Insertion of Port-A-Cath
It has been determined that you require a special IV to be placed for your chemotherapy treatments. This IV is surgically implanted with the tubing going into a vein underneath the collar bone. The port itself is a titanium box; it will not set off metal detectors. The chemotherapy is given through that box.
This is a fairly straight forward procedure. Anatomy is very consistent. A needle will be placed under the collarbone to access the vein. Once thatís done there are a series of maneuvers to place the IV.
FYI: There are two other structures to keep aware of while doing this procedure. One is an artery, which is not as big a deal as the most important structure down there which is the lung. There is always a risk of puncturing the lung while doing this procedure, no matter how experienced the surgeon.
Hereís what to expect:
Morning of surgery:
Please check-in at the place and time Patricia has asked on your registration sheet.
Once checked-in, you will be taken to a pre-op room and asked to change into a hospital gown. Your family can stay with you. We ask that you limit the number of family members as the rooms cannot accommodate a large crowd. Your family can keep your clothing or it can be placed in a locker for safe keeping. A nurse will check your vital signs and go over important medical history.
You will see me prior to the surgery and have an opportunity to ask any additional questions that you may have.
A nurse or an anesthesiologist will start an IV. In some cases, a sedative will be given to relax you prior to going to the operating room. Once you have been taken to the operating room, your family is to go to the waiting room until your surgery is completed.
In the operating room:
Once in the operating room, you will be transferred to the operating table. In the room, there are key personnel including the circulating nurse, a scrub tech, anesthesiologist, and myself. Several monitors will be connected to watch your vital signs during the procedure. Once all that is complete, you will be given anesthesia to go to sleep. The average duration of this procedure is 30-40 minutes.
Once your surgery has been completed, you will be taken to the recovery room and I will let your family know your surgery is done. You will spend approximately one hour in the recovery room, sometimes less, sometimes a bit more, depending on how you metabolize the medications given to you.
When you are awake, the nurse will help you get dressed and transfer you to the discharge area. At that time, your family will be called to come and sit with you. You may be given some juice, soda, or crackers or assisted to the rest room if necessary.
Your discharge instructions will be given to you as well as any prescription for pain medication that I may have written.
Once you go home:
Expect to be a bit groggy for a while. I ask that you do not drive a car or operate any machinery that day. You will have no other restrictions as far as your diet or activity.
Sometimes, the anesthesia can make you a bit nauseous. Donít be alarmed, that usually resolves by the next day.
This procedure may be more painful than your breast surgery as instead of removing tissue, we are inserting a device. You may take Tylenol, Advil, Aleve, or any other over the counter pain medication as before f you like. The prescription is for a narcotic and is stronger just in case you need it. If you do not have pain, you do not need to take any prescription medication.
If you will be receiving your first chemotherapy treatment within 48 hours, I may leave the first needle in place with a bulky bandage. Keep that in place and dry until after you have received your treatment. The bandage must be removed in order to receive the treatment but after the treatment is completed, you may leave it uncovered and shower as usual. Leave the steri-strips on and they will peel on their own.
If you will not be receiving your first chemotherapy treatment within 48 hours, please remove your bandage the day after surgery and you may shower. Under the bandage you will again see steri-strips. Leave those alone, they will start to peel off over the following 7-10 days and you can eventually peel them off without harming the incision.
It wonít always be necessary for me to check the incision after surgery as you will be going to your oncologistís office and they can let me know if there is a problem. Of course, if you are unsure of anything at any time, please call the office.
Thank you for allowing me to participate in your care. It means a great deal to me and my staff that you would trust us with such an important matter.
Should you have any questions, please do not hesitate to contact the office or staff.
Dr. Arlene Ricardo