Told by phone, Invasive Ductile Carcinoma-- little other info

april - ports are often put in by Interventional Radiology since they are threading the port into a vein in your chest and you are not having other surgery simultaneously.  This is common, not just at KP.  Your port is usually placed opposite from your mass, and I would advise having a bra on and showing them where you want your port.  Mine is subclavian just below my collarbone but near the hollow of my throat - higher than some folks have - so it is never in the way of a bra.  Dosing for chemo is done by standards and by BSA (body surface area - a mathematical calculation of height and weight)  - and this usually done by the pharmacist.  You will be weighed each time you receive chemo as your weight may change from treatment to treatment.

Port is not gonna effect your arm movements at all...at some point you forget that it's even there

Good night

1. Port implant is not "sort of surgical" - it is surgical.

My Bard Power Port (it's purple) was implanted the day before I started neoadjuvant chemo by my Surgeon. Ports are usually put in on the non-surgery side. According to my Surgeon, it is 'harder' for the surgeon to put a port in if you are thinner.

My port was implanted in OR at the local hospital under a general. I woke up still in the OR in time to see Surgeon walking out the door. He went up and told Hubby I'd be ready to go home in an hour or 2 so Hubby went to go do barn chores. Well I was taken straight to Discharge - not Recovery so they called him and caught him while still in the parking lot to come get me and to the barn we went.

I have had no problems with bra straps or seatbelts bothering my port (it's been in for 5+ yes).

Check with your Facility to see if they have numbing spray - mine did. If they don't ask for a 'script for EMLA cream (or generic) to put on approx 1/2 - 3/4 hr before infusion. It HURTS to access a port without some numbing - had it done without once - not nice. (Put a small sqiare of Saran Wrap over the area to keep EMLA off your clothes and it helps it to work better.)

With a power port, it can be used for IV associated with surgeries. It can be used for blood draws. Mine has been used twice with surgeries but has only been used once for a blood draw. That time I already was scheduled for a port flush so the RN that does the flushes just did the blood draw at the same time. I have great veins so it's easier to just go ahead and use them than to have to have an RN do the draw and flush. (It takes an RN, NP, PA or MD to access a port - not a blood tech.)

April,

Also wanted to add that mammograms are notoriously bad screening tools. There are legions of us who were dx'ed within a relatively short time of a clean mammo. I had a clean mammo 13 months before my 4 cm tumor was found.

April,

Kids do get numbing sprays or EMLA more often than adults! Not for shots or blood draws, which are too fast to make it worthwhile and create anxiety more than pain, but for IV's. I first learned of EMLA from a pediatric nurse. EMLA takes about 45 to an hour to work, so advance planning is necessary, but the numbing spray works just fine.

April,

Just ask for the spray. I have them spray it on for 15 seconds. It feels a bit like a cold "burn" , though not painful, when it's numb enough. After that I don't feel a thing and it takes less than 10 seconds for them to access the port. You can try EMLA, but I think it's overkill since the spray works so well.

I have never paid a cent for a PET scan. Not sure why your second opinion mo thinks it's imperative, but as you may have seen in your reading, it is not standard unless one suspects mets and lots of women do not get them pre-tx. Yes, they are enormously expensive and expose you to radiation. However, if you would feel more comfortable having and have the resources to self pay, perhaps you should.

The infusion center has the spray. Usually it's offered, but if your nurse forgets just ask. They've got lots of it! Also, if you know that you are sensitive to adhesives, ask for gauze and paper tape. They use it to cover the port site during the infusion and after they de-access the port. I did not know this would bother my skin, but I had a big red rash in the exact shape of the occlusive dressing after my first infusion. Not really a big deal, but if you know your skin is sensitive, you canavoid it with paper tape and gauze.

Check with Facility if they have the numbing spray. I did all my infusion accesses wiith the spray. It was just a VERY slight prick. I did have an access once with no numbing of any kind and it HURT big time. Now I use generic EMLA before each flush.

Kaiser does have the spray. EMLA is a bit expensive. I have excellent prescription coverage but it was still $45.00. I would try the spray before spending the money, I never feel a thing.

April,

Somewhere on one of the threads, I posted the story of my first infusion where I used EMLA and the spray. I had the nurses cracking up over the overkill. But yes, you can use both. I never did use both again

I think not eating after midnight is the biggie. The sips of water to take meds probably only apply to needed prescription meds. You could probably get an answer if you called interventional radiology or email through the patient portal.

I have an extremely small port - so small it is not visible under my skin - it is literally about the size of a pea.  The oncology nurses always grimace when they see it - so I use both EMLA and freezing spray.  Being totally numb allows the person accessing the port to be a bit more relaxed and less afraid of hurting me.

april - usually for surgical procedures they want nothing by mouth after midnight (NPO) except for necessary meds with a sip of water, and the remainder of the instructions usually involve showering the morning of the procedure with anti-bacterial soap, leaving jewelry and valuables at home, bringing ID and insurance cards with you, and having a ride home.  Interventional radiology in most med centers is usually staffed if you can figure out how to call them directly.

I love my small port!  They always get it and have never hurt me.  I have had it for four years and it has been accessed at least 50 times, never a problem - oncology nurses access ports all day long, they are very good at it.  Don't worry!

Several things - are you planning to stay at KP, or go with the other oncologist? The reason for not doing a PET right after a procedure is that you may have uptake in the area of your procedure that shows as a false positive. Anywhere you have a surgical site, or other situation that causes excessive uptake of the injected material - for example I have degenerated disks and I always have uptake there - will skew the PET results. Also, PET results, while nice to have are not really imperative. If those results would change your treatment plan - say if you were not already planning to have chemo - then they would be more important, but since your treatment is essentially the same regardless, I'm not sure how critical the PET is to do prior. Your infusions will be 21 days apart - chemo might start to have an effect but I don't know that something big enough to be seen on a PET would be gone. If you have the PET soon I would think it would be ok. Don't think I would pay out of pocket for one if I could have it in a reasonable amount of time. As always, this is just my opinion.