Fast track to de-portation

Yesterday marked two years ago to the day that I had my 8th and I very much hope, my last chemo.  I remember the day clearly.  I had been anticipating it for so long expecting a sense of elation and celebration when the 8th cycle was done. Instead I remember being overwhelmed and crumbling in a soggy heap when the needle came out.  So it was by a strange coincidence that I was again in the oncology suite on 4 April, and again being prepped for needle insertion.  But this was very different.  There was no chemo ordered, and I was in the midst of 2 days of appointments for my regular check ups.  In a gap between appointments, I slathered my Emla cream on the port area and headed to Floor 5 to have my port flushed.  It was before my appointment with Dr W2, but I was not expecting any huge surprises as I had already seen the results of the bloodwork and seen Dr W (my breast surgeon), my radiotherapy consultant and endocrinologist.  They had written the magic “no recurrence” words (on my file and Dr W felt there was nothing worrying in the pain I had had in December.  However, I know Dr W2 looks at things through his oncology eyes, and I was still nervous about my appointment with him.

The port flushing went smoothly and happily there was a good blood return.  Before long I was “flushed” and heading out of the suite towards my appointment with Dr W2.  I had to wait a bit as he was held up in arriving at the hospital.  As always, I heard him before I saw him, and to my surprise I was ushered in a few minutes after he arrived.

He asked the usual questions and I had my list of questions for him too.  He always expresses interest in what is going on back home in Yangon and with the recent events I was fully expecting his questions on this too.  He did the usual examination and to my surprise announced that perhaps the port should come out!  What?  I have been wishing the port out for 2 years and willing him to say that he felt I would never need it again (yes, yes completely wishful thinking).  My response was to ask if it was no longer needed.  I was completely unprepared for his reply.  “I don’t like the look of your veins on this arm”.  He said.  They are much more pronounced than usual.  I don’t like it”.

My bubble was instantly burst and my worry head swung straight into action.  He was concerned there could be a clot forming and even though the port was working fine, it should come out if there was a risk of clotting.  I asked him what that would entail, knowing that surgery or some sort was inevitable, yet illogically wishing for magical port disappearance.  He told me that the surgeon who had inserted the port would be the one to remove it and he phoned him.  Then and there, right in front of me!  I asked the two key questions I had had and he replied quickly to these, meaning no change in meds or ongoing treatment.  He then set me up with an appointment for Dr P, the (appropriately initialled) port surgeon.  And then I was back in the waiting room somewhat shell-shocked, explaining the unexpected turn of events to my friend.  And still waiting for his questions about Yangon!

Dr P was operating all afternoon and his schedule was full but he could fit me in the following morning!  I was ushered through the paperwork side of things and asked to return at 9.15 in the morning.  I had a growing list of questions which were difficult for the nursing staff to answer.  I called on the help of our liaison manager and she talked through all of my questions with Dr P.  Along with the questions such as “when would the surgery take place?, “would it be safe/wise to travel a day after the surgery.  To India?”, “would the stitches be dissolvable or need to be removed?”, there was a question sneakily hidden in the midst of the other ones – “can I keep the port once it is removed?”  I seriously wanted to see this device, which I had hosted for 2.5 years and never actually seen except as a shadowy form on an x-ray.  I most definitely wanted to keep it!

My questions answered, I headed off finally, knowing I was to fast again (the second time in 3 days), to return for a consultation with Dr P at 9.15 with the likelihood of surgery under local anaesthetic at 11 am.  Now I am the biggest wimp on the planet when it comes to surgery and I begged for a “happy pill” to get me through this.  This was obliging agreed to and I was prescribed ONE Xanax tablet to take that night before sleeping!

I spent the evening updating family and slept fairly early in preparation for the scary stuff in the morning.  Thanks I am sure, to the Xanax I slept fairly well and rose early with increasing anxiety.  I packed most of my belongings away and took out a few essentials to take in with me, unsure exactly what I would do with my purse and credit card while under the knife.

My plan was to buy a book before my appointment with Dr P, but that was thwarted by the bookshop being closed until 9 am and I was at counter 5 long before then!  I was ushered very quickly into Dr P’s consulting room and he agreed that the port should come out.  Gulp.  It was really going to happen.  He looked at his schedule and said that he would see if he could do it right away to save me waiting until 11 am!  I asked for some happy pills and told him I was very nervous.  He asked me if I had anyone with me and when I said that I was on my own, he said that I should try meditation!  It would not be safe to send me off on my own after the procedure if I was unclear what planet I was on!  I then produced my Emla and asked if that would help as preparation.  He laughed and said that it would do no harm!  I then repeated my request to keep the port and again he laughed, amused by my curiosity about it.

I was then taken back to the waiting room, and signed the necessary papers.  the nurse told me that the surgery would be at 11 am and I could go and have a light breakfast if I wanted to.  I decided not to as it would be too much like tempting fate.  No food = no need for general anaesthetic!  I headed straight to the bookshop and somehow one book turned into four and I wandered up to the easy chairs to read while waiting for the clock to reach 10.30 which was my reporting time.  Within 10 minutes my mobile phone rang.  The time had been changed and could I come straight back to Counter 5 and be taken to theatre! GULP!

I did my obedient puppy act and went to counter 5, and was led up to the 2nd floor to the Theatre suite.  After depositing my essentials and the four new books in the safe, I was met at the door by a gowned nurse who exchanged my shoes for a pair of theatre shoes which I could have gone sailing in.  then I was given a gown and theatre cap and had to change ready for the surgery.

This was the first time I had walked into the OT – every other time I was wheeled in, partially sedated and lying flat on my back without my glasses so this was a very different and far too clear view for my liking.  I climbed onto the operating table and the staff started prepping me.  My blood pressure was very high, unsurprisingly as I had absolutely no sedation or synthetic happiness.  Within about ten minutes Dr P arrived and the serious stuff began.  A small frame was placed over my head and a green gauze sheet over it so I was suddenly housed in a green world as the work began.  After the local anaesthetic was injected, the incision was made, but I continued to feel pain until a few more doses had been administered.  This is something I have experienced before – the need to have higher doses of local anaesthetic.  Dr P responded immediately when I said I could feel pain and he administered more anaesthetic.  The procedure took a good bit longer than I expected, because my port had been placed quite deep.  Finally it would out though and I felt (and heard) Dr P cauterising the area to stop bleeding.  Rather alarmingly, I first heard this as “stop breathing”, which scared me until I realised it was his Thai pronunciation!  He then removed scarring and finally I could feel the area being closed and stitched.  The whole procedure had taken around 45 minutes, excluding the prep time.  I was SO glad it was over.

The green gauze sheet was removed, and Dr P’s smiling eyes appeared above his surgical mask.  He was waving the port at me and was highly amused when I greeted it with a cheery “hello!”.  This was bizarrely reminiscent of giving birth and being introduced to your new baby!!

I handed my spectacles, my nose stud, and my amazing port and ushered out of the OT and back to the changing area and recovery area.  It was OUT, I had finally been de-ported and could already feel it easier to move my neck.  The Frankenstein button on my neck has gone and I no longer have this weird foreign body in my chest.  I certainly made life so much easier for me but for now at least it’s work is done and it is not helpful to keep on hosting it.

The anaesthetic is now wearing off and bruising appearing but that is all part of the healing process. Ironically though, this has resulted in a change of plans but not for the reasons feared.  I actually had gone ahead and booked my ticket to India for Friday (6th April) but with a fresh surgical wound, heavy baggage, a complicated journey and hot weather and dust of dry season it would not be wise to travel to India.  but that is a whole other story, for another day!  I will take a few days to regroup and recover a bit from the hectic first months of the year and my de-portation.

13 thoughts on “Fast track to de-portation

  1. So glad to hear the port is over and out! I can’t imagine having one so long, but mine was an external catheter so — hang on to your hat – the removal involved simply pulling it out.

    Take care. The blue geckos must be dancing now:)

    jms

    • Thanks J – yes, my onc likes to keep them in a long time “just in case” as they are much easier to howk out than to put in. Gentle dancing maybe tomorrow, very tender today!
      PS I first saw the pun de-ported on one of the breast cancer forums and it stayed with me, until finally I could use it to refer to my own de-portation ;)

  2. Love this imagery. I’ll never think of de-portation in the same way again. I’m so glad you got rid of it. Your account reminds me of when mine was removed. It was a bittersweet moment, as I was somewhat afraid I’d have to have it reinstalled in a few weeks if I had a recurrence (the first installation had punctured my lungs). But I quickly got over it and liked the idea of swimming without it. Thanks for the post. I’m sure you’ll get to India soon. xx

    • That is the thing – I didn’t want to ask to get it removed as I was convinced that I would need it again if I did! I already feel my neck freer to move without my Frankenstein like spot where the catheter fed into the jugular – eeeeew.

      India is off for the meantime – I don’t have enough days to get there and back so will head later in the year. I feel really bad as I haven’t seen hubby’s family since before I was diagnosed :( x

  3. Sorry that you miss out on your trip to India – but yay for deportation! That cuppa looks good. I had six rounds of chemo and was very scared of getting a port – there were increasing dramas getting a vein each time but got through to the end without one. However my the veins on my poor right arm have hardened and kind of drawn in the surrounding skin, creating long valleys on the back and front (like the worst track marks you can imagine) that both look and feel pretty ghastly. There really are no pleasant options when it comes to chemo! I was struck by the size of your not-so-little ‘friend’. Here’s to swift healing!

    • Thanks L, yes I feel bad that I have to delay seeing my family in law in India as I have not been back since diagnosis and they have been so supportive. Another time though, and I am glad I didn’t push myself and try to travel as it would definitely have been unwise. But yes YAY indeed for being de-ported! I am SO glad it is out, just have lingering paranoia that I might need it again one day :( I had 8 cycles and it really did help – once I got over the fear of it being used (which took about 7 cycles ;) ) and now I don’t blink when getting it flushed/cleaned. You are right, chemo does not come with a light or easy option. I am still fascinated by the device – it’s quite a machine!

  4. I’m surprised they left it in for so long, P. Even with the possibility of recurrence, they don’t usually leave them in for 2 years, at least over here. Did they ever use it for anything after chemo was done?

    So glad you’ve been deported! A milestone, no matter when it happens!

    • Yes, it is the practice over here – in fact when I asked about it earlier they said they usually keep them in up to 4-5 years as importing is a more tricky procedure than de-porting. o, after chemo it was not used at all and had to be flushed regularly to prevent it clogging or clotting….

      But yes, it is a huge milestone and already I feel my neck movement so much freer. :)

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