I message my colorectal oncologist Dr. Cannon’s nurse on Wednesday and ask her if I need to prep anything for Friday’s port check. She says “it may be best to have someone come with you JUST in case they say that the port needs to come out.”

Just in case the port needs to come out?

The port’s not coming out. That’s ridiculous. 

I don’t secure a ride.

On Thursday I get a call from a nurse at Alexandria Hospital’s Heart and Vascular Department, where the port check is happening. Also, where I got the port placed. “It’s two quick x-rays,” she says. “One still, one live with contrast. And no eating after midnight and no liquids after 8am. In case the port needs to come out.”

In case the port needs to come out?!

“But,” I tell her, “I have another cancer and they use my port for immunotherapy…”

“Can you ask them if you can get immunotherapy by IV?”

OK. Sure. I’ll call my other oncologist and see if I can get immunotherapy via IV for the next six months. I hate IVs. I hate needles. And I don’t know what is going on. Things are moving fast.

I was not told my port might need to come out. I was told I might not continue chemo, but that call isn’t being made until October 8th after I get all these tests done. But this time I take it seriously. Maybe my port needs to come out.

I call my friend who I’m supposed to have lunch with on Friday. “How about instead of lunch,” I say, “we go to the hospital instead!”

I rummage around in my cabinet and find a carton of bone broth, from before, that I can have for breakfast. I have a clear Gatorade, from before, in the back of my fridge if I need it.

A friend comes over that afternoon. “Wow,” she says, “if they take your port out…. That’s a physical manifestation of moving from one chapter to the next.”

I don’t know if I’m ready to have my port removed. I love my port. It’s been with me through all of this. It makes my life easier.

Am I moving from one chapter to another? Am I done? 

What does done even mean, I think. When is done?

My friend Katie wants to throw me a party when I’m done.

“When are you thinking?” she’d asked.

“I dunno… March?” I’d said.

“March?!”

“Yeah,” I’d said. “When I’m done with chemo and immunotherapy. When I no longer have to walk into the infusion center.”

Is that done?

Or is done the end of chemo? Am I done with chemo? We don’t know.

Or is done when I’m done with the scans after three years? Or done with the scans after five years? Or done after five years of endocrine therapy? Or is it never done because I will always be afraid of recurrence? Maybe there is no done. Maybe I’m already done and just don’t know it.

If I’m done—with chemo—can I do the things? The things I can’t do when I’m on chemo? Can I just… get a pedicure whenever I want? Get my hair colored? Eat sushi? Have an oyster? Get food from the hot bar or the salad bar? Get on an airplane? Take creatine again? Can I go to the gym and just… keep progressing with no setbacks? What do I do with all the stuff? The ginger chews and peppermints and tea and Pepcid and the Immodium and gas-x and ice gloves and the chemo clean-up kit? Do they just… go away? When I’m done?

I fast. I know the drill. I set my alarm early so I can hydrate enough. I drink the bone broth so I can get my morning protein. I pack a banana and a protein bar—high sugar and a little more protein to pick me up right after the procedure, before I can get lunch. A full bottle of water to rehydrate.

My friend drives me to the hospital. When they call me back I say to her, “OK. Should be about 30 minutes. Or two hours. See ya when I see ya!”

I’m taken back. I recognize it immediately: where I was just over six months ago—a month after my mastectomy, getting my port placed so I could start chemo the next week. 

I walk into the familiar curtained-off “room.” I change into the gown that has snaps at the shoulder so they can pull it down and expose my chest. I put on the grippy socks. Tan. Size XL. (Always tan. Always size XL.) My vitals are taken. My BP is a little high, for me. Normal, for most. Temp fine. Pulse ox fine. As always.

The doc comes back. “OK!” he says. “This should be quick. Just two quick x-rays and you’re out. About five minutes.”

“Um,” I say, “I was told to come fasted in case you need to take my port out.”

“Who told you that?” he asks.

I tell him: Dr. Cannon’s nurse. And one of his.

“OK, let me call Dr. Cannon.”

Sure, I think, just go ahead and call my oncologist—the clinical director of the molecular tumor board at one of the best cancer centers in the country—at 11:30 on a Friday morning and see if he just happens to be available to answer the phone. 

He will not be available to answer the phone.

But it’s the right call—to call and see.

He describes the procedure. What they’ll be looking for. Clots. Blockages. Scar tissue that may have formed around the end of the catheter, making it difficult for the chemo to come out. 

“Can I see the port?” he asks.

I unsnap and pull down my gown.

“Looks fine,” he says. “I think it’s fine.”

He goes to call Dr. Cannon.

“Well, I guess I’ll get an IV started, for the sedation, just in case,” my nurse says. She starts touching my left hand and turning it this way and that. It makes me anxious. 

“The last time I had a hand IV it was in my right hand,” I say. “Right about here.” I point to a vein.

She looks. “That’s a good vein.”

It is a good vein. Knowing where my good veins are is not something I would have chosen to know about myself. But here we are.

She gets the IV ready and leaves. I wait, in the bed, alone, behind the curtain.

I hear muffled voices. I remember the last time I was here, coming out of the light anesthesia. A woman was wailing. I was annoyed. I had had a mastectomy the month before. This was the easy place. I sat in the bed alone then too. That was just six months ago. 

I think of everything that’s happened since. Six rounds of FOLFOX. Two more surgeries. Four nights in a hospital. Another round of chemo that sent me to the ER just last week.

And today my port might come out.

What do I say, I think, if they say the decision is up to me? Am I done?

A nurse comes to wheel me into the OR. The same OR I was in before. There are two nurses there. One is wearing a cap with whales. I love whales.

They say they heard I’ve started to get prepped in case we need to take the port out. One goes to get me a surgical cap to put over my hair. I’m very familiar with the cap. I’ve worn several this year.

“I only want it if it has whales on it!” I yell after her.

She comes back. It’s the standard blue one. 

“No whales,” she says, “It’s blue,” and hands it to me.

I stuff my hair under it.

“Blue is totally your color,” she jokes, and instructs me on how to scoot onto the operating table.

I think of Hawaii, when I saw all the whales. Every winter. The humpbacks, like what’s on her cap. My ex and I were on a hike, before we got married. We turned the corner and looked out at the ocean and they were everywhere—the whales. Their blows, side fins, a tail. 20? 30 of them? It was one of the most breathtaking things I had ever seen. It was my mission to find the whales every year. I became an excellent whale spotter.

“This little cuff is just so you don’t scratch your nose,” the nurse says before she secures it to my right forearm and I’m tied to the OR table. I remember why. Because once they give me the twilight sedation I’ll have no idea what I’m doing or what is going on. So they just tie you down.

When we rounded the corner of that hike, I asked my ex, “Do you wanna know what my favorite color is?” I pointed out at a particular part of the ocean. “It’s that,” I said. “It’s that exact shade of blue.” Not the shade of the surgical cap.

While on the OR table, I’m hooked up to electrodes, for the heart monitor they’ll secure to me if I have to be sedated, for when they might take the port out. They’ve read I’m sensitive to wound adhesive so they’ve found the hypoallergenic electrodes they use for babies and bring them over. They have little elephants on the stickers.

“What’s your favorite whale?” the one nurse asks as the other sticks the electrodes to me. 

“Humpbacks,” I reply. “I lived in Hawaii for four years. I’d see them every year. December to March.”

“Hawaii!” Both nurses exclaim. “The dream!”

Was it?

“OK,” she says, “Look to your left.” Like I did last time. I do—I look to the left.

They place the lovely surgical paper over my face. It’s blue. It’s there so I can’t see as the doctor cuts into my chest, in case they need to take the port out.

As I look to my left she unsnaps the right side of my gown, pulls it down, and wipes cold antiseptic all over my right chest and neck.

“It’s blue!” she says. “Looks great on you!”

I remember the morning of my mastectomy. I woke up to a text from the one who showed up on my doorstep. The one whose fingers were the last to touch my left breast. The one whose lips were the last I’d felt on mine. 

He said, “I’m sure you’re asleep. But, before you go in I wanted to say you’ve got this. And I’ll be here on the other side more than ever.”

My heart did a little flutter when I read that.

I miss you so much, I remember thinking. I missed my friend. I was so glad we were talking again.

“Side note -” the text continued, “one of my favorite birds is the blue-footed booby.”

I smiled. 

“Thank you so much for this,” I wrote with a heart.

“The bird part, right?” he responded right away.

We both know it wasn’t the bird part.

“Of course,” I wrote with an angel face.

“If food is scarce and a male’s feet fade,” he continued, “he becomes less attractive almost immediately, and his mating success drops.”

“So take care of your feet, boys!” he wrote with a crying-with-laughter emoji.

“I understand completely,” I responded. “Blue is my favorite color.”

“Mine too,” he replied.

I still miss you, I think, on the OR table, with the blue surgical cap and the blue antiseptic and the blue surgical paper that’s covering my face.

Where did you go?

The doctor walks in. “So I talked to Dr. Cannon.”

“What did he say?” I ask.

“He says to keep the port in.”

We all laugh. “SORRY TEAM!” I exclaim, hungry, thirsty, de-conned, with an IV stuck in my right hand.

The safety check starts. The doctor says, “We’re here with Allison Houseworth to do a port check for…” He looks down at my port, “nothing…” he says.

I laugh. The nurses laugh. He laughs.

I see the large TV screen they’ll look at as they do the imaging. I ask if I can watch. “Sure!” they say and remove the blue paper from in front of my eyes.

And I see me. Inside me. My collarbone, my rib cage, my port, there on the big screen—the catheter running down into my heart. The doc takes an x-ray. 

“I’m going to access your port now,” he says. I watch the screen and see as he punches the needle in. 

“I’m going to push the contrast now,” he says. “Take a breath in and hold.”

I do. I inhale and see my lungs expand and watch my ribs expand with them. 

“And exhale,” he says.

I do. I watch as my lungs deflate and ribs release and I see as he pushes the contrast into my port. I see it on the screen—the contrast—black. I see it flow through the catheter of my port and spill into my heart and disperse, like squid ink in the ocean.

We’re done.

The port is fine.

They wheel me back to my curtain-room. I eat my banana, drink water. I get dressed and go to lunch.

I get a call that night from Dr. Cannon.

“I’m so sorry, Allison, about the confusion from earlier,” he says, “I can’t remember what we decided.” He sounds a little stressed. Very unlike him. “And they caught me in the middle of an end-of-life conversation.”

My heart drops. A conversation I decided he would never have with me. Ever.

He stops talking. I tell him he’s so nice. I tell him I know it’s the job but I’m sorry he had to have that conversation. I remind him of our plan, all the tests he’s running to figure out what happened—why I had a bad reaction to this last round of chemo. Was it an infection? My port? My heart?

“And we wanted another Signatera, right?” he asks.

“Yes,” I tell him. “You wanted another Signatera.” To see if there were any molecules from the rectal tumor in my bloodstream. 

I try not to think about this. I try not to think about this like I try not to think about various ways conversations with this oncologist could have gone. Could go. Because if they find molecules, and I can’t do chemo, then what happens? I stop the thought. I have my port. It is fine. There is no infection. One thing at a time.

It sounds like he’s getting choked up, on the other end of the phone. He gets off quickly. I stare out my window.

I remember one of our last meetings. I sat in his office and told him my mental health was getting worse. With every blow my body took, my mental health took three. I needed a plan. Answers. A timeline. Something to put my mind at ease. He looked at me and spoke with me without breaking eye contact. He told me to hop up on the table.

I do.

Before he begins his check-up he looks me dead in the eyes and says, “You have climbed every mountain in front of you so far. Just keep going. You can do this.” I give him a little nod.

He checks my lymph nodes. He places a stethoscope on my back, behind my heart, behind my lungs.

He tells me to take a deep breath in.
And I do.

 

---

 

To read more about the ER visit, click here.

To listen to an audio version of this on Spotify, click here. To listen on Apple Podcasts, click here.

To get posts sent directly to your inbox, click “Subscribe” at the top of the page.