Comes With an Owner's Manual

Last Monday I had my port was inserted for my upcoming chemo treatments. We arrived at admitting at 8 am and when my hospital bracelet was put on, I saw that my doctor was Dr. J (for no particular reason, I am naming him after Julius Irving, the basketball player). This is the very same surgeon who nicked my friend’s lung during her port insertion. My anxiety level jumped up about forty notches, but I managed to remain calm for some time. We had to make our way from admitting to the 3^rd floor and today there were no volunteers to guide us to where we had to go. Fortunately, my boyfriend Dave, having spent an entire day at HSC while I had my lumpectomy, knew how to get around the building. Once we were on the elevator up to the 3^rd floor, my calm exterior started to crack. Tears began to stream down my face, but I was in front, facing the door, so no one behind me could see me. When we got off the elevator Dave asked me what was wrong and I showed him my bracelet and told him. I took a minute to pull myself together, and then we headed for the right nursing station.

When we arrived at the desk, I gave them my file. While I was waiting, I noticed a large whiteboard with a whole bunch of writing on it. I homed in on the list of patients in for day surgery, who their doctor was, and what procedure they were having. There were 7 names, and 6 were having ports installed by Dr. J. This made me feel better. I reasoned that if he was doing this many today, he did this many each day he did ports, and that he likely does them at least once or twice a week, and he would have to have done many successfully in the 3 years (approx.) since my friend’s surgery. I calculated that the odds were in my favour. At this point, you may guess that I have been an accountant for many years (or a bookie).

Once I changed into the gowns I was given, I decided to take a picture out my window for this blog and for a facebook post. I find that having this blog in mind as I am embarking on these treatments helps keep my mind busy and I feel less anxiety about what is going to happen. 

A nurse came to put in my IV and I explained to her what happened with the vein in my hand at my MUGA scan appointment. I asked that she not put the IV in my hand. It took a bit to get the vein in my arm to pop up, but it did and I got the IV in my forearm. Let me tell you, it is a stingy place to get an IV, but I figured I could put up with it to save my hand. While she was taping everything in place I told her of my concerns with Dr. J and what had happened to my friend. We talked about it for quite a bit and she said that Dr. J was very experienced and what had happened to my friend only occurs in about 3 to 6 percent of port insertions. She also told me she worked directly with him for a few years and could say he was a good surgeon. She asked if my friend had been short of breath and I said, “No, she was in a great deal of pain, so she went to emergency where they tubed her chest.” The nurse’s eyes grew wide when I told her this. She asked when it happened and I said that I thought it may have been in late 2010, but I wasn’t positive. She told me that she may have been in that surgery with Dr. J at the time.

Sometime later, I was wheeled up to the pre-surgery area. The OR nurse introduced herself and explained the port insertion surgery to me. She showed me what a port and catheter look like. It was all shiny and purple and I hoped that I would get a port just like it. She then explained that they would make a small incision in my skin and fat, and make a little pocket for the port to sit in. They would not be cutting into any muscle, so I needn’t worry about that. I was kind of sad that the port was under my skin and no one would get to see how shiny and purple it was. She then demonstrated on herself how the port and catheter would sit. Just then, Dr. J walked in and introduced himself. He started explaining what he was going to do and when he got to the part about inserting the catheter, I said, “This is the dangerous part, right?” I am trying to remember exactly what was said and in what order, but I may not have it exact. I recall saying to him, “My friend had her lung nicked during this procedure and you were the surgeon.” He sat back and said something like, “You’re the one!” I am guessing that the IV nurse told him what I had told her. He did seem to know about what happened with my friend aside from what I told the nurse, because he told me that he had stopped putting the catheter down towards the heart and started putting it directly into the jugular. He said he went back to running them down towards the heart after patients complained about how irritated they were with the catheter in their neck. He also said the chance of a pneumothorax during the procedure is pretty low. The nurse asked how the patients were irritated and Dr. J said it bothered them that they could feel it when they turned their head. I told him it would be irritating because it is a reminder. He told me the choice was mine and I could have it put in my jugular if I wanted and I told him that my mom’s port was fine and so was another friend’s port, so I would go with what he normally does. He remarked I seemed to know a lot of people with ports and I said, “Yes, unfortunately.” I honestly don’t want to be reminded of the port and why I have it either.

In the operating room, before they put me into a conscious sedation, I heard a song playing. I asked Dr. J what it was. I think he told me, “Rolling In.” I asked who it was by and I could not make out the name as he had on a surgical mask. If anyone has any idea what the song is, please let me know. I fell asleep listening to the song and did not wake up until I was back in my room downstairs. Even though they told me I might be drifting in and out with conscious sedation, I knew I would be out, because I didn’t get much sleep the night before.

Once I awoke I was aware of a pain in my shoulder when I would move a certain way.  It was away from the port insertion and didn’t hurt all of the time, so it seemed not directly related to the surgery. A nurse took out my IV and explained how to care for my incision and gave me my owner’s manual for my new Xcela Power Injectable Port. Besides the owner’s manual, I received a purple bracelet and a purple card with the port’s serial number, my name, and Dr.J’s name on it. Oh yes, I also received a purple keychain tag identifying what type of port I have. After she explained everything, she took out my IV so I could start to get ready to go home.

 Once I started moving around the pain in my shoulder was excruciating at times and it seemed to be muscular as it hurt when I moved and really, really hurt when I tried to lie down.  It was so bad, I cried so they decided to send me for an x-ray. My original IV nurse came back in to give me morphine and saw that I didn’t have an IV any more. She got me a morphine pill instead and told me that when they do the surgery they place your arm over your head and I may be having pain from being in that position. I believe her, because my arm barely worked after I had to keep it in the same position for the biopsy. When the other nurse heard that IV nurse went to get me a pill, she realized she took the IV out too soon and was kicking herself. A little while later, I heard her being berated in the hall by another nurse who was taking over the next shift, “You never take out an IV until they are walking!” Right after the x-ray, I was waiting by the x-ray reception to be wheeled back to my room when I overheard a lady at the desk talking on the phone, “What is it? A PICC line? What are you people doing up there? This is the 5^th one today!” Apparently, everybody was catching heck today. The x-ray turned out to be fine so they let me go home.

It has been 3 days since my chemo port was put in and my shoulder is still quite sore and the area of the surgery is tender, but oddly itchy as heck. I know that I am allergic to the adhesive on some bandages, but besides being itchy there, the skin over the port is itchy as well. It seems weird, but my mom said it was the same for her and that it would go away.

On Wednesday I got the call I had been waiting for, I start my chemo treatments tomorrow morning. I only realized today that tomorrow is Friday the 13th. I am not superstitious, but I do find it kind of a coincidence.  Right after I got that call, I called Kendall and told her I need to get my hair coloured before Friday. Today, I got the most glorious colours put in my hair, a peacock green with royal blue bangs and highlights. I will be so styling at chemo tomorrow!