Portacath: What is it and will it hurt?

“And breast cancer is a dance of initiation, for no woman who dances with cancer is ever the same. She has visited the source and tasted the waters of life and death, savored the sweetness and the sharpness of her own mortality, and tasted her desire to survive.” (pg. Xiii) Breast Cancer? Breast Health! Susan S. Weed

Ten days before my scheduled mastectomy surgery I saw the doctor who had previously treated my mother. She died five years earlier from pancreatic cancer. He would become part of my cancer treatment team.

“Dawn, your veins are exactly like your mothers. They are small, they roll and then collapse. They will not support the several hours needed for your IV tubes treatment. Have your mastectomy surgeon insert a portacath immediately.”

Not a single person on my “cancer treatment team” had mentioned this to me.

My stomach tightens and I can hardly breathe. “Several hours, that sounds awful. What is a portacath anyway?”

“A portacath consists of a reservoir (the portal) and a tube (the catheter). The portal is implanted under the skin in the upper chest. It may appear as a bump under the skin in thin patients, less visible in patients with thicker subcutaneous fat. The catheter runs in a tunnel under the skin, going over the collar bone and then enters the large vein in the lower neck (the internal jugular vein). Since it is completely internal, swimming and bathing are not a problem. The septum of the portal is made of a special self-sealing silicone rubber. It can be punctured up to one thousand times and therefore can be used for many years”. Dr Eisen Liang

A few days later, I made the two hour trip to Seattle where the rest of my treatment team resided. Since I was on my way to Portland for a workshop, I thought that I would just “drop by the hospital,” have the procedure and continue south. See, I have this part of me that thinks that I am akin to the Energizer Bunny: strong, durable and can get through anything. It is both my greatest strength and greatest delusion. Sometimes I need help. As my husband is affectionately fond of saying, “Dawn, you are not as big as you think you are.”

What was I thinking? What was the staff thinking? The procedure hurt like hell without benefit of anesthesia or pain pills.

A few hours later, stunned, I got into my car (because I am tough, don’t you know) and drove three hours through pouring rain, four o’clock traffic jams, a blur of tears and throbbing chest pain. I hunched low in my seat terrified that a cop would pull me over as I could not tolerate the seat belt across my chest.

Once I arrived in Portland, my colleague tenderly helped me into my night gown and tucked me in bed with ibuprofen. She then went to fetch us dinner. I put the covers over my head and sobbed. I cried because I was scared, in pain, relieved and incredulous that I had allowed myself to be hurt in such a flippant manner.

I would come to understand that nothing makes me feel as vulnerable as the cutting of flesh on my body. It leaves me defenseless as if the thin coat of armor normally worn has been ripped away leaving me exposed to all of life’s vicissitudes. Paradoxically, this small death in yet another series of life’s small deaths brought to mind the saying; “Dying in order to live” which is at the very core of all the great religions. Reflections on death as a companion and teacher were the beginning of another spiritual passage.

As I tried to get my tears under control another part of me lectured me about having such a ‘stiff-upper-lipped-I-can-do-it-myself-cavalier-attitude’ instead of asking simple questions like, “will it hurt, can I have something to dull the pain during the procedure and should I be driving alone?”

This is a perfect example of parts colliding. My tough girl part was totally driving the bus while my vulnerable parts (especially the parts that had been physically abused as a child) were screaming for help.

Normally, I refrain from sugar because it makes me sick and is an addiction for me. Nonetheless, before my colleague left to get dinner I begged her to pick up a quart of ice cream. I needed comfort food to settle me down. Forgetting that the ice cream would then become my next problem (heartburn, not able to sleep and off and running into my sugar addiction) but in that moment, I didn’t care.

True to form, I simply wanted to bulldoze my way through something that I thought may be a little unpleasant.

You can read more about portacath insertions here,

Next: Preparation for the mastectomy



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  1. Dear Dawn,

    Your last two blogs have touched me deeply. Your transparency and honesty about the roller coaster ride of your grief and fear lights a path for the rest of us. Vanity and courage coexist as parts in me too. In feeling compassion for your experience I somehow learn to love myself more. Amazing.


  2. Ron Kelley says:

    As you relate your story, I cry. I cry for you. And I cry because I think of how when my wonderful partner in life, the most wonderful wife I could imagine, had to endure these things you relate. When she did, I just wanted to clutch her to my chest and hold her so tight that no harm could reach her…
    But love and caring sometimes just aren’t enough. Sometimes even the White Knight can’t fight the battle on the enemy’s field. Sometimes his shield is just not big enough. When we were at the stage you are relating now, it was one more step of fear. How high would the steps of this new menace go? Could this ferocious dragon be slain?


    • Hi Ron,

      I am so very sorry for your loss. I am sure you were a loving help mate as she moved on to her next journey.

      Kind Regards, dawn

  3. Dawn, As always an honest response to your life and the curve balls you have been handed. Always tenacious, and always poised, that is our Dawn. Blessings Helen

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