Shoshiplatypus

Tuesday 8th March 2016

The Deportation of Shoshi

I’ve been deported… It’s OK, I’m still living in the UK, safe and sound, but today my port-a-cath was removed. I had to go in to the Day Surgery Unit at the hospital and it was removed under local anaesthetic. When I first heard that I wasn’t going to have a general, I was a bit scared, and phoned up to find out exactly what would be done, and was reassured that they do this all the time, and I would not feel it, and a nurse would be by my side to reassure me throughout.

After a session with the nurse where she checked my details and whether I had allergies, crowns, metal implants, etc. etc., I went back and sat with my hubby in the waiting room until I was called to go and change into a gown. I put my bag of clothes in a locker and pinned the key around my hospital wrist band. After this I sat for about 5 minutes in another waiting room until the surgeon was ready for me and I went to the anaesthetic room adjoining the theatre, where I got onto the couch. At this point the nurse took my wheelchair and said it would be safe in the recovery room. They gave me the local anaesthetic and then I was ready to go in.

The whole procedure was a lot easier than I’d expected. The worst part was the injection of the local anaesthetic which really was quite painful! It was injected in three parts, into the skin surrounding the port. It worked very quickly and the surgical registrar (standing in for the consultant who was performing an emergency operation) began the procedure almost immediately. Initially they covered my eyes with some gauze because they said the operating lights were very bright, but this was removed, and the lights had a sort of grille over them which directed the light downwards so they did not see over-bright to me. The area was swabbed, and then covered with a blue paper sheet which was stuck to that region of my chest, with a hole where the port was. All the staff, surgeon, anaesthetist and nurses, were very friendly and reassuring, and told me exactly what was going on throughout, and asked if I felt any pain (which I did not). I could feel a certain amount of pushing and pulling, and it was interesting watching the theatre nurse passing the instruments to the surgeon as required, but I could not see what was happening because I had to keep my head turned away in order to stretch the area, and anyway I was lying back and couldn’t really see. Maintaining this position throughout did make my neck feel rather uncomfortable.

He opened up the skin along the scar from when the port was inserted so there shouldn’t be any more of a scar than I already had. He had to spend some time freeing the port; there were two stitches holding it in place, and then my body had produced a certain amount of collagen and scar tissue which was anchoring it fairly firmly, and this had to be freed. He then told me he was going to pull it out, and all I felt was some pressure and movement, and I never felt the catheter coming out from the central vein and over my collar bone – he said there are no nerves there. It was dropped into a dish and I was able to see it again after 10 months! The catheter was quite a bit shorter than when I saw it last, because it was obviously made long enough for people of all sizes, and they must have trimmed it down somewhat.

After this it was a matter of sewing me up again, and absorbable stitches were inserted under the skin. I could feel a slight vibration as the thread was pulled through the skin, but no pain. There was a final touch of some skin adhesive to finish it off – this is like superglue and will come away eventually. There is no dressing on it. It is waterproof and I can shower when I like, and I do not need to return for any stitches to be removed, or dressings changed or anything. They told me someone would phone me tomorrow to check that everything was OK, and I’ve got a number to ring if I have any concerns.

During the evening the local anaesthetic started to wear off and it was becoming quite painful, as if I’d been kicked in the chest, so I took some paracetamol and this has dealt with the pain. I shall continue to take it over the next day or two but it should heal quickly.

I was actually feeling rather attached to my port (emotionally as well as physically!) after having had it for 10 months, and I was quite accustomed to the hard little lump on my upper right chest wall, and the catheter which I could feel under the skin, running over my collar bone, and I used to fiddle with it sometimes! I feel quite bereft in a funny sort of way, now it is gone. I asked if I could keep it but they said no – health and safety and all that – they used to let people keep them in the old days but now they are worried about infection – I said they could wash it, and anyway, it had been in my own body and I wasn’t very likely to catch anything off myself! But no – rules are rules, so I had to wave goodbye to my port. They are sending it to histology to see if they could grow any cultures from it, and if they do, they’ll contact me and put me on antibiotics, but there is very little likelihood of that. Everything apparently looked absolutely fine.

I was then wheeled into the recovery ward where I was reunited with my wheelchair and given a cup of tea and a biscuit, after which the nurse took my locker key and fetched my bag of clothes for me from the changing room. After I had got dressed I went into the discharge lounge and sat with my hubby until the nurse came in with the discharge paperwork, and after this we were free to go.

This port-a-cath has been absolutely brilliant. When I was first told I was to have chemo, the oncologist said it would be injected into my hand, but I objected to this on account of the excruciating pain I always experience when they stick needles in the back of my hand, and she said I could have a PICC line instead. Later I did some online research and discovered the benefits of a port, so I requested this instead and they were happy for me to have it. It was more trouble to install, and to remove, but so much more convenient for me, especially through the summer months when I was having my treatment – being completely buried under the skin, there as nothing to show except a small bump, and I could shower and do everything as normal without having to worry about it. In addition, it required less frequent flushing than the PICC – every six weeks if it wasn’t being used, instead of every week – and while I was having my treatment this happened every three weeks anyway, before and after each infusion. I only had two six-weekly appointments at the Ricky Grant Unit to have it flushed after the end of my chemo, before it was removed.

The removal of the port really does mark the end of my cancer treatment – it’s a real red-letter day. However, in the same way that my emotions were very mixed when I was given my cancer all-clear, so they are today – of course I am glad it is no longer needed and has now been removed, but it’s the passing of an era and I feel rather sad about it in a funny sort of way! I shall feel absolutely fine about it soon, I know – just as I do now about my all-clear verdict. It’s just another milestone along the journey back to health, and I am grateful.

I would recommend a port to anyone about to undergo chemotherapy.

Any old port in a storm.

Friday 11th March 2016

Healing Well

The wound where my port was removed is healing well. I have not had to take any paracetamol apart from on the first day, although it remains tender to the touch. I have been able to shower and everything seems to be fine. Yesterday the hospital phoned to check that all was well, and I was able to reassure them that it was.

Here is a photo of how it looks today.

You can see there is some bruising – I do not bruise easily (I can often knock myself quite hard and I never get any sympathy because nothing shows!) – but there is some yellowing of the skin. You can also see the tiny scar further up which is where they opened me up to insert the catheter attached to the port when it was installed ten months ago. Removal of the port did not involve opening this up again – just the main scar below the site of the port.