PICC or Port? An Inconvenient Cancer Convenience

One of the first decisions you’ll have to make after receiving a diagnosis of cancer is to decide whether you want a Peripherally Inserted Central Catheter (PICC) or a Port. Both are essentially tubes inserted into your body to make accessing blood draws and attaching chemo and saline bags more convenient for everyone involved, including techs, nurses and doctors.

Any patient with cancer will tell you that getting blood drawn for testing is as commonplace as bad hospital food and butt-bearing hospital gowns. I estimate that throughout my experience with stage 2 non-specific, non-Hodgkin lymphoma, I had blood drawn no less than one hundred times. I must have joked about them being vampires many times. My chemo and saline bags were swapped out daily and nightly. I counted down my bags like a rocket launch: 5, 4, 3, 2, 1. Blast off time meant I could go home and not return until next month. I was giddy on the mornings when my last bag of chemo would be empty. I calculated when the bag would drip its last drop, and I called my wife to come get me at that exact time. She drove a hundred miles to come rescue me and take me home. If you ask, the best part of being in a hospital is leaving it.

What is the difference between a PICC and a port? Simply put, a PICC is a tube inserted into your veins usually in an arm similar to the way blood is usually drawn from a vein opposite an elbow. The PICC itself dangles and has to be taped down to keep it from snagging. Installing a PICC is considered minor surgery. A radiologist has to install it. PICC lines require regular maintenance. I had a PICC only during my first cycle. During my weeks at home, my wife had to flush it a couple times a day with saline and clean the exposed parts. Sometimes, the PICC wouldn’t work properly when staff drew blood.

After my first week of hospitalization — with five more scheduled over the next half year — I elected to have a port installed instead. Again, a doctor and radiologists made an incision in the upper right side of my chest and inserted a long, thin tube that was pushed until it went into a vein in my neck. A port is pretty flat against the skin. On the whole, it’s not as noticeable or inconveniencing as a PICC. The port easily allowed staff to connect chemo and saline bags and to draw blood. In between week-long hospital stays, I got blood draws once a week. The port made these more tolerable.

I will say, however, that both a port and a PICC can malfunction on occasion, for various reasons. There were times that I’d be directed to raise my arms over my head and to cough on purpose to build pressure to get the device to work properly and for blood to flow. At times I felt like I was weirdly gesturing to that old “Y.M.C.A.” song. More than once, the nurse gave up and simply took blood from my arm, defeating the purpose of the port or PICC. My PICC would sometimes get snagged at night from my tossing and turning, both at home and in the hospital. One night, I accidentally got tangled up in my IV line and yanked it right out of my chest. I tried to hook it back myself, but l had to eventually page my nurse to come and reinsert it. The same thing happened a month or two later. If you ask me, the port had one drawback. Remember that 1950s song by Paul Anka, “Put Your Head on My Shoulder”? My wife likes to lay her head on my chest when we cuddle at night at bedtime. I like it, too. But sometimes she’d lay her head right on my plastic port, which hurt like a dickens.

The port was my last reminder of my cancer. I wanted my cancer behind me. I didn’t want anything to remind me of it. Some nurses told me that some patients kept it for years. Not me. The moment I was allowed to have the port removed, I jumped at the chance. I drove 100 miles to get it done. I was told I’d have to stay in bed for a couple hours after the surgery due to the anesthesia. Impatient to move on, I asked to have the port yanked out without anesthesia. The radiology techs and doctor said they had never seen anyone do it without something to dull the pain. I will say this: the doctor did such a fine job of sewing up the incision after my port was removed that you almost can’t tell I ever had it.

Throughout my grueling six-month cancer ordeal, I wrote poems. I wrote dozens of them. Eventually, the collected poems, arranged chronologically, were published as a book. Funny, hilarious, sad, comical, tragic, uplifting, and poignant, “Running from the Reaper: Poems from an Impatient Cancer Survivor”would be a useful companion for anyone diagnosed with cancer or going through treatment. It would be a good resource for anyone who cares about someone with cancer or who cares for them, which can be ordered online.

One poem that is not included in the book because it happened months after I “Rang the Bell” is the following poem, written after I had my port removed without anesthesia because I was too impatient to wait a couple hours for the anesthesia to wear off. More than anything in the world, I just wanted every trace of my defeated cancer to be behind me. I didn’t want anything that reminded me of it.

MACHO MAN

I had my port removed

after a follow-up scan revealed no sign of cancer.

If you don’t know what a port is

it’s a device that was implanted beneath my skin

on my chest with a tube that was shoved up a vein

into my neck. They said it was for convenience’s sake

so I wouldn’t have to have blood draws from my arms

and so they could hook up chemo and saline bags.

I had to fast before the surgery.

I hadn’t eaten anything or drank my morning coffee.

I was hangry and grouchy and sick and tired of hospitals

and of being poked and prodded.

The nurse said I’d have to wait in bed in recovery for two hours

after the procedure until the anesthesia wore off.

Impatient as ever,

I opted to have the port yanked out without anesthesia.

“I’m tough. I can handle it,” I declared, with some misgiving.

Then I told her the stories of how I was attacked by a bear

and a pack of wolves when I was a kid growing up in Alaska.

I gritted my teeth during the surgery, but I made it through.

As soon as the wound was stitched, I jumped off the table.

“I’m going to get a burger and then go to Starbucks,” I said.

The doctor, nurse, and tech shook their heads in disbelief.

“We don’t know how you managed that,” they said.

“Men are wimps. They always ask for anesthesia.”

As I bolted for the door, I replied over my shoulder,

“Because I’m a Manly Man!”

As I strode down the hall I could hear them singing

that snappy song from The Village People.

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