The Big Epic

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More Than I Ever Wanted to Know About “Chemo-Ports”

I enjoy learning new things and exploring how things work. But I prefer to do that about my own interests and at my own pace. The past few years, we learned more than we ever wanted to know about how surgery is used to treat cancer by removing tumors and how CT Scans are used to monitor any future growth. We felt good that we were becoming familiar with the routines that I would likely face every few years when the cancer recurred. We did not, however, expect to face an entirely different type of treatment so quickly. As you have been following along with my health adventure this spring, I am on the fast track for learning about trial medications and traditional chemotherapy. And I’ve learned the downside of needing IV access to my arm veins for lab draws and medication infusions. To save you the hassles of learning while under stress, or simply to give you some interesting trivia to file away in your brain, let me share with you more than I ever wanted to know about “Chemo Ports.”

Since February, when we first learned that this cancer had reappeared, I have been at the cancer center at least once and sometimes twice per week. Each time I am there, they need to draw another tube or three of blood to monitor how I’m doing. Now that I am undergoing traditional chemotherapy (infusing poison into my veins to hopefully kill all fast-growing cells, including cancer cells), the staff takes tubes of blood out to be analyzed at the lab, then runs bags of fluid saline and medications into my veins. UGH!! A simple needle stick on each visit would be bad enough. But when you have veins (like mine) that dance and move around and blow valves to make themselves useless, it means multiple needle jabs until they finally find a “good” vein.

 

 

Once the nurse has used the needle to properly place the catheter line in the vein, the line is covered with a clear bandage and capped off so it can be used as needed for the rest of that visit. I bruise easily, so with multiple pokes every visit, you can imagine what my arms looked like. Yep, every shade of blue, purple, green, and yellow!

This bruising compounded the challenges. It became a treasure hunt to find a good vein which wouldn’t move or blow and which was not in the middle of a bruised area. Eventually, the staff would call for the ultrasound team to come each time to do the line placement. It was miraculous how their little machine helped them see the veins so they could get a good placement on the first try! Whew! What a relief!

And then… and then…

…the infusion nurse had enough of the hassles. One visit, she kindly and politely asked me why I refused to have a “port.” I didn’t really know what that was, other than it was something that many people who had cancer seemed to eventually need. I asked for more info and made it clear that I was in favor of doing ANYTHING to make the vein access be faster and easier. She explained the pros and cons. I quickly said “YES! Let’s make this happen.” She called my doc’s office, got the referral needed, and I was on the to-be-scheduled list to have a port implanted.

While we are waiting to get appointment with the intervention radiology team (which takes about forever to get scheduled), let’s talk a little more about ports. What are they? What do they do? How do they work?

Now wait a second! Aren’t ports the places where ships are loaded and unloaded to move cargo between water and land as the goods are moved around the world? Or aren’t ports the safe harbors where smaller boats can be anchored for repairs or to be protected from storms? No, No! My computer geek friends disagree. They say that a port is where network connections start and end for communications. How does any of this have anything to do with cancer treatment??

Okay, time for some explanations, similar to those given by my nurse. Here’s where the geek in me shines (hee-hee)!!

What Is a “Chemo Port” and What Does It Do? At the simplest level, a “Chemo Port” gives easy access from surface level skin to a deep vein. With consistent access, it is easy to draw blood for monitoring health and lab work, and to deliver fluids and medications through this larger vein through the heart for almost instantaneous circulation to the rest of the body.

 

At a more detailed level, the port is a device about the size of a quarter which is implanted under the skin of the chest. It is usually made of metal, with a rubber “septum” which can be pierced thousands of times with a needle through the skin. It has a small rubber tube called a catheter which runs under the skin between the access point of the port, into a larger vein (often the jugular vein), then ends just above where that vein enters the heart. In other words, the catheter is like a pseudo vein which bridges the gap between the port at surface level and the deeper, larger vein. This catheter also works like a vein extension to allow easy blood draws at the surface as needed.

I have a “double port” which simply means there are two access points in the device. This can be helpful if two different meds need to be run at the same time. It also means that if one point is temporarily blocked, the other point can be used immediately before taking time to flush the blockage. And when IV contrast is needed for a CT Scan, they need to use both access points.

How is a “Chemo Port” implanted into my body? There are several places a port could be used. The most common location for chemotherapy infusions is to place the port approximately 1” below the center of the right collarbone. This is done with a minor operation by the interventional radiology team. It takes one last IV line into the arm (last one, woohoo!) to run medications which relieves pain and anxiety and makes the patient very sleepy but not unconscious like with a general anesthetic. A local anesthetic is also used to numb the skin. 


Ultrasound is used to determine where to make each cut and where to place each piece of the port. A small incision (approximately 3 cm) is made in the skin on the front of the chest where a “pocket” will be created under the skin to hold the port. In addition, a small cut is made at the base of the neck to access a deep vein. The catheter is threaded under the skin between these two points, then threaded through the jugular vein until its tip is just above the heart. The end of the catheter is then attached to the port. All of this is verified by xray, then the incisions are glued closed. The surgery itself only takes 30 minutes or less, prep and recovery time take much longer!

Now, let’s go back to earlier images for a moment. At first it sounds ridiculous to compare a “Chemo-Port” with a marine port or a computer port. But if we look more closely, we find similarities: cargo is moved from one place to another, whether that is physical goods, computer information, or heavy-duty chemotherapy drugs! And a port just as easily allows things to leave, including making blood draws easier for the cancer patient. I guess my joking about ports isn’t as far-fetched as it first sounded!

All of this is More Than I Wanted to Know about Chemo-Ports … but I’m so grateful someone invented them and that they are now routinely implanted for cancer patients. It makes life SO much easier every week when I go back to the cancer center for another blood draw and/or treatment!

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Since I am an active cancer patient yet again, I decided to add a “health adventures” tab to my website. You can follow my current cancer journey in a couple of ways:

  • click HERE to see frequent mini updates plus links to the pages below.
  • click HERE to see a compilation of all the mini updates archived in one place: and
  • click HERE to see photos and read blog stories about the ups and downs of this stressful journey plus posts from past health challenges.
  • Feel free to poke around the site and check out other Big Epic Adventures I have documented in the past—backpacking and other outdoor fun, becoming a certified Nature and Forest Guide, trip reports, and other daily activities.

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If you hate to miss the latest reports from my Cancer Journey, you can bookmark this intro page to read frequent mini-updates (which will not be emailed directly to you) OR you can scroll to the bottom of any page and sign up to receive an email notification whenever I make a new full-length blog post (not just an update to the intro page) which will include stories, photos, explanations, and a somewhat weekly summary of mini updates.

(THANK YOU for following with me on this cancer journey! I appreciate every comment, encouragement, prayer, good wishes, little gifties and other types of support. I can’t imagine doing this alone…)

3 Comments

  1. I appreciate your positive outlook on a very challenging situation and wish you well.

  2. Grateful you finally got one. I’m sorry it took so long for someone to finally ask you about refusal. Sure seems like someone dropped the ball along the way and I could be one of them… I had thought you tell you about Carol’s, at one point, but apparently got distracted. Please forgive!!!

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