A Port In Every Storm

"Looks like you are healing well from the biopsy. That's good." Dr. Spotts took my hand to help me sit up after the exam. Before I'm fully upright, she added, "You have cancer."

July 27, 2010. She dropped the bomb just like that.

The room started to spin. I held my breath. My husband's face slowly came into focus. My first thought was not about myself but about how sad for him that his wife had cancer. Before my first tear fell, the nurse put a tissue into my hand. Sharon was good at her job.

"You need chemotherapy. I'm sending you to an oncologist. She will devise a treatment plan," Dr. Spotts said this quickly. No breaks in her speech to ask a question or give a voice to my state of shock.

At the time, I'll admit, I thought she exhibited less than ideal bedside manner. It didn't take long to realize that she, too, was good at her job. Dr. Spotts knew I was headed for a meltdown and when that happened I wouldn't be able to digest anything she needed me to know. Todd, my husband, would be in the same shape. Get out the important parts. Deal with the tears. Keep moving forward. I had family and friends to help with my emotional state. She was in charge of keeping me alive. I admire her handling me this way.

The prospect of chemotherapy scared me most of all. I'd seen many movies about people with cancer. I knew how sick it would make me and how I'd wish that I wanted to die before it was over. Consenting to chemotherapy felt like giving a doctor permission to poison me, kill every good cell in my body, and turn me into a rag doll in the process.

Thank God there have been advances in treatment and the management of side effects related to chemotherapy. My experience was nothing like on the big screen in the same way that actual childbirth is nothing like it's depicted on film.

I completely turned myself over to my new oncologist. I trusted her and hung on every word she said. I followed every direction, except one. Dr. Allison explained that many, if not most, chemotherapy patients opt for a PICC line or port to be placed in their chest. That way the chemicals would be delivered without damage to my veins.

"But you have very good veins. You're young and otherwise healthy. I'll leave it up to you," she said.

"Let me try it without the port. Can I get one later if I change my mind?" I asked. It seemed so invasive to have a permanent catheter placed under the skin below my collarbone. And very scary to contemplate a cannula inside my right internal jugular vein for several months.

"Sure. It's your call." Dr. Allison typed instructions into her desktop computer and scheduled my return to begin Chemotherapy in a few weeks.

TAC Chemotherapy is one of the most caustic chemo cocktails on the market. It works, but in the process it burns up the small to medium-sized veins it passes through. After the nurse inserted an IV into my arm and flushed my vein with a little saline infusion it was time for the first drug. Adriamycin, sometimes called doxorubicin, is a bright red fluid injected very slowly into an IV by syringe.  It's administered this way because the nurse must control the speed by which the Adriamycin makes contact with my vein, monitor me for adverse reactions, and monitor the IV site to be sure the cannula is still in my vein and not leaking fluid (nicknamed The Red Devil) into my surrounding tissues.

I knew I might have made a bad decision when I turned down the PICC because immediately my right arm started to burn, not on fire burn, but bad enough to make me question my judgement. Three weeks later at my second treatment, it took the nurse three tries to find a viable vein for my IV. 

"Why don't you have a port?" she asked.

"I thought I'd try without it first," I answered, sheepishly.

"Ok. You've tried it. Now get one before I see you again."

Yes Ma'am, I thought (picture me saluting her).She was right. Having a PICC line or port inserted turned out not to be so bad after all. I was asleep during the procedure. The incision healed quickly. The port under my skin looked like a raised bubble on my chest but I didn't care. It was much preferable to further damaging the veins in my right arm.

So, don't be a hero. If your doctor offers you a PICC line or some other form of catheter port before chemotherapy my humble advice is DO IT. Save your veins. You'll need them for the rest of you life.

My arm a few days after a blood draw

Every time a nurse attempts to start an IV or a tech pokes me multiple times to draw blood, I am reminded about what a martyr I can be at times. From only two exposures to TAC therapy the best vein in my right side collapsed leaving behind a valley running up my arm. Imagine a dry river bed or a flattened plastic tube. That's my vein. And it, most likely, will never be any better. Don't let this be you.

The bruising got worse before it got better

In short, I stand firmly on the pro port side of the argument. If there is an argument to be had. Who knows? The only conflict might have been with myself.