Category Archives: Chest Port

Chest Port Installation

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When the nurse called last week to tell me about my new prescription she also let me know that the doctor had finally cleared me for my chest port. I’m not sure what, if anything, has changed, but for some reason they’ve decided to move forward with it at this time. If you don’t remember, I was originally supposed to have it put in before my first chemo treatment, but an initial blood test indicated that my blood doesn’t clot normally and that I might be a bit of a hemophiliac. Apparently that was enough to cause them to think twice about sticking a semi-permanent tube into the largest vein in my body. But I guess that they’ve decided to move forward with it before the chemo treatments damage the smaller veins in my hands and forearms.

Like most new things, I’m pretty nervous about having it put in. Mostly just because I’ll have this extra little bump sticking out of my chest for 6 months, but I’ve been told that I’ll quickly get used to it and that in the long run I’ll appreciate having it.The unit is about the size of a quarter and is maybe 3/4 of an inch thick. It’s installed just under the skin and connects to a catheter which will run into one of the larger pulmonary (I think) veins in my chest. Then, when it’s time for chemo they simply plug-in and go!

That part will be a welcome change as there have been difficulties starting an IV both times that I’ve had chemo so far. Both times they tried to start it in my hands, and both times the first person had to call in for backup. This last round they wound up going into a vein near my wrist.

Hopefully, a thing of the past

When I asked why they don’t just go into the vein in the arm (where they take blood draws from and where you normally see IV’s put in) they said it was because they like to “preserve” those veins whenever they can. Like I said, the reason they do chest ports is because these drugs are powerful, and for the lack of a better term, they are corrosive and can damage these smaller veins. So when possible they like to put chemo into a large vein in the chest where it won’t do as much damage.

So, the tentative plan is to have the procedure done next Wednesday a few hours before my next chemo treatment. I’m still waiting for the follow-up call to schedule the appointment, but I’m pretty sure that this will be happening. We are also meeting with the oncologist again on that day, so next Wednesday is shaping up to be a pretty big day!

In happy news, I’m done with my injections for this round! We’ll find out after my next blood test on Tuesday whether or not my white blood cell count was indeed boosted and if it was worth it!

“He’s more machine now than man; twisted and evil”

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The Chest Port Placement procedure went off without a hitch yesterday. And while I’m not quite Darth Vader yet, I do feel like I’m much closer to being a cyborg than I was yesterday.

We checked in at 8:30 and I was prepped for the procedure with an IV and saline/anti-biotic solution.

I probably could have smiled... but I was a bit drugged

When they were ready for us I was moved down a floor to where we meet with team doing the procedure and went over all the paper work and release forms etc. At this point they showed us what it was that they were about to put into me:

The procedure was quick, and from my perspective was very much like the lymph-node biopsy I had at the end of September. For both I was given a mild sedative so that I was relaxed and then then a local anesthetic for the cutting, digging, and probing part. But unlike the lymph-node biopsy, which from my perspective took about 10 minutes (it was actually closer to an hour) the chest port placement was actually about 10 minutes.

Afterward we moved back upstairs to the bed (as pictured above) and I had to stay for about an hour and a half for monitoring before they let us go. But after a quick nap, we were soon on our way home.

I haven’t been able to see what it looks like yet since I was told to keep the surgical dressing on until later today when they’ll take it before chemo. But I can feel it. The port is located just under the skin on the other side of my collarbone from where I had the lymph-node taken out. The catheter then enters a vein (I was told they have several options and I didn’t catch which one they actually went into) and the catheter ends shortly before the vein connects back up with the heart.

It’s a little sore. It’s just above the pectoral muscle so it hurts a bit if I move my right arm around. Also it just feels tight, both from the trauma done to the area from the procedure and because I can feel the port just underneath the skin, stretching it a bit.

Now I’m just curious to see how they take this thing and plug me in. I’ll find out later today.

Didn’t really know what to write about. So I thought I’d ramble for a bit:

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There was one bit of mildly concerning news that arose from our visit with the oncologist, and that would be the continued issues with my white blood cell counts. Even with the Neupogen injection I receive for 5 days after chemo my WBC count was only at 3.0 k/u when I went in for chemo again on Wednesday. This is still well below the normal range, though I guess it’s an improvement over the 1.5 k/u that it was at after my first treatment (which was the impetus for putting me on the drug). In fact it’s twice as good. Even so, the doctor indicated that it’s still an underwhelming result and if it does not show signs of improving before my next treatment on the 24th, then she will consider taking some additional action, including extending the injections for a few additional days after treatments. I’m really hoping that it won’t come to that because as it is,  those injections will really start to take their toll by the time Monday and Tuesday roll around. So hopefully the same magic that suddenly caused my blood to clot in a more normal way will take effect on my white blood cells production now.

One thing that should help is exercise. The doctor is encouraging me now to start to exercising as regularly as possible and for at least 30 minutes a day if I can. Initially it was recommended that I not exercise much at all since the goal was work towards putting weight on me and keeping it on, and they didn’t want to anything to derail that effort. But now that I am back up to a normal weight for myself she would like to see back on an exercise plan to get my cardio back up (it’s pretty sad right now) and prevent further muscle loss.

I had pretty much forgotten how thin I had become when this all started. I’m back up now to a normal weight for me, I was 148 when I checked in for chemo on Wednesday, but when I was diagnosed almost 2 months ago I was in the low 130′s putting my Body Mass Index (BMI) squarely in the “Underweight” category. This week though, I was reminded twice how much better I guess I’m looking now. When we went and saw the show I was supposed to be in on Sunday, we stuck around to talk to people afterward I was approached by my good friend Trish who was firstly surprised to see me, and secondly told me right away how good I looked and that I had put on some much needed weight. Trish and I did a couple of shows together last spring and summer. Her comment sort of surprised me at first as I didn’t really realize that I had looked underweight during that time though in hindsight that makes alot of sense. That was the period of time when my cough and other symptoms first developed and when I first started having inclinations that something wasn’t quite right (of course I ignored everything for another month or two).  Still, it was interesting for me to hear that perhaps I was in worse shape than I thought I was, even back then.

The other person to comment on my physical appearance was my doctor. Although we’ve spoken several times I hadn’t seen her in 5 weeks, and the first words out of her mouth when she passed us in the hall before the appointment was that I looked better. I guess 5 weeks and 15 pounds make a big difference.

What’s funny is that a few weeks before my diagnosis I even commented here on the blog about how scrawny I seemed to be. I had posted some pictures of my friends and I golfing in Hawaii and I included a picture of myself with the caption “It’s not often that I see a profile picture of myself. I ALWAYS forget how scrawny I really am.” Looking back through more of those pictures of me from our Hawaii trip this summer, and I have to admit that I’m looking pretty thin, and I still had a few weeks to go before I’d get to my worst. Thankfully there aren’t to many pictures of me at my low point.

It’s actually kind of hard for me to go back and look at some of those pictures of happier times, especially those golfing pictures. About a week after I was diagnosed my dear friend went into the hospital and has only recently started his own long journey of recovery. It’s hard to think about how long it will be before the 3 of us are all healthy enough to get back on the course again, but I already look forward to it, and in fact I think about that day almost every day. I’ve already decided that the two us who are (or hopefully, were) sick are going to ride in a golf cart. Dane can walk!

That’s probably enough rambling for now. On Monday or Tuesday I’ll post some pictures of this chest port that I have in me now. I wanted to wait a few days so that I could get some good progression photos of the bruising. The bruise is about 2-3 inches across and is responsible for most of the “tightness” that I described the other day, but it feels much better today than it did yesterday. I was initially concerned that there might be a problem since the bruising seemed much worse than I was prepared for, but the doctor put my concerns to rest when she basically told me “Meh, I’ve seen much, much worse” =)

Chest Port Pictures

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The CT Scan last week went as expected.

Jedi Knight Cancer Patient is hoping for good results!

Contrast this with pictures from the last time I had a CT Scan and you can see that we’ve really come quite a ways, at least as far as my comfort level with these things goes. In fact this time the process was even easier than expected as they were able to access my chest port and use that to administer the intravenous  contrast solution, saving my precious arm veins from another IV.

As they were “plugging me in” it occurred to me that I had yet to really talk about my chest port since the surgery last month. To start, you may want to a take moment to remind yourself what it looks like on inside, before checking out these pictures of what it looks like from the outside.

This picture was taken this evening. You can see can see the chest port under my skin. It’s  little discolored as it tends to bruise a bit for a few days after being accessed. It’s not like bruise caused by trauma to the site, it’s just a small collection of blood under the skin which oozed out of the port as needle is removed from the unit. At least that’s my understanding, it could also just be bleeding from the skin cause by the needle puncture. The benefit of a chest port is that they are able to use larger thicker needles, but thicker needles leave bigger holes and the skin tends to bleed a bit more than with smaller needles.

You can see the three little bumps which form a triangle, the nurses aim for the center of this triangle when they go to access the port. Directly above is the incision scar from when then put it in. Also pictured is the scar below my neck and above my collar bone from the lymph-node biopsy surgery that I had almost three months ago now. Long after I’m done with treatment I’ll have these scars to remember it by. OR, as I’ve said before, I may just come up with stories about this knife fight that I got into at a bar that one time… you should see the other guy!

We took a few more pictures from various angles so that you can get a better idea for how it sticks out from my chest a bit.

In that previous picture, the lighting is such that you can actually kind of see the catheter line a little bit too. If you create an imaginary line using the two little dots closest to the camera (so the bottom of the inverted triangle and the dot on the right), and if you follow it up the chest, you can kind of see a an ever so slight “ridge line” created by the difference in lighting on either side of it. I normally can’t see it, it’s barely visible here due to the perfect angle of the camera and the lighting. I can’t see it, but I can feel it with my fingers running up for about an inch or an inch-and-a-half where it disappears under my collar bone before running deeper into my chest.

… that’s my little nubbin.

Kinda weird, isn’t it?

It’s actually really odd seeing these pictures. I’ve pretty much accepted the fact that I have this little device inside of me, but looking at these pictures… it looks like there are alien eggs, or some kind of transmitter that’s been implanted in me. At the very least you’d think I should be able to tap it like a button and ask to be “beamed up.” That’d be pretty neat. Is that too much to ask? I’d take that over a cure for cancer any day! Though I would imagine that if we did have have the early stages of  Transporter technology, all of that molecular breaking down and putting back together again would probably cause cancer… but since I already have that: so bring it on!

The Chest Port … IN ACTION

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Yesterday I posted pictures of my chest port, but I realized that I never included any pictures of it in action. Well is is what it will look like when they “access it” (the term they use) today for Chemo.

And what it looks like up close:

As you can see they just plug right in. The shiny stuff is a layer of film or tape that they stick over the access needle just as extra layer to hold everything in place. I wish I had a better picture of what they actually stick into me, I’ll see if I can get a better photo today during chemo. The whole process is so much simpler and believe or not, less invasive than an IV.

I wish they were able to use it at the clinic here in town for my blood draws, but they can’t, it has to be done by a nurse. So my blood draws continue to be taken through the veins in my arms, but even that is beginning to get more and more complicated as they are having to deal with scar tissue in and around those veins from the repeated pokings. By “more complicated” I just mean that they tend to hurt more and bleed for longer afterward.

The pictures above were taken the day after I had the chest port installed, and as you can see the area around the port was a little bruised and discolored. It’s not too bad in those pictures. It got worse. Much, much worse:

Sorry for the grossness. I promise not to post anymore shirtless pictures of myself for at least a short while. 2 days in row might have been a bit intense for some readers. To make it up to you, here is a picture of Pepper in her Christmas hat:

For the record, I do not and will not ever approve of dressing up pets. But Christine cannot be stopped. (Correction by Stine: “That’s not true! I’m anti ‘dressing up dogs’ as well… With the exception of her raincoat, which is practical. And her Christmas hat, which is cute.”) So there’s that.

Today is chemo session 3A, its my 6th treatment and the beginning of the 3rd cycle. We also meet with the oncologist today to discuss the results of my CT Scan from last week. Like I said, we are expecting good news and have no indications so far that it will go any other way, but there is always that little bit of uncertainty in the back of my mind, so I’m understandably a tad nervous. Check back tomorrow for the results of that conversation.

I haven’t seen the results from my CBC test yet, but as they haven’t called to cancel, I assume at this point that my white blood cell count is within the “safe” range for chemo, but probably still well below normal levels. The rest of my blood work that has come back is all normal including the liver function test that they run once a month (to ensure that the chemo drugs are not damaging my liver).

We are going to try some new tactics today to help minimize the anticipatory nausea that I’ve started to get. Basically I’m going to try taking some of the anti-anxiety medication that I’ve been prescribed BEFORE we leave for the hospital. It will mean that I should be pretty high by the time we meet with my oncologist but I think it’s worth it in the long run.