Spiders & Snakes, er, Blood Clots

Based on my experience, the process of accessing a chest port runs roughly as follows:

1. The nurse gives you a shot of lidocaine to dull the nerve endings above the port;

2. They lay out all their equipment on a sterile field;

3. They swab down the area around the port to sterilize it;

4. They stab a large needle connected to some tubing into the port;

5. They attach a big syringe of saline solution to the tubing and pump that into you;

6. They pull back on the syringe to make sure they get a blood return;

7. They pump a syringe full of heparin into the tubing; and then

8. They cap off the tube and lay adhesive over the needley part to make sure the needle doesn’t come out, and you go on to your next appointment.

Frequently, as they’re doing Step 5, the nurse will ask if you can “taste it.” And oddly enough, I usually do. This because the line runs into vein that goes directly into your heart, so as they pump in drug -- or the saline -- it goes straight into your heart where most of it is then pumped up the big artery to your head. And having a big wash of saline solution hit the blood vessels in your head pretty much overwhelms your senses of taste and smell.  So much so that, as I’ve noted previously, it’s now a smell I pretty much detest.

But this is not a post about the smell of saline. This is a post about blood clots. 

Tomorrow, I go in for a “port assessment.” The nurses are no longer able to get a blood return from my port, which is a problem on a number of levels and so needs to be corrected. It could be that the port is in the wrong position, or that I’ve kinked a line somehow, or, most likely, that my body has layered scar tissue of some sort across the end of the tube and that scar tissue is now acting as a valve. Push fluid in, and the scar flap opens to let the fluid in; pull back on the syringe, and the scar flap closes and prevents anything from coming back.

But here’s my question: what if, as a result of monkeying with my port, whatever scar tissue has formed at the end of the tube -- and we may as well just call it a blood clot -- is dislodged and, like the saline solution, goes wooshing into my heart and then up the relevant tube to my brain?

I have to say, I’m not really excited about the idea of a blood clot rushing to my brain. I’m no doctor, but I have this vague sense that blood clots roaming around the blood vessels in the brain can lead to things like aneurysms, strokes and other terrible conditions that can seriously hamper a person’s day. And as a type I diabetic with stage IV colon cancer, I feel that I’ve pretty much had my full share of serious medical conditions that can hamper your day. I don’t much need or want another.

Thus, I’m really hoping the SCCA has a roaming blood clot mitigation strategy that they follow when they start messing with your chest port, cause I’m not sure I’m going to want to lie down for this procedure if they don’t -- at least not without a hefty dose of Valium or Xanax first.

Blood clots and spiders: two things I’d really rather not be exposed to, though at least the spider you can smash with a shoe before it tries to kill you.