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Thursday, March 13, 2014

Pop-Top

“You really need to get a port,” the hematologist said. He kept up this mantra for more than twenty years.

My veins have always been small, the best ones seem to automatically retract or dodge away from an oncoming needle. By the time I was twelve years old I had three scars where a doctor had cut the skin to get an IV line started. Some times it took a few tries but they always succeeded eventually.

By the time I was an adult the IV nurses who knew me best wouldn’t come near me until I had soaked both arms in hot moist towels to plump up the veins. The nurse would choose a child-sized butterfly needle and take a deep breath. I tried all the tricks I knew for my part of this drama. I drank several glasses of water to hydrate. I meditated and relaxed. I wouldn’t let them try to stick me until the blood products were hung beside me, just in case it took several tries. I didn’t want too many pinholes oozing all at once if the first few attempts to start the IV failed.

When I had a hemorrhagic stroke in 2002, I awoke to find that they had inserted a line into my femoral vein. The doctor increased his nagging, “You need a port.”

“Not yet,” I said, “Not yet.”

I couldn’t quite explain why I kept putting it off. I knew there was a risk of infection, ports could get clogged and have to be replaced on a regular basis. I new it was surgery and my automatic response to surgery had always been, no. I knew once I made the decision, there would be no going back. Unlike people who have a port for chemotherapy, I would have one for the rest of my life.

Nurses said, “You’ll love it.”

“Doubtful,” I thought. I guessed that the nurse might love it, but I couldn't imagine that I would.

“You’ll wonder why you didn’t do it earlier.”

“Probably, I won’t,” I said.

I held them off until I was 64. By that time the only veins that could be felt or seen were on my hands and they were dotted with scars from previous use.

“Ok,” I said after one day there were four failed attempts and the one that succeeded was on the base of my thumb. “Ok, I’ll have a port put in.”

I almost reconsidered when the surgeon explained that he was going to cut my jugular vein and run the plastic tubing to just above my breast where the port would be implanted. Then the line would continue downward just above my lung.

It took a few weeks for the scars to heal, but once it was in they could easily test my clotting levels and give me additional fibrinogen.

Now there is a round bulge about the size of a quarter just under the surface of my skin. I can also feel the plastic tubing that runs from my neck to the port. It is a foreign object and I do not love it. Nor do I wish I had done it earlier. The nurses don’t shudder when they see me walk in the door. But, it only takes one skin stab to start the infusion or draw a blood sample and I have to admit there are some benefits to having a pop-top.

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