, and uniformly enough.  So we're going with ice in the plastic boxes the size of shoes, and in zip loc bags for the hands.

CheeseQueen57's picture
CheeseQueen57
Posts: 768
Joined: Feb 2016

I‘m convinced that acupuncture kept my neuropathy to a minimum, just a little numbness in my little toes. My arthritic hands would definitely not been able to take the ice. 

evolo58
Posts: 319
Joined: Dec 2017

After my poor veins got a beating after eight chemos the last time, I'm going for a port this time. I was a little shocked to see that they expect the port to be in there for five years. Egads. Well, if I pass that five-year mark, that wouldn't be such a bad thing!

The one thing ... and I admit this is vanity on my part ... is that I like wearing u-necked blouses. Do you cover that bump up? It looks pretty obvious in pictures on the Net. I like how one lady had some sort of daisy applique on it.

derMaus's picture
derMaus
Posts: 502
Joined: Nov 2016

Mine is pretty prominent, especially when the light is right. I thought about getting it tattooed but don't really care that much, as I don't wear anything that low cut anymore. I still have fantasies of inking all the scars on my stomach, though...

evolo58
Posts: 319
Joined: Dec 2017

That someone would come up with a cute way to cover it up, other than a scarf. I see tattoos, but really don't want one of those. My preference. 

Ribbons
Posts: 48
Joined: Nov 2018

My port was put in on a Wed. and used on that Friday. I was really dreading it, but it was pretty easy. I was sedated but not totally under. The biggest problem was that I have developed a real sesitivity to tape, and they had put a lot of tape on that area, so I had so much redness and itching!! I had planned to use the port for blood draws, but it was going to be such a process that I decided to just get those the usual way from my elbow arm vein. I have problems sometimes with disappearing veins but the lady at the lab where I go is very good.

Soup52's picture
Soup52
Posts: 851
Joined: Jan 2016

Mine ahows up but I dont worry about it. I wear whatever.

LadyMox's picture
LadyMox
Posts: 132
Joined: Sep 2018

On Tuesday I'll get a port.

zsazsa1
Posts: 159
Joined: Oct 2018

Lady, ask them to buffer the lidocaine with sodium bicarb.  It will make it so that the lidocaine numbing medicine doesn't burn when they inject it.  They will give you some intravenous sedation, and it will be over really fast.

Are you already on a blood thinner?  I figured you might be, because of your having had blood clots at diagnosis.  If they haven't mentioned it, call your doctor now and ask what you should do about your blood thinner.  They may want you to stop it a day or two  before the insertion, so that you don't have excessive bleeding.

If you're not on a blood thinner after the insertion, watch for tenderness in your neck or just under your collarbone.  It is possible to develop a blood clot near the catheter after insertion - I did.

For some reason, the IV nurse has trouble accessing my port when I am sitting up, but no trouble when I am lying down.  So now I just know to lie down to have it accessed.

I put EMLA numbing cream on mine with a tegaderm (plastic cover - ask the IV nurse for a few to keep at home) at least an hour beforehand.  It still hurts some to have it accessed, and I don't know if it would hurt a lot more if I didn't do the EMLA beforehand.  But once it's accessed, there is no discomfort at all with the infusion.

I still get all my draws from my vein, because I don't want them to access the port unless it is necessary, to reduce the risk of infection.

Don't fear the catheter placement.  It's a nothing procedure, very easy.  

Cass83's picture
Cass83
Posts: 160
Joined: Feb 2017

I was awake for my port insertion (in 2017) and felt a few "bee stings" as they warmed me, but it was tolerable. I had my first chemo the same day (I live an hour away and it saved on an extra trip). I have a "smart port" and it was used for all my blood draws, scans, sedation for colonoscopy. I still have it and plan on keeping it until I get to my once a year visits. The numbing cream I have is LMX4 (lidocaine) and I have never tried getting accessed without it.

I remember feeling like it was going to fall out when I bent over for the first couple of weeks, but I got use to it and even forget about it now. I still take the seat belt strap off and put my arm outside of it so it doesn't rub on the port too. 

LisaPizza's picture
LisaPizza
Posts: 149
Joined: Feb 2018

Just to balance the experiences described, i did not have a port. I had 6 cycles of chemo. All was mostly fine. Sometimes the chemo made my arm achy, sometimes not, and sometimes the other meds were uncomfortable going in too, sometimes not ... but never terrible pain. My veins seem to be fine post chemo. I did have the chemo leak very slighly at the last few minutes of one chemo. Burned a bit but not extreme. However, it did turn into superficial thrombophlebitis.  I thought I was going to have permanent discoloration and hard bump ... but it actually did resolve nearly entirely.

LisaPizza's picture
LisaPizza
Posts: 149
Joined: Feb 2018

Just to balance the experiences described, i did not have a port. I had 6 cycles of chemo. All was mostly fine. Sometimes the chemo made my arm achy, sometimes not, and sometimes the other meds were uncomfortable going in too, sometimes not ... but never terrible pain. My veins seem to be fine post chemo. I did have the chemo leak very slighly at the last few minutes of one chemo. Burned a bit but not extreme. However, it did turn into superficial thrombophlebitis.  I thought I was going to have permanent discoloration and hard bump ... but it actually did resolve nearly entirely.

zsazsa1
Posts: 159
Joined: Oct 2018

I would have rather gone without the portacath too, because of the risk of infection, and the risk of blood  clots.  BUT, when I learned about the risk of extravasation of the chemo chemicals, I decided to have it placed.  Despite the fact that I DID develop a thrombus, and had to go on an anti-clotting agent, I am still glad I have it.  It makes infusion day SO much easier than it would have been.  If I were to have a big problem with the Portacath, it is very easily removed.

Cass83's picture
Cass83
Posts: 160
Joined: Feb 2017

My mother had chemo in 1982. They did not have ports then. Her chemo was given in the vein and she screamed  for them to take it out, it was burning. They did not remove it. I have always remembered that. When they told me I would have chemo, that flashed in my mind. Thankfully, with a port, I didn't feel the chemo at all.

janaes
Posts: 676
Joined: May 2016

Im not sure when the port thing started but i had one inserted in me for my first chemo in 1992. Im a fan of them i got mine taken out last year not knowing if i was going to loose my insurance. I wanted the prosedure done before i lost insurance. I ended up getting insurance after so i could have kept it but ot was the best desision ay the time. I miss it sometimes when i have to do blood work or when i had my cat scan but i get over it pretty quick.

Tamlen's picture
Tamlen
Posts: 142
Joined: Jan 2018

Thanks to the wisdom from this group, I got a port and demanded that it be in before I started chemo. My first onc wasn't talking about a port and I wouldn't have known to ask for one. I am so happy to have had it for chemo! I have a "power port" and it's used for everything -- blood draws, chemo. It burned a bit at the collarbone for about a month after insertion (no clot), but I don't even think about it being there anymore. I've not had any problems with clotting and I don't use anything to numb before access -- it's just a tiny pin prick, no worse than a blood draw needle in the arm vein -- and then I feel nothing for chemo.

barnyardgal
Posts: 149
Joined: Oct 2017

I was in twilight sleep and don't remember anything but I didn't have any problems after. I was a little worried because I sleep on that side, but after the first week I could sleep on that side again. I still have it, and go for port flushes every 6 weeks. Since I have to drive 30 miles to get to that center, when I get blood drawn, or go for my CT scan, I just go to the closest Kaiser center so they can't access the port. So I'm ready for my port to be out, but my oncologist wanted to wait a year or so after treatment in case of recurrence.

NoTimeForCancer's picture
NoTimeForCancer
Posts: 2463
Joined: Mar 2013

I'm with LisaPizza, I never had a port.  What I didn't know, and learned after the first chemo, chemo is hard on your veins.  So when I said to the chemo nurse, "we'll have to remember that spot for the next time", she said no, it probably would not work.  On my third chemo, they really had a hard time sticking me and they had to call the "IV team".  Ugh.  They did an ultrasound to find a deep vein.  While not horrifc, I also knew I didn't want to do THAT again.  

Since I had the radiation after the first three chemos, my veins kind of bounced back, but when I told the oncologist before starting the last three she said, "we may need to do a port".  I said, "let's just keeping going with only three to go" and I was lucky I was able to get it done.

There are deffinitely pluses with the port, and the way I did it was good for me.  

evolo58
Posts: 319
Joined: Dec 2017

That's how I felt after the last chemo.

For most ladies, they get six chemos. But please realize you might get more in first-line treatment (I did.) And if you progress or recur, you get more chemo. In the meantime, your veins can be blown all over the place. I had nurses constantly find blown veins. Some nurses are much more skilled than others, and some veins are better than others. It was getting pretty awful at the end.

So when I found that my disease probably progressed (no PET scan, but the CA-125s are really high, and the CT scan found a few areas of concern .... it would be the height of folly to write everything off as benign!), I went for that port.

It's been five days out. I wouldn't say it's been easy, and I envy those of you who didn't have any trouble. Sometimes, I don't really notice it. Sometimes, it can hurt ... strangely near my neck and not the port area itself. Usually, though, a couple of Tylenol does the trick, and it's been less tender with each day. I see the medical oncologist on the 5th. She will probably take a good look at it. I haven't removed the port dressing yet, making sure it doesn't get wet while bathing. I see lots of brusing beneath the bandage. I'm guessing it isn't going to look pretty when I remove the dressing.

I can do most tasks (paying attention to not doing heavy lifting, etc.), though I can see where it can take up to a month for things to get more back to normal. I seem to tire more easily, but my body HAS gone through quite a bit.

Even if it turns out I DON'T need chemo, though, it can come in handy. I have the NTRK fusion, which might make me a candidate for larotrechtnib, also known as Vitravki. This is a pill, not an infusion. My doctors are fighitng like mad to get me on it. From what I gathered, many doctors and patients prefer to keep the port in for a while, though. even if it's not being used. I'd rather not go through that again if I don't have to! Hopefully, it's almost ready to go. It may very well be that I'll be put on Doxil/Avastin first, THEN on Vitravki in the future if need be (hopefully, a long, long time from now). I'm prepared either way.

bluehyacinth
Posts: 48
Joined: Feb 2016

I did not want a port, had 9 chemo treatments and have been on Keytruda every 3-6 weeks for over 2 years.  I had great veins, and still ok. I am glad I did not have a port. I get blood drawn every time I get Keytruda and they use the IV so no extra blood draw visits or pokes. It all depends on the veins and how skilled the nurses are at a facility. The chemo goes through your veins whether you have a port or not so veins will always suffer a bit of an insult. It is the scar tissue from too many inferior pokes or using the same place or not paying attention to valves etc that makes it hard to insert the IV, and if the nurses and or (but mostly) those blood draw people in labs poke around too much scar tissue will quickly build up. So it really all depends.

LadyMox's picture
LadyMox
Posts: 132
Joined: Sep 2018

Hoe much does it hurt to have your port accessed? II'v got my port but haven't had it used yet.

CheeseQueen57's picture
CheeseQueen57
Posts: 768
Joined: Feb 2016

Ask doctor to prescribe topical lidocaine. Put it on and cover it with press and seal about an hour before you’re having it accessed. Piece of cake. No pain. Good luck. 

MAbound
Posts: 670
Joined: Jun 2016

There's also a numbing spray that was used on me right before they accessed my port. Worked like a charm and was no hassle for me. Be sure that you only let a chemo nurse or specially trained phlebotomist access that port. It's a sterile procedure and you don't want just anyone using it to draw bloodwork from between infusions.

derMaus's picture
derMaus
Posts: 502
Joined: Nov 2016

I've had both the lidocaine cream and the numbing spray, and prefer the spray because it's instantaneous. If you get the cream, you want to apply it at least an hour in advance and cover it with plastic wrap to enhance the effects. The spray is just applied and works within a few seconds, but not every place carries it. You'll want to check out your options in advance. Good luck!

Tamlen's picture
Tamlen
Posts: 142
Joined: Jan 2018

My first cancer center used a lidocaine injection immediately before -- that hurt more than the port access.

My current cancer center (Dana-Farber) uses nothing and there's barely the feel of a pin prick. They seem to have it down to a science. They ask me to breathe in for a count of three, then instruct me to breathe out. Just as I start to breathe out they press hard on the port to hold it from moving even the slightest bit and insert the access needle. It amazes me every single time that it hurts less than the average blood draw from my arm.

CheeseQueen57's picture
CheeseQueen57
Posts: 768
Joined: Feb 2016

I‘ve had the port accessed without topical stuff too. It’s not painful. Definetly not as painful as a venous puncture. 

evolo58
Posts: 319
Joined: Dec 2017

From a normal needle piercing my skin (for me, it was a little more painful than a flu shot.) I didn't even notice that the nurse started the saline until it was hooked up to me! A little discomfort when the needle was pulled out, but nowhere near as bad as my "hunt the veins" experience with an IV draw.

Northwoodsgirl
Posts: 524
Joined: Oct 2009

I didn’t experience any more than a mild needle prick. I didn‘t need any numbing lidocaine or Emala cream (?) . The tip of the port-a-cath catheter sits at the superior vena cava and it is a very large structure thus the chemo is diluted with more blood at the infusion point. Also there is less chance of the chemo causing extravastion of tissue by leaking outside of the vessel. 

Lori

pinky104
Posts: 540
Joined: Feb 2013

My sister, a nurse, recommended I get a script for the numbing cream, which I did.  I used it once and found it wasn't worth the cost.  The nurses make you breathe out when they're going to insert the needle, and it only hurts for one second, and the pain is gone as fast as it happens.  Don't stress out over it. What surprised me was the first meds that were put in, which I think are both Benadryl and steroids.  I felt like I'd had a buzz from a few drinks, then they wore off and I felt like I missed them for the rest of the infusion time.

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