Last week I went for my portacath insertion, which means commencement of phase two in the breast cancer marathon.
What Is A Portacath?
It is a device that facilitates the administration of chemotherapy into the venous system (i.e., into my veins). It is a fabulous gadget that is used to make the administration of chemotherapy and blood draws easier. It can also reduce the risk of certain chemotherapy-caused side effects. This device will be placed under my skin, in the upper part of my chest (though some people have it placed in the arm).
Why Have One?
Because there is greater blood flow through the central veins than through the peripheral veins (i.e., in the arms, hands, legs and feet), chemotherapy can be administered through the central lines with less risk of causing chemical phlebitis (inflammation of a vein).
Though not everyone chooses to have a portacath, it is definitely the Silver Lining choice for me. My decision is based on the level of toxicity of the chemotherapy I am about to receive and the potential damage that chemotherapy will (very likely) do to my veins. When I was an inpatient nurse, I was always relieved when a patient had a portacath because it meant that I didn't have to poke and prod (ouch!) at overworked or destroyed veins.
How Is It Inserted?
The procedure is performed under local anesthetic, with the aid of imaging guidance (ultrasound and X-ray) in the angiography suite of radiology department. This sounds fancier than it actually is.
The actual procedure takes less than an hour. An intravenous sedation is given (SL!) to make the local anesthetic injection less painful. There will be a skin incision 3 centimeters long on the chest wall for the port pocket and a 5-millimeter incision in the lower neck to enter the vein. Absorbable sutures are used for the chest wound and are buried under the skin.
Is this T.M.I.?! Perhaps not, because The Husband asked me, "Is there an incision?"
What Is The Surgical Preparation?
Prior to most medical procedures, patients are required to be "NPO" after midnight. The Latin translation is nil per os. For practical purposes, this translates to "nothing by mouth."
The purpose of being NPO (i.e., fasting) is to protect your lungs from aspiration. Aspiration is what happens when acid, food or liquid in your stomach gets regurgitated into your lungs. This is bad.
Anesthesia causes a person to lose all reflexes, including the gag and cough reflexes, which protect the airway and lungs. While anesthetized or sedated, it is easier for anything in the stomach to be regurgitated into the lungs. Eww.
So I went NPO.
What Happens After It Is Inserted?
I was able to go home two hours following the procedure, after recovering from the sedation. The Husband was with me and drove me home, as I was quite tipsy and pretty sleepy.
I kept the dressing on for three days, which meant no shower and that I'd take it off the day before I began chemo.
Though the portacath ensures that I won't be wearing any tube tops (which is a good thing because that should never have happened anyway!), I feel good about its use as a chemo-delivery mechanism, which is my Silver Lining of the day.
Next post: First Chemotherapy Infusion.