The day is set - I get my new little buddy called a "port" embedded under my skin on the 19th of August. What's a port you may ask? I know I did so I looked it up on wikipedia and here is what they said:
In medicine, a port (or portacath) is a small medical appliance that is installed beneath the skin. A catheter connects the port to a vein. Under the skin, the port has a septum through which drugs can be injected and blood samples can be drawn many times, usually with less discomfort for the patient than a more typical "needle stick". Ports are used mostly to treat hematology and oncology (hey that's me!) patients, but recently ports have been adapted also for hemodialysis patients.
A port consists of a reservoir compartment (the portal) that has a silicone bubble for needle insertion (the septum), with an attached plastic tube (the catheter). The device is surgically inserted under the skin in the upper chest or in the arm and appears as a bump under the skin. It requires no special maintenance and is completely internal so swimming and bathing are not a problem. The catheter runs from the portal and is surgically inserted into a vein (usually the jugular vein, subclavian vein, or superior vena cava.)
The septum is made of a special self-sealing silicone rubber; it can be punctured up to one thousand times before it needs to be replaced. To administer treatment or to withdraw blood, a health professional will first locate the portal and disinfect the area. Then he or she will access the port by puncturing the overlying skin with a 90° Huber point needle although a Butterfly needle may also be used. (Due to its design, there is a very low infection risk, as the breach of skin integrity is never larger than the caliber of the needle. This gives it an advantage over indwelling lines such as the Hickman line.) Negative pressure is created to withdraw blood into the vacuumized needle, to check for blood return and see if the port is functioning normally. Next, the port will be flushed with a saline solution. Then, treatment will begin. Also, after each use, a heparin lock is made by injecting a small amount of heparin (an anticoagulant) into the catheter. This prevents development of clots in the system. The port can be left accessed for as long as required, the port is covered in a dressing to protect the site from infection and to secure the needle in position.
The surgery itself is considered minor, and is typically performed under both local anaesthesia and conscious sedation. Patients sometimes have a little discomfort with breathing after the procedure, and can be managed with over the counter anti-inflammatories & tylenol.
A port is most commonly inserted as a day surgery procedure in a hospital or clinic by a surgeon or an interventional radiologist, under a local anaesthetic. When no longer needed, the port can be removed more simply in a clinic or doctor's office.
A port consists of a reservoir compartment (the portal) that has a silicone bubble for needle insertion (the septum), with an attached plastic tube (the catheter). The device is surgically inserted under the skin in the upper chest or in the arm and appears as a bump under the skin. It requires no special maintenance and is completely internal so swimming and bathing are not a problem. The catheter runs from the portal and is surgically inserted into a vein (usually the jugular vein, subclavian vein, or superior vena cava.)
The septum is made of a special self-sealing silicone rubber; it can be punctured up to one thousand times before it needs to be replaced. To administer treatment or to withdraw blood, a health professional will first locate the portal and disinfect the area. Then he or she will access the port by puncturing the overlying skin with a 90° Huber point needle although a Butterfly needle may also be used. (Due to its design, there is a very low infection risk, as the breach of skin integrity is never larger than the caliber of the needle. This gives it an advantage over indwelling lines such as the Hickman line.) Negative pressure is created to withdraw blood into the vacuumized needle, to check for blood return and see if the port is functioning normally. Next, the port will be flushed with a saline solution. Then, treatment will begin. Also, after each use, a heparin lock is made by injecting a small amount of heparin (an anticoagulant) into the catheter. This prevents development of clots in the system. The port can be left accessed for as long as required, the port is covered in a dressing to protect the site from infection and to secure the needle in position.
The surgery itself is considered minor, and is typically performed under both local anaesthesia and conscious sedation. Patients sometimes have a little discomfort with breathing after the procedure, and can be managed with over the counter anti-inflammatories & tylenol.
A port is most commonly inserted as a day surgery procedure in a hospital or clinic by a surgeon or an interventional radiologist, under a local anaesthetic. When no longer needed, the port can be removed more simply in a clinic or doctor's office.
Here are some of the complications (rare) that can happen according to wiki : Infection - a severe bacterial infection can compromise the device, require its surgical removal, and seriously jeopardize the health of the already weak patient.Thrombosis - formation of a blood clot in the catheter may block the device irrevocably. To prevent clotting the portacath is flushed with saline and heparin, usually by a nurse or other medical professional, at least once every four weeks, or more often in conjunction with administering medication.
Mechanical failure - is extremely unlikely. It is possible in a rare event that part of the system could break and become lodged in the circulatory system. In such case it is unlikely to cause any serious harm.Pneumothorax - Attempts to gain access to the subclavian vein or jugular vein (jugular vein!?! That ain't cool!) can injure the lung, possibly leading to this complication. If the pneumothorax is large enough, a chest tube might need to be placed. In experienced hands, the incidence of this complication is about 1%. Arterial injury - The subclavian artery can be inadvertently punctured. This usually leads to a subcutaneous hematoma and occasionally a pseudoaneurysm. An alternative site may need to be used for port placement. Puncture of the carotid artery is more rare, since attempts to access the nearby jugular vein is increasingly done with ultrasound guidance. I've also read about some that "flip" or move around a bit which seems to cause discomfort and a bit of difficulty inserting the needle into the port.
Mechanical failure - is extremely unlikely. It is possible in a rare event that part of the system could break and become lodged in the circulatory system. In such case it is unlikely to cause any serious harm.Pneumothorax - Attempts to gain access to the subclavian vein or jugular vein (jugular vein!?! That ain't cool!) can injure the lung, possibly leading to this complication. If the pneumothorax is large enough, a chest tube might need to be placed. In experienced hands, the incidence of this complication is about 1%. Arterial injury - The subclavian artery can be inadvertently punctured. This usually leads to a subcutaneous hematoma and occasionally a pseudoaneurysm. An alternative site may need to be used for port placement. Puncture of the carotid artery is more rare, since attempts to access the nearby jugular vein is increasingly done with ultrasound guidance. I've also read about some that "flip" or move around a bit which seems to cause discomfort and a bit of difficulty inserting the needle into the port.
So, my next question was "why do I want one"? Here's what breastcancer.org has to say - Your oncologist may recommend (like mine) that you have a port or "port-a-cath" inserted in your upper chest wall (the space between your collarbone and your breast) to make chemotherapy easier and more comfortable for you. What? More surgery? Don't panic. This is a simple, same-day procedure that doesn't require general anesthesia (my surgeon says he will use an IV med to knock me out enough that I won't remember what happened - "you put a what - where!?!?"). You will have a chest X-ray to confirm that the port is positioned correctly. When chemotherapy is over, the port can be removed quickly in another same-day procedure.
The port is about the size of a quarter, only thicker, and will show only as a bump underneath the skin. There are several benefits to having a port:
No need to find a vein every time you receive chemo. A special needle fits right into the port, so all you feel is the stick—not the poking, prodding, and false tries in your arm. The nurse may numb the skin first with ice or a cream, to lessen any feeling at all (yes, please).
A port may be especially valuable for women who might be experiencing some swelling of the arm on the side of their surgery.
The medication goes right into the main blood supply entering the heart, so it can be sent quickly and efficiently to all parts of the body.
Some types of chemotherapy can be very uncomfortable if injected into a vein just under your skin. The port avoids this potential discomfort.
Getting blood for blood tests can usually be done through the port, decreasing the number of times you need to have a vein "stuck." One site I looked at even points out that it's possible to feel the chemo going through your veins while using an IV - eewww that can't be fun and it causes all sorts of damage I hear if some of the chemo meds get into the surrounding tissue near the IV needle site. Plus I have always had horrible veins to find for sticking needles into so with all of this information I've decided to go for the "Full Meal Deal" and get the port - might as well get the whole experience right? And I've kind of been missing the quality time my surgeon and I used to have together.
The port is about the size of a quarter, only thicker, and will show only as a bump underneath the skin. There are several benefits to having a port:
No need to find a vein every time you receive chemo. A special needle fits right into the port, so all you feel is the stick—not the poking, prodding, and false tries in your arm. The nurse may numb the skin first with ice or a cream, to lessen any feeling at all (yes, please).
A port may be especially valuable for women who might be experiencing some swelling of the arm on the side of their surgery.
The medication goes right into the main blood supply entering the heart, so it can be sent quickly and efficiently to all parts of the body.
Some types of chemotherapy can be very uncomfortable if injected into a vein just under your skin. The port avoids this potential discomfort.
Getting blood for blood tests can usually be done through the port, decreasing the number of times you need to have a vein "stuck." One site I looked at even points out that it's possible to feel the chemo going through your veins while using an IV - eewww that can't be fun and it causes all sorts of damage I hear if some of the chemo meds get into the surrounding tissue near the IV needle site. Plus I have always had horrible veins to find for sticking needles into so with all of this information I've decided to go for the "Full Meal Deal" and get the port - might as well get the whole experience right? And I've kind of been missing the quality time my surgeon and I used to have together.
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