MCL - Medi-Ports

MCL - Medi-Ports
Blue, purple, and gold abstract...because the other pictures in this post may be creepy.

(Originally published March 10, 2022)

Warning: You may find the images in this post uncomfortable. Needles and blood are shown. If you wish to just read the weekly update, scroll to the bottom of the page.

As part of my cancer treatment, the oncologist requested that I get a Medi-Port installed. After an excruciating week post-treatment 1, I looked forward to getting this implant and a return trip to Inova Alexandria Interventional Radiology at the beginning of March.

This small device makes it easier for medical staff to administer the drugs for my treatment and will also take the pressure off my forearm veins during and after treatment.

The Interventional Radiology folks focus on making their procedures as comfortable and trauma-free as possible. From the surgeons to the medical assistants, they are very clear about what they are doing, why they are doing it, what you should expect to experience, and ask what you need to make the situation as comfortable for you as possible.  Since many of these procedures are done under light sedation, they warn you before they do things that might cause sensation - especially pressure.

This level of communication helped me be more comfortable with what was happening, as well as prevented me from flinching at inopportune times. Apparently, they had issues with other patients trying to "help" the doctor.  Since the surgeon is working in the carotid artery (the large artery at the neck), any patient assistance is not welcome.

The install felt like they were mostly rooting around under my right collarbone. No discomfort or pain.

At the end of the procedure, they gave me a bracelet, a key fob, a card for my wallet with the detailed information on the medi-port for medical personnel, and detailed instructions on healing.  I suspect this thing will be with me for a few years as I go through the cancer journey.

The day after the portal install in early March.

The most uncomfortable part was when the sedation wore off. For the first week, the right side of my neck ached and I now have a new lump under my collarbone that looks like a cluster of large zits.  Not the most attractive accessory, but it makes it easier for the doctors to help me get well and saves my veins.

In person, you would be able to see the section attached to the Carotid artery.

The Medi-Port made a huge difference in my last treatment experience.  Just being able to use both of my arms over 3 days in the treatment chair was a huge quality of life improvement.  I also enjoyed having no vein pain during the first week post-chemo.  The only way I can describe the sensation is to imagine delayed onset muscle soreness after 100 10-pound wrist curls and add your lizard brain screaming "don't do that!" during blood pressure measurements.

The Inova Mount Vernon Transfusion staff was also able to use the Medi-Port for this week's blood transfusion.  Again - free arms!  I could spend the 6 hours I spent in the transfusion chair drawing.

They were kind enough to let me take some pictures as they installed the IV.  The whole process takes about 2 minutes at most.

Adding the IV Port. I don't even feel the needle.
The IV port. This will be removed at the end of the transfusion. For multi-day treatments, this stays on - but I can't take showers.
When they install and remove the IV, they push saline through the lines to test the port and sterilize. In this picture, the nurse is drawing blood for the tests to make sure I get the right blood type.

The Medi-Ports are mostly used for transfusions and adding IV medications to your body.  They can also be used for drawing blood, but if the only thing you are doing is a blood draw, the phlebotomists are just going to find a vein and take your blood.  It's much quicker (with a skilled phlebotomist) and they don't need to go through the sterilization cycles.

For me, this device has been a game-changer.

The first mL or so of blood is mixed with saline, hence why the blood appears watered down in this picture.

The infusions went smoothly. No reaction to either bag of blood or issues with my body rejecting the process.  I had a pleasant day of drawing, listening to audiobooks, and a free lunch courtesy of the hospital and my insurance company since I received 2 bags of blood and was there 6 hours.  I also brought my own snacks and beverages.  I'm starting to get pretty good at packing medical "Go" bags.

2 days later, my hemoglobin had returned to non-emergency levels.  The consistent hemoglobin drop is a result of my body not creating its own blood vs. internal bleeding. Hence the regular visits to the Outpatient Transfusion room. If my body behaves the same way it did the last time I had a transfusion, I should be able to go a couple of weeks before I have to do this again.

The nurses in the Inova Mount Vernon Transfusion room have been warned that they will be seeing a lot of me over the next number of months.  Unlike the Interventional Radiology folks, who tend not to see frequent flyers, the nurses expect to see me again. I look forward to getting to know them better.

We are using the Hemoglobin (Hgb) number in the CBC with Differential test to determine whether I need to get a blood transfusion any particular week.    My body needs to keep that number over 7.  That is still well below the 11+ my body needs to operate.

Last Tuesday's transfusion made a difference. The Sunday prior, I was starting to drag and feel my blood pulsing in my head. I'm learning that the pulsing is a cue that I am likely to need a transfusion; however, the confirmation of this need has to be through the blood tests.  I'm OK with that.

Unfortunately, Wednesday morning, my spleen started to act up again.

I'm choosing to see the spleen swelling and discomfort as my body trying to process the transfusion, even though we saw this behavior the last time during Week 2 post-chemo.  It's probably something else, but this is the most "empowering" story I can come up with right now.

Until the oncologist sees the test results over the next week, we don't know why my spleen seems to retract and heal during week 1, then blow up again during week 2.

I am also now objectively severely immunocompromised. I barely have any white blood cells at this point.  This is actually expected as part of my chemo treatment. Good practice for staying home.

The oncologist will take a close look at the test results as they come in over the next week. As of Thursday, he wasn't seeing anything that indicated that anything was unexpected or worsening. If nothing alarming comes up over the next week, we'll talk about trends this coming Thursday and begin making decisions around whether we continue the current treatment plan or call this treatment attempt a failure and start the second-line treatment.

Meanwhile, I had a "free" weekend where my family is out of town. I encouraged partner to take a day to play golf with friends. This provided some desperately needed alone time and rest.  I'm grateful to be well enough that he can leave the house for a half day and we can both decompress.  We both needed it.