Port goes in tomorrow, Dr. Shergill on Wednesday

Quick plan update. I jumped on the phone first thing this morning with the interventional radiology team at Saint Mary Medical Center, and they found me a sliver of time tomorrow instead of Wednesday. The port goes in then. I need to be at Saint Mary's by 11 a.m. to prep, with the procedure itself at 1 p.m. It involves anesthesia, so the rest of that day will be slow moving. Then Wednesday I head to University of Chicago to meet Dr. Ardaman Shergill, with my husband and my son John coming with me.

So, what is a port? In plain language, a port (the full name is a port-a-cath or implanted venous access device) is a small disc, about the size of a quarter, that sits just under the skin of your upper chest. A thin, flexible tube called a catheter runs from the port into a large vein near your heart. Once it is in, the team can give chemotherapy, draw blood, and run IV fluids through that one access point instead of fishing for a vein in your arm every single visit.

Why does it matter for FOLFOX? FOLFOX is given over a couple of days, with one of the drugs (5-FU) running on a slow continuous infusion through a portable pump that I take home for about 46 hours. That kind of infusion really should not go through a regular arm IV. The chemo is also irritating to small veins, and over months of treatment those veins get tired and scarred. The port protects them, makes infusions safer, and means I am not getting stuck over and over.

What is involved in getting one? It is a same-day outpatient procedure done by interventional radiology. They use light sedation (a kind of twilight anesthesia) plus numbing medicine at the site. Two small incisions, one near the collarbone and one a couple of inches lower on the chest, the catheter gets threaded into the vein under live X-ray guidance, and the port disc gets tucked into a little pocket under the skin. About an hour on the table, then recovery. Sore for a few days, restricted lifting for a week or so, and then it just lives there quietly until they need it.

Accessing it. Every time I come in for chemo or labs, a nurse pushes a special angled needle (a Huber needle) through the skin into the center of the port. That is the part I am bracing for. I remember my mom's face every single time, that sharp little wince and the sound she made, with her poor beat up chest from years of treatment. There is a numbing spray, and you can also ask for a lidocaine cream (often called EMLA) put on about an hour ahead, which actually does help. I will be the patient who asks for it every time. The honest truth is that infusion nurses do this all day long, and it is easy for any of us in healthcare to forget that the person on the other end of the needle has a whole nervous system bracing for it. I am going to be vocal. Slow down, give me a second, use the cream.

Now, Dr. Shergill. She comes very highly regarded, and I feel lucky to be getting her eyes on my case. She is a medical oncologist at University of Chicago Medicine who specializes in comprehensive care for all stages of gastrointestinal cancers, with particular expertise in pancreatobiliary and lower GI cancers. Her research focuses on targeted therapies, especially the KRAS pathway, and she sits on the leadership team for the GI cancers committee at the Alliance for Clinical Trials in Oncology, an NCI-funded research organization. Board certified in Internal Medicine and Medical Oncology. She practices at the Duchossois Center for Advanced Medicine in Hyde Park. Her full bio is here: https://www.uchicagomedicine.org/find-a-physician/physician/ardaman-shergill

I have also added that link to her card on my Care Team page, so anyone wanting to learn more about the people in my corner can click straight through.

Two big days, back to back. One step at a time.