What To Expect: Port-A-Cath Placement

Hopefully, should any of you ever need a port-a-cath placed the doctor’s office will call you in advance to notify you when and where to arrive for the procedure.  I was not that lucky.  When I woke up that morning, I was having a small bout of nausea.  Nothing really that new, but it was enough to make me put off breakfast.  I’m pretty lucky I did.  Around 8am I received a call from Oro Valley Hospital that they were “bumping me up” in line for Dr. Westerband, a vascular surgeon, to put in my port-a-cath.  The nice lady on the phone asked if I had eaten.  I told her I hadn’t, but then asked what time I had originally been scheduled.  She said sometime in the afternoon, but the morning patient cancelled.

Why?  They hadn’t notified him either and called at 6am to tell him he needed to be there pronto for check in.  He wasn’t nearly as flexible as I was and told them he couldn’t make it that day, to reschedule him with more notice.  I, on the other hand, called my parents for a ride and headed to the hospital.  The sooner this was done, the better.

If you’ve ever had surgery, getting prepped for a port-a-cath is pretty similar.  They ask for a height and weight, take vital signs and ask what medications you are taking.  Then, the nurse –who happened to be the wife of one of the doctors I work with—asked me why I needed the port-a-cath.  I told her and she looked awestruck.  I wish I could say this was something I was getting used to, but I wasn’t.  Plenty of nursing staff along the way had told me that things would work out fine and they were pulling for me.  Heck, the anesthesiologist for my colonoscopy had played with my hair in a very maternal way and told me she knew things would work out.  With each stranger telling me how sorry they were, it pulled me back into a victim role.  Cancer had my life.  I didn’t want that feeling.  I wanted to know I was going to beat it.

Fortunately, we didn’t really have time to spare.  They needed a urine sample (this was my third in three weeks) to make sure I wasn’t pregnant and then I had to change.  Before the procedure, they needed a chest x-ray.  No one really explained why, but the metal photo tray is awfully cold!  Then the nurse started an IV and connected me to an antibiotic (to prevent post procedure infection).  They connected me to a monitor to watch my heart and left me alone to watch some TV while we waited on the doctors.

I was nervous and wished Milo could be with me, but the suddenness of the procedure meant that he was already at work and it was too late for him to locate someone to cover.  I would be going through this with the support of my parents until Milo finished work.  A few deep breaths, some Drew Carey on TV and I was ready to wait it out.

The anesthesiologist came in first with the OR nurse.  They explained how they would put me under, without intubation, for the procedure.  He was a very nice man and insisted that he needed to give me some Versed (which I was afraid wouldn’t work) to help relax me.  He wouldn’t do this, however, until the doctor came in.  I couldn’t sign informed consents with drugs in my system, so it was a good thing I didn’t take my pain killer that morning.  I signed the anesthesia consent and he back out he went.  Dr. Westerband entered next, confirmed about a thousand things I had covered with other people (like medications, age, disease) and then explained the procedure.  He would go in through the jugular in my neck and run the catheter, a long plastic tube, just to the end of my vena cava, the vein that returns blood to the heart.  The port itself would rest just above my breast on the right side.  I’d have two incisions: the small one on my neck and a much longer one on my chest.  I couldn’t lift more than 20lbs for 2 weeks, but I would be able to work if I wanted.  The port, in his opinion, should rest for a week before use.  If I needed pain medication, he could write me a script but since Vicodin, Percocet and Tylenol 3 are all about the same strength, he didn’t think I would need it.

For the record, take the freaking medication.  You will need it no matter what.  In fact, if you have a generous doctor you should ask for a muscle relaxer.  I was so tensed up from positioning on the table and trying not to cause myself pain that my right shoulder was one giant muscle spasm for the first two days.  I tried heat, ice and finally gave in and got myself a relaxer.

After that, he had me sign my consent, the anesthesiologist returned and gave me some Versed…and that’s the last thing I remember until the recovery room.  I woke up to a really nice nurse doing my vital signs.  She told me how sorry she was about my diagnosis and how she knew everything would be all right.  She asked if I felt any pain, which at the time I didn’t, and if I wanted to try ice chips.

Once again, ice chips rule!  I have no idea what they do during surgery or procedures to make patients so thirsty; maybe it’s just the fact that you aren’t supposed to eat or drink that does it, but I was starving and thirsty.  More so than I’d be in a long time!  This is where I discovered a problem.  The cath was placed on my right side, which is my dominant side.  I wasn’t hurting, but I was tender enough that bringing a spoon to my mouth was a huge challenge, especially with limited motion in my neck.  I tried several very inventive ways to get ice into my mouth, only to have it land on (or in) my gown.  I finally switched hands and at one point used my fingers.  I was desperate.

The nurse couldn’t discharge me until my second chest x-ray was back.  This would confirm the placement and let us know if the doctor would need to go back in to fix it (Really? Shouldn’t this have been done before we left the OR?)  I wasn’t really excited about the idea of waiting, but I did.  Thankfully, she pulled some strings and was notified shortly that the cath was in the perfect place and I was free to leave.  She made me walk around first –I was wobbly—and pee –you’ll learn this is very important to nurses—before my discharge.  I needed help dressing, so she brought in my mom.  I wish I could say I was embarrassed, but at that point I was groggy and didn’t care.  All I wanted was food and to lie back down.

It was several hours later that I realized what a fool I had been not to insist the doctor give me another script.  My script for the Tylenol 3 was one every four hours.  This did nothing to ease my pain.  I was so near tears that evening that my parents insisted on calling all of my doctors until they got a hold of one.  His suggestion: double up my Tylenol 3 until the morning and then they’d get me something stronger if I needed it.  I would have done that myself, but I am a stickler for rules and the bottle said one.  I took two and conked out sitting up, which was the only way I could sleep for the following two days.  Lots of pillows and time on the couch helped here.  It was five days before I could lay flat again; I still require a pain killer from time to time.

All I think now, though, is that someday I will show my children the scar on my chest and tell them that Mommy fought a horrible disease and won.  I only hope that my children won’t have to know what cancer is.


One thought on “What To Expect: Port-A-Cath Placement

  1. jdp64 says:

    Dad and I wish, along with you, that your children never know any critical diseases. We support you 100%, and right now wish we were rich so we could ease your financial worries..

Support is always welcome.

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