Intravenous Port Placement and First Chemo Infusion

On August 22nd we went to the Hunstman Cancer Institute (HCI) for the placement of a port in my upper chest just below the collar bone on the right side.  The port is under the skin and provides direct access to a major vein as it leaves the neck and returns to the heart and lungs.  It will be used to take blood tests and to infuse fluids and chemotherapy drugs.  (It works both on an “in” and “out” basis.)  I would just have this “bump” under the skin that is used to find and access the port when needed. The Oncology nurse strongly recommended taking this option instead of having a new intravenous vein-finding adventure every time.  

The port placement procedure is done under mild sedation using a fluoroscope to precisely identify and place the port correctly.  It took longer to fill out all the questions of past surgeries, medications, etc. than to actually do the job.  I had very little pain during or after the procedure.  After a short wait while the sedation wore off, we came back home.

On August 28th we again returned to HCI for a CT abdominal scan.  This was to establish a baseline for future scans after each round of chemotherapy or other therapy that may be recommended.  It was pretty routine in nature, except that they did not use the port because only a full-fledged nurse can access it, not a radiology tech.  They had to infuse iodine during the scan and it took two pokes to find a vein.

August 29th was my first Chemotherapy Infusion.  Again it was at the HCI.  We are getting to know the road there pretty well and will be making many future trips.  The Infusion Center is a large glass walled clinic arranged in four chair pods.  I think there are eight pods and four additional private bed areas for those who may need them.  Besides comfortable infusion chairs, TV with cable access, and a DVD player, each pod has its own nurse, so you get to know her pretty well. Our nurse was Britany and she was very good at answering questions in a professional and friendly way.

A separate nurse that floats among the pods accessed the port.  It was kind of a sharp poke but we were given some lidocaine cream to numb the area for the next time.  They first took blood samples to determine if I was healthy enough for chemo that day.  This will be done each time and the total procedure will follow the same routine each time for these six infusions spread over a nine week period.  While the blood work was being done, they gave me a liter of hydration fluid—mainly saline with electolytes.  The flow of the IV is not a slow drip.  It is still a drip, but only slightly slower than a full stream.  When the blood work came back and said I was a “go” for the day, the hydration was done and I was given some very effective anti-nausea drugs via the IV.  Then a bag of the first chemo drug, then a second bag of the second chemo drugs.  They do those separately to be able to quickly determine exactly what may cause an allergic reaction of some kind.  They leave nothing to chance.  Once the two chemo drugs were done, than another bag of hydration.  Total time was about six and a half hours of dripping time.  I had no pain or other type of reaction.  They de-accessed the port by withdrawing the needle (painless) and putting a band-aid on it that could come off in a couple of hours.  Came home with three anti-nausea prescriptions, that leave nothing to chance.  They are extremely effective at preventing nausea rather than trying to treat it after it is going strong.  I’ve thought quite a few times of when the pharmacist visited us and said that “if you ever actually vomit during this, we are not doing our job and want to know”.  I am on Day four of this cycle and so far, no vomiting. Next day for infusion is Friday Sept 5th. Then a week off.

Perhaps you would be interested in my some of my thoughts while sitting there during the infusion session.  The HCI sits high on the hill above the University Hospital and is still considered University of Utah property.  Out that large glass wall of windows you can see lots of the campus and all the way across the Salt Lake Valley.  You can see the Church Office Building and the spires of the temple, out to the SLC Airport, to the South and West where the Rio-Tinto (Bingham) Copper Mine is and all kinds of other things.

While just looking at that view, and thinking of how we are hoping for a miracle with these problems, I thought of how my heritage is full of miracles.  John Pack was in the first company of pioneers with Brigham Young.  He is depicted in bronze on the “This is the Place” monument which I could not see, but is not too far away from the HCI.  He started a school that was the predecessor of the University of Utah.  So we have a pretty strong connection to this location where I have my treatments.  We are also direct descendants of survivors of the Martin Handcart Company.  I don’t have to detail those miracles.  I had a few miracles in my career in being able to complete long standing dream projects that had languished for sometimes decades but had never actually been initiated. I have experienced miracles in my personal life with previous health issues.  It was through faith and support of my family that I pulled through those times (and with the help of mom’s cinnamon rolls).  So while we are hoping for another miracle in today’s challenge, I think the chances are really good.  It is in our heritage.

Thanks for all your prayers, love and support.  I have a great team helping both my family and me in this challenging time.