Infusion Using A Port
I have looked, and I see relatively little information concerning what
is involved in chemotherapy, from a patient's point of view. The whole
matter of "What should I expect?" is a major hurdle for those newly
diagnosed with cancer, and it is important to provide enough
information to allay their many fears. Since Monica and I are
professional photographers and since I am currently undergoing
treatment for stage IV pancreatic cancer, we are uniquely positioned to
provide a bit more information on the web. What is pictured
is a fairly typical chemotherapy session, as would be administered in
any major cancer center. These photographs were made on September 18,
2006, at Kirklin Clinic (University of Alabama, Birmingham).
About a month ago, I had a "port" installed, which provides a simple
and relatively painless method to administer chemotherapy drugs. Before
I had the port installed, each chemotherapy visit would entail multiple
needle sticks, both to draw blood for tests, and then again to attach
an IV for infusion of the drugs. The placement of an IV is no fun,
especially when, as was usual with me, they would have to make three or
four attempts to hook one up, each time in a different place in either
my hands or arms. The port has made this a much simpler
operation. There is one relatively painless stick, and that is it. This
has reduced the fear factor considerably, and is worth it for that
reason alone. For some people, that fear keeps them from getting
treatment in a timely manner. After having chemotherapy drugs
administered both without and with a port, I can wholeheartedly say
that having a port installed is a very worthwhile thing to do.
cancer blog may be found at http://diehlmartin.com/cancer.html
arrive at the clinic, I check in both with the blood test lab, and also
with the infusion department. Because I have a port, the blood tests
will be done using the port, rather than sticking me with a needle to
find a vein. So I leave my blood test paperwork at the infusion
department, and wait for them to call my name. They then take me back
to one of the infusion rooms, and hook up the port.
Figure 1. The port is in the lump near the third button up. The port is
entirely under the skin, and is in the fat layer. There is a tiny
catheter that goes from the port up to the jugular vein in my neck. The
port is painless, and doesn't itch. In order to hook up to the port, I
undo several buttons on my shirt, and that provides all the room they
Figure 2. First the nurse puts down a barrier to keep any spills from
staining my shirt. It has an absorptive layer on the top, and a plastic
barrier layer on the bottom.
Figure 3. Next, the nurse applies a disinfectant to the skin over the
port, to reduce the risk of infection. The material they use seems to
be iodine based, which temporarily stains the area, letting them know
exactly where the disinfectant has been applied.
Figure 4. The area is then sprayed with a chemical which cools and
numbs the skin over the port, which makes it so that I can barely feel
the attachment to the port.
Figure 5. There is a special needle assembly which is made specifically
to work with a port. Here the nurse is about to puncture the skin with
the needle, and push it into the reservoir in the port.
Figure 6. This picture shows the configuration of the needle assembly.
It looks terrible, but I could barely feel it. It is made to hook into
the port and to stay hooked to it, and not fall out.
Figure 7. Once the special needle is inserted, it provides a pathway
through which blood may be drawn, and through which the necessary drugs
may be administered. This needle, once inserted for the day, is left in
until all of the day's procedures have been completed. Once again, I
could barely feel it.
Figure 8. This close up view shows how the needle goes through the skin
and into the port. As compared to having an IV installed, this is easy
Figure 9. Once the port is set up, the procedures can begin. There are
multiple vials of blood drawn. The first one is always wasted as there
is some contamination possible in the sample, which would throw off the
blood test results. By the second vial, the blood is suitable for their
Figure 10. The vials are actually little vacuum bottles, which draw the
blood out without requiring any mechanical aid on the part of the nurse.
Figure 11. Once the blood is drawn, the port is injected with heprin,
which reduces the possibility of the blood clotting in the port, and
Figure 12. Next, the nurse adds some gauze pads to add some mechanical
support to the port, and tapes it all to my skin. This is necessary, as
once I close my shirt and head back to the waiting room, I could be
bumped which might cause things to shift. The gauze pads help prevent
this from happening.
Figure 13. Once the port is accessed for the day, I can button up my
shirt and have just the access tubing sticking out of my shirt. Now I
go out and wait until the blood tests are completed. There are some
problems which blood tests can discover which would preclude them from
giving me a chemotherapy treatment. Until the tests are done, they do
not know if they can proceed or not.
Figure 14. After about an hour wait, I am then called back into the
infusion room, and seated in one of their big recliners. The nurse
first injects an anti-nausea medicine, since some forms of chemotherapy
can cause nausea.
Figure 15. The nurse then hooks up the port access to her infusion
pump, and starts infusing saline solution (salty water, as Edna called
it) while we wait for the gemcitabine mix to be prepared in the
Once the gemcitabine is ready, the nurse sets the pump to inject it
over a 90 minute period.
Figure 16. Once the gemcitabine is set to pump, there is little to do
but lie there and wait. Sometimes I read, and sometimes I sleep. If
there are any other shots I am to receive, I usually receive them
sometime during the infusion. Once the gemcitabine is done being pumped
in, the nurse unhooks the access tubing and needle from the port, puts
on a band aid, and I am free to leave.
Monica and I celebrate the day with lunch at some place nearby. We make
the best of the day, with a date. After 35 years of marriage, we enjoy
every chance we get!
From my perspective as the patient, chemotherapy is time-consuming, but
with the port installed, it is not problematic at all. My only regret
is not having the port installed before the first round of
chemotherapy. It has made infusion so much easier, that it is very much
worth the hassle of getting it installed.
Some people worry about physical scarring from having a port installed.
This is a particularly baseless fear. I have some photos of what the
scars looked like less than two days after the port installation, shown
Given two weeks of healing, and other than the lump where the port is,
you would never know anything happened. Assuming a person is in
remission, removing the port can be done, and once done, no one should
be able to tell that there ever was one.
There is no reason to fear having a port installed.
My cancer blog may be found at http://diehlmartin.com/cancer.html
Diehl Martin passed away in
October 2007. If you need to contact someone, please contact Monica Martin.
Change: 22 September 2006
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Contents, elements of style copyright 2006 by Diehl Martin