Port-O-Cath

As you know this week I had a new distribution system for chemo installed. Instead of a PICC line I now have a Port-O-Cath.
Not many images are available on the Internet but I found one that is OK.


As you can see it is a plastic box (mine is white) with a membrane and a central tube.


It's in the membrane that we insert the needle that brings the liquid flowing in the tube then to my right jugular vein. All this was inserted under my skin so when healing is complete I will not have to worry about a bandage or an opening in the skin (open door to infections). The needle going through the skin to distribute the chemo is like this.

The nurse takes the white part between the fingers of one hand. With the other hand she feels the skin to locate the valve and maintains it in position while the right hand pierces the skin. The attached tube stays outside on the chest so they can plug in pouches of chemotherapy or other treatments. My scars are still fresh but it should be less apparent with time. The Yellow or blue is a bruise, it will disappear eventually ;-)

The operation is done with local anesthesia. I am laying on my back with the head turned to the left. Nurses install surgical blankets leaving only the part where surgery will take place (neck, part of right shoulder and chest). Injections of anesthetic is what hurts most then you feel fingers pushing and pulling and lifting your skin but it don't feel pain. There are two incisions because they have to install the tube in the jugular (upper incision) and then adjust the length at the other end where they have inserted the valve (other incision). By the way the tube connection on the valve is similar to the fittings on a engine's carburetor.
When everything was installed I had to stay 3 hours on the back under observation. She was watching for bleeding but also the connection that I mentioned is quite fragile so I could not use strength from the right side (not lift my head, not lift my arm etc..) in case the tube wold dislodge and start floating in the jugular.

Anecdote: Toward the end of the operation, the doctor said: YIKES!. So I said, this is not the kind of sound a patient wants to hear from the doctor operating on him (do not forget that I do not see anything because the blanket covers my face). He hesitated and said, no no everything is fine is just the thread that came out of the needle. A little later he sighed and immediately said that this was perhaps not a good thing to do under the circumstances because I could interpret it negatively. We all laughed.