After the Great Vein Explosion of 2013, from which I still have a weird bruise/rash on my hand where the IV was inserted, I finally opted to have a PortaCath…inserted? Placed? I prefer installed, since it’s a titanium implant with a self-sealing rubber lumen and a long tube that goes into the jugular vein, and all of those words make me feel like the Terminator. I am now half girl, half robot, all lean, mean chemo machine.
The procedure is performed under something called “conscious sedation,” which is a bizarre oxymoron to me. I mean, when somebody is inserting tubing into a vein in my neck as thick as my pinky finger, I don’t want to be any kind of conscious at all. Fortunately, what they should really call it is “extremely happy adult naptime,” because I was far, far more sedated than I was conscious. Heavy on the sedation, light on the consciousness, just how I like it when I’m getting cut open with a scalpel.
I wasn’t allowed to eat or drink anything past midnight on the night before the operation, which of course means that at exactly 12:01am my mouth became the Sahara Desert and I was struck with an absolutely insatiable craving for potato chips. I tossed and turned in bed for a long time, trying not to focus on thirst and hunger and therefore focusing on absolutely nothing but thirst and hunger for at least two hours. I eventually drifted off to sleep, and woke up to the completely unfamiliar sound of the alarm I never, ever set anymore because I had to get to USC by 7:30am for my pre-procedure blood tests and other prep.
Somehow, when I sleep until 11am, I never wake up hungry. But when my alarm starts blaring at 6:45 in the morning, I wake up absolutely dying, dying for a sausage, egg and cheese biscuit from McDonald’s. I KNOW IT’S BAD FOR ME. But have you ever eaten one? It’s like the perfect lovechild of all the world’s best breakfast foods in one greasy, fatty disgusting sandwich. It’s also something that I associate with treating myself, since I only ever let myself have one when something horrible is happening, like I have a killer hangover or I have to go the airport at the crack of dawn. Whatever, I don’t have to explain myself to you, internet! If you don’t like the sausage, egg and cheese biscuit from McDonald’s, you’re un-American and the terrorists win.
As I was getting my blood drawn and my vitals checked in the prep room, having neither eaten nor hydrated since 7pm the night before, the nurse asked me if I was currently experiencing any pain.
“Does hunger count?” I asked. “I’m ravenous.”
Also, am I going to be out of here in time to get McDonald’s breakfast? I added in my head.
As I was lusting after my disgusting fantasy biscuit, the nurse set up my IV and it dawned on me that this the last IV I’ll be getting for quite some time. This new device does everything – it can be used to draw blood, administer chemotherapy, inject contrast for CT scans, MRIs and MUGAs and just about anything else you can think of. It can remain implanted for as long as I need it, requires no maintenance except for a monthly saline and heparin flush and means I’ll never have to deal with a blown out vein again. And best of all, no more tourniquets. I hate the way it feels as my arm goes numb and the nurse starts slapping me to try to find a vein. Never again!
Once everything was good to go, the doctor came in, obtained my consent for the procedure and let me play with the different Portacaths they had available. I actually ended up with a model known as a PowerPort, which is a deep, beautiful purple and shaped like a heart. Sadly, it is hidden underneath my skin, so no one will know that it totally matches this J. Crew sweater that I love.
I shifted myself over to a shockingly comfortable surgical table, and then the nurse asked me – I swear I’m not making this up – “Are you ready to take a magic carpet ride?” I answered with a whole-hearted affirmative and she pumped me full of my favorite drug in the world, Versed. In fact, I learned today that Versed is often referred to as “vein champagne,” a nickname I find to be unbelievably apt because it does make me feel like it’s New Year’s Eve and I’m looking fantastic in my glittery dress and the handsomest guy in the room is about to kiss me at midnight for good luck. Modern medicine is amazing.
Thanks to the drugs, the rest of the procedure plays back in my memory like a time lapse.
The first frame is the injection of the local anesthetic. I remember it stinging a bit, but I didn’t care. I was far away in another world, high out of my mind on happy juice.
Next frame. The nurse is asking me how I’m doing. It takes a massive amount of effort to bring her face into focus. “I’m dreaming about the Lion King,” I slur. I really was.
Next frame. My dream shifts. I’m in a forest somewhere. Wait, maybe a cave. There’s some tugging and pressure near my neck. I hear the doctor’s voices but I feel like they’re on a TV someone left on in the background.
Next frame. The doctor is sewing me up. I’m not sure how I know, but I know. She says, “We’re just about done!” I literally do not believe her, because it feels like I’ve been in the room for thirty seconds, tops. In reality, it took about half an hour.
Next frame. I’m being wheeled into the recovery room. The drugs are starting to wear off, but I’m sleepy. The nurse turns the lights off and lets me nap.
When I wake up for good, I discover my new hardware is pretty subtle. Take a look:
The top incision, near my neck, is where the catheter is inserted. The longer incision is where the pocket was created for the PowerPort, which is the roundish button below it. There’s a thin tube connecting the two and arching down into my jugular vein, where it stops just inside the entrance to my heart. The little red prick in the center of the port is where the nurse accessed it with a special needle to ensure that it was placed correctly, which it was.
All in all, the procedure was a piece of cake. Truthfully, the worst part about it was that we didn’t finish it in time for me to get that sausage, egg and cheese biscuit before McDonald’s stopped serving breakfast. Dammit.