It’s 00:22, and I have just woken up after about two hours of sleep, just like every night.  I began to wean off from steroids on Sunday, three days ago.  It has been quite hard; I still do not sleep, but do not have the usual buzz and energetic feeling thanks to steroids during the day.  I am no longer a super human.  Instead, I have a headache, my eyes cannot seem to tolerate bright lights, and I feel grotty and tired.  I am almost missing the steroids! 

I went to the Royal Marsden to talk to Lucy about my veins on Monday.  I ended up having a long chat with Lucy, and Juanah (one of my consultant haematologists).  We all agreed, my veins will not last through the whole chemo, and it would be advisable to have a ‘central venous access device’ for the intravenous (IV) chemo drugs.  What they tend to do in Royal Marsden is to fit in an ‘implanted port’, which is what I will be getting.  An implanted port, also known as a portacath, is a device inserted under the skin into the body, usually on the right side of chest.  There is a port, made up of a portal body, and this is connected via a thin tube (catheter) inserted into one of body’s veins.  The port can be felt under the skin, but can hardly be seen.  When the entry to the port is required to give me the chemo drugs, they can do this by puncturing through a special membrane of the port with a special type of needle.  I will have the same portacath for the whole duration of treatment.  When it is finished, they will take it out.  Simple! 

The portacath is inserted (and then eventually taken out) by a surgeon, under general anaesthetics (GA), so today I had my pre-op assessment.  My operation is this Friday.  They do not waste time in the Royal Marsden!  Usually, this sort of procedure is done as a day case, however, the anaesthetist who came to assess me yesterday, decided that I should stay the night.  The reasons: the operation would be on a Friday afternoon, if anything went wrong afterwards, I would be in the hands of A&E in Homerton again; I had a complication, bronchospasm during my last GA, so they had to place a longer tube down my windpipe; I have had a chest infection with collapsed lung since the last GA; and I reacted by coughing and wheezing to the Rituximab last Tuesday.  He thought, there were too many little (chest/lung) issues, so for precaution, I will be staying the night.  Let’s hope, I will have slightly more pleasant night than last time!

Portacath

A diagram of an implanted port.