us lymphoma survivors, we’re pretty good athletes

Us lymphoma survivors, we can be pretty good athletes. Witness: Jon Lester throws a no-hitter.

Lester had anaplastic large cell lymphoma. That’s a type of Non-Hodgkin lymphoma that effects the B cells.

There are two types of cancers that effect the lymph nodes — Hodgkin’s Disease and Non-Hodgkin Lymphoma. Hodgkin’s Disease has about four different sub-types and accounts for about 8,000 cases per year. What distinguishes Hodgkin’s Disease from N-HL is the presence of a Reed-Sternberg cancer cell. HD patients have R-S cells, N-HL patients do not. Non-Hodgkin Lymphoma is a much more diverse set of diseases. There are over 30 different sub-types which altogether account for 50,000 or so cases per year.

I’m not a Red Sox fan, but I decided to be just for last night. It is always good to see someone with cancer go on and do well. And it’s pretty darn cool to see a fellow lymphoma survivor and athlete pitching at the top of his game, in the elite ranks.

I just wish he pitched for someone else, you know other than the Evil Empire the Second. :)

Ports Revisited

Since I wrote a post a rather tongue in cheek post about ports back in January, I’ve gotten several questions about them. So I have decided to revisit ports and answer a few questions. I’ll TRY to be serious this time.

General Questions about Ports

What is a port?

A port is short for “mediport.” A port is a small device that is implanted under your skin so that medicine may be delivered directly into your blood system. Blood can also be drawn out of the port to be sampled. The port is sometimes also called a venous access catheter.

Why would I want or need a port?

There are a few reasons you might want or need a port.

1) Certain chemotherapy drugs (including those used to treat Hodgkin’s Disease) can cause serious irritation to the veins when they are infused. When the drug is injected through the port rather than into another vein (such as one in your arm), the drug doesn’t directly enter the skin and the likelihood to cause irritation is drastically reduced.

2) Frequent use of the peripheral veins (i.e. those in your arms and hands) can cause scarring and make the veins difficult or impossible to access. The port “saves” a lot of wear and tear on these veins. Most blood draws and treatments can be given through the port.

3) If you are getting frequent treatment or need frequent blood draws, a port (as opposed to another device) allows you to swim, shower, and basically maintain regular activities.

How does it work?

The port is placed completely under the skin, usually on the chest below the collarbones, but other locations can be used as well if desired or necessary. The port forms a small bump under the skin. This raised part is called the port’s reservoir. The reservoir has a plastic membrane or bubble of self-sealing rubber in it called a septum. The septum leads directly into a large vein or artery.

A nurse uses a special needle called a Huber (or “butterfly”) needle to “access” the port. The nurse places the Huber needle through the reservoir and into the septum. This allows access to the large vein. The nurse can then either draw blood, inject medication, or simply leave the needle in place for future use.

What does a port actually look like?

A port looks something like the image to the left.  This is the reservoir part.  Ports come in different sizes.  The standard adult size port is about the size of a quarter.  I have a pediatric port because my mediastinal lymphadenopathy was so large that a standard size port wouldn’t fit.  My port is about the size of a dime.

There is a catheter (the long tube like extension attached to the reservoir) attached to the port that leads from the port itself into a large vein or artery.

How long can you keep a port?

A port can be kept indefinitely.  Reasons to remove a port include problems with it (such as infection) or simply because it isn’t needed anymore.

When not used regularly, a port needs to be occasionally flushed with heparin to keep it functioning properly.

My Experience With the Port

How did they put it in?

My port was placed using just local anesthetic.  It was done in a surgery room in the radiology department.  The surgeon made two incisions — one on the right side of my chest below the collar bone and a second incision in my neck on the same side.  The chest incision was the “pocket” where the port itself was placed.  The second smaller incision was for tunneling the catheter.

I think the standard procedure is to actually put the port on the left.  Mine went on the right side because I had so many masses in my chest.

Did it hurt to put it in?

Not really.  It was more unpleasant than painful.  I had the option for more anesthesia than just local, but to be honest for me the risk of anesthesia would outweigh the mild unpleasantness factor.

The painful part was injecting the lidocaine.  That felt like getting stung over and over by a bee.  Pleasant?  No.  Painful?  A little, but totally doable.

When the surgeon was actually working on the port, it felt like he was tugging at me.  Not painful, just strange.

Does accessing the port hurt?

Accessing the port still requires a needle stick.  It hurts probably just as much as getting an IV in the arm, but the advantage of the port for me is there was only one time that required two sticks.  I have lost count of how many times I’ve needed to be stuck more than once for an IV or blood draw.

What does the scar look like?

I took some pictures of my port to show people what it looks like.  I’ve found most people are really curious and have never seen a port before.  I had no clue what one looked like and had trouble finding any pictures — so hopefully this helps “explain” what a port looks like and gives you more of an idea of what to expect.  (If you’re like me, you like to know EXACTLY what you’re in for.)

First, this is what a port looks like when it’s actually hooked up and accessed.  The dressing is placed over the top of it to keep it clean and dry.  The clear tube coming out of the port is what gets hooked up to the IV machine or to the syringe for chemo.  I took this picture on one of the few days I actually had my port left accessed at home.

(When the port is accessed, you can’t get it wet.  But sometimes I would have to see my oncologist the day before chemo and he’d draw labs … to avoid the second stick the next morning when I got chemo, I’d sometimes leave the port accessed over night.)

This is what my port scar looks like day to day.  The sort of slightly bruised area directly below the scar is where my port reservoir is.  My scar is about 2″ long.  This is what it currently looks like, about one year out of therapy.

Although there was also an incision on my neck, I don’t seem to have any scar there.  That incision was quite small.

Does having a port effect your daily life?

I run with my port, I shower … I usually forget it’s there except for when a seat belt occasionally rubs up against it or something.  I like the port because my veins aren’t very good and the port saves a lot of needle sticks.

Anyway, I hope this helps!