Wednesday, April 30, 2014

April 30, 2014 — Bye, Bye Port

Personal lymphoma stories I can tell on this blog have been few and far between lately — which is a good thing — but today I passed a milestone of sorts: I had minor surgery to have my chemo port removed.

This was supposed to happen at the end of last summer, but I’d put it off for various reasons. Then, when I landed in the hospital last October with my pulmonary embolisms (and subsequent internal bleeding and kidney failure), there was no question of doing it then. Now that I’ve put that mess behind me and am off disability and back at work, it seemed the right time to do this.

The surgeon was Dr. Aron Gornish, the same doctor who’d put the port in seven years ago. He’d expressed some concern that the port had shifted recently and was in the wrong position (which, he thinks, probably happened when I was getting the temporary dialysis port put in). Fears of a complicated port-removal fortunately proved to be unfounded.  The port came out easily.

I'd been feeling a great deal of anxiety ahead of this procedure, and I’m not sure why. My worries focused around pain. I’m a veteran of four local-anesthetic surgical procedures — two bone-marrow biopsies and the installation and removal of the dialysis port — and felt pain with none of them. So, you’d think I would be cool, calm and collected about this one.

Not so. If anything, I was more nervous about this surgery, not less. I spoke to Claire about it this morning, through my bleary-eyed, insomniac haze. She thinks it’s because I know more (rather than less) now about what those procedures are like — how, when you’re conscious on the operating table, you just lie there, feeling like you’re right on the cusp of feeling or not feeling pain. You realize how close you are to a perfectly horrendous experience, and how it’s all in the surgeon’s hands whether or not you’ll soon be moaning and clenching your teeth.

Is knowledge truly power? Not in this instance, it seems.

I’d asked Dr. Gornish, several weeks ago, about whether I could expect to feel any pain. “That would depend on your pain threshold,” was his only reply. (Note to surgeons everywhere: this is not a wise thing to say to a patient asking that question, even though it may technically be true. You should talk instead about all the steps you methodically take, in the operating room, to avoid causing pain.)

I didn’t get much sleep last night, because I kept recalling the experience of the dialysis port insertion back when I was in the CCU, and how weird it felt to be lying there with a surgical drape over my face, feeling the tugging and pulling of the surgeon as he completed his mission. I couldn’t help thinking of what it would be like this time if I could feel the cut of the scalpel after all, and if I would jump when the hard little port with its tail of flexible tubing was pulled out through the incision. I imagined how helpless I would feel in that situation, but how the surgeon would have no choice but to forge on, since the procedure couldn’t be halted midstream.

Those fears were groundless. Except for the pinch of the first Lidocaine injections, I felt no pain. I could feel plenty of pressure, along with the predicable tugging and pulling. A number of times I could hear the hiss of the aerosol can of topically-applied Lidocaine, which Dr. Gornish picked up and used frequently. The operating-room nurse couldn’t be more solicitous, engaging me in small talk about our kids and my job, at what I assume were the most critical moments.

I was wearing a blood-pressure cuff and pulse oximeter throughout the procedure. The nurse remarked how, as soon as I’d heard Dr. Gornish say the port was out, my pulse and blood pressure dropped to a normal level. For sure, the body doesn't lie.

I’m home now, with a waterproof bandage covering the incision, under which (they tell me) are steri-strips and dissolving stitches. I’m supposed to keep icing it today, to avoid additional bleeding. I’m also told I have to be careful, when showering, not to get too much water on it, and am not supposed to do any upper-body exercising. Apart from those things, though, there are no special precautions.

I’ve been dreading the port-removal experience for the past six years or so, ever since I heard a fellow cancer support-group member tell of the agony she felt when her doctor just “yanked it out.” Was that a bit of hyperbole on her part, or was her surgeon not so thoughtful about the anesthetic? It doesn’t really matter. I’m just glad to have this experience behind me.