As soon as it became clear that my initial treatment would be chemotherapy, the doctor recommended a port insertion. I wondered: What’s a port?
Thinking back now to all the confusion and worries of those early days, I couldn’t even tell you anymore if it was a doctor or nurse who explained ports to me, although I am sure someone did. I can tell you, though, that my young cousin, who has a port for managing a long-term illness, came to visit me on my birthday, just before I got my port. She brought me a delicious and beautiful cake, and showed me her port and explained how it works. Truly, this was one of the nicest and most helpful things anyone has done for me during my cancer treatment – so nice and helpful, in fact, that it makes me want to linger around the cancer center, checking in on new patients: “Are you getting a port? Would you like to see mine?”
A port, sometimes called a Port-A-Cath, Medi-Port, or PowerPort, is a small medical device that makes it easier to access the veins. It looks and feels like a small, solid button, firmly anchored into the soft tissue of your chest, just under your skin. My 8-year-old daughter calls mine my “button.”
By the time you are diagnosed with cancer and your treatment plan is taking shape, you’re most likely familiar with the minor ordeal of IVs and blood draws. Phlebotomists and nurses have stuck you, drawn blood, administered intravenous medication and fluid, moved IVs to reduce the chance of infection, and so forth. Perhaps they have stuck you more than once trying to find a vein, or perhaps they have complained about your particular veins: so small, so prone to roll out of the way!
A port reduces the hassle of drawing blood and starting IVs. Both jobs can be done by inserting a needle directly into the port. There is less mystery and suspense with a port than with the veins in your forearm or hand: it works just about every time, with a fraction of the false starts. Yes, there is still a pinprick as the needle goes into the port, but there are virtually no misses, and no risk of collapsed veins.
Inserting a port is a relatively minor outpatient surgery. In my case it took about half a day, from showing up at the hospital to being released. Once the incision heals up, you don’t have to think about the port very much: you can swim, take a shower, and so forth. (You just can’t play heavy contact sports like football or hockey, because you need to avoid any direct blow to the port.)
A port should be “flushed” once a month. This is done by injecting saline solution and a small amount of a blood thinning medication into the port. If you’re using your port for chemotherapy infusions or blood draws on a regular basis, the nurses should automatically flush the port each time they use it. Flushing the port only becomes an issue when and if you begin going more than a month without using it for testing or treatment. The other day I asked to have my port flushed at a doctor’s appointment, because it hadn’t been used in a month.
The port does not completely protect you from needle sticks. My first chemotherapy infusion, if I remember correctly, was administered through an IV in my arm because the port insertion was still healing. Not all nurses and techs are allowed to use the port; they need the correct training, and often a doctor’s order. For basic blood draws for labs, sometimes a butterfly needle in the arm is just as easy; at the university clinic where I get my primary care, I don’t think anyone is trained to access a port and they don’t have the right equipment. At The Cancer Institute of New Jersey, when I wanted to use my port for IV contrast during a CT scan, they had to call down the nurse who was qualified to do it. At Sloan-Kettering, they would not use my port until they X-rayed it to be sure it had been inserted correctly, since they had not inserted it themselves. In general, for any test or treatment other than a chemotherapy infusion, if you prefer the port to a needle in your arm, you have to speak up.
Here are a couple of useful links about ports:
And if you would like to see what a port looks like once it is inserted, and have more of a visual sense of how it works, this YouTube video by Oncology Associates in Omaha, Nebraska is pretty good: