On a recent flight home, I had a very interesting conversation with the lady sitting next to me. This delightful woman happened to be a breast cancer patient currently on chemotherapy. When she found out I am an infusion nurse, she immediately showed me her “implanted port” , which is located on the inner aspect of her left upper arm.
It is amazing how strangers offer so many personal health information once they find out you are a nurse!! During the course of our 4 hour flight, there were so many things she had shared about her chemo treatment. Aside from the nausea and vomiting and fatigue post chemo, she said her chemo nurses always seem to have a hard time accessing her arm port. They usually have to do it twice and the needle sticks out of her port. She asked – Is it always difficult to access an arm port?
Well, this was one of those made for TV moment, when the entire cabin abruptly became silent, as if everyone was waiting to hear my response. So here’s what I told her (yeah and maybe the entire cabin too) based on my experience.
- Ports inserted in the arm are usually slimmer than the ports implanted on the chest. As a result, perhaps nurses are adjusting a bit when they palpate for the septum of the port. Upper arm ports are not as common as chest ports.
- Chest ports have more support being that it is in the chest area than arm ports, where there’s no firm anatomical support in the upper arm. This can make a difference in stabilizing the port during access. For arm ports, it’s best if the arm is rested on a flat surface to provide the extra stabilization support for better access.
- The access needle length will need to be shorter since arm ports are not as deep as chest ports.This will eliminate the needle from sticking out of the port septum and the “rocking” movement of the needle while in place.
- At times, dressing over the access needle may not stay in place as well as it would for a chest port, so some adjustment may be needed.
- From an advantage point of view. it generally takes less effort to roll up a sleeve to provide access to the upper arm port than to completely remove a shirt for access to the chest port. Upper arm implantation does not leave scars on the neck or chest, which may prevent patients from wearing wide-open neck clothes because of cosmetic concerns.
It was a pleasure to meet this unfortunate but courageous woman. Before we parted, just like two good friends, hugs were exchanged and she said to me, “Warrior Mode ON”!!