Pam,

Yes. Both a port and a PEG. Here's my story:

My first round (out of three) of IC was done on an in-patient basis and without a port because they were eager to get started. So they put an IV in my arm and pumped in the drugs. I had the TPF cocktail: Docetaxol (T), Cisplatin (P), and 5-FU (F). They get the T&P into you in only a few hours but they take several days to get the F into you. The F is very unpleasant (many bad side effects) and its rough on your tissues as well. In particular, because the F was going into my arm (through small veins), it caused really bad marks all along the inside of my arm which made me look like a drug addict for a couple months. Once they finished pumping these chemicals into me, they sent me home. I was feeling sick as a dog after this and, at my first follow-up appointment, I threw up in front of the nurse (fortunately, I got to the sink and didn't make a mess... but I was embarrassed).

Toward the end of the first round (each round was 3 weeks long, and you feel pretty much okay during the 3rd week), the gave me a fancy Dual-Lumin PowerPort. The "Dual-Lumin" aspect means they have two little wells to stick needles into and so can have two different streams of stuff flowing into you at the same time; this can be very handy. The "Power" aspect of this means they can put some things into you under pressure; I'm told this is useful when they want to give you contrast agents for CT or other kind of imaging scans. So the port can save you from getting all kinds of needle sticks (blood tests, imaging exams), not just for the chemo. But the best aspect is that it causes the stuff to flow into a huge vein (not a small one, like in your arm)... so when they gave me the 5-FU later, it had a chance to mix with a larger volume of blood (and get diluted) before coming in contact with the walls of the veins and this means your tissues don't get hurt as much by the 5-FU.

So they started the 2nd round of chemo on an out-patient basis using the port. I got the T&P while still in the hospital (for just a few hours) but they sent me home with a portable pump full of 5-FU that dribbled into me over the next few days. Fortunately, my MO reduced my dose of 5-FU by 20% so this 2nd round was a LOT more tolerable than the 1st round.

At the end of the 2nd round, I was complaining of some pain in my arm and my MO sent me for an ultrasound exam. This exam found I had a blood clot in my arm which they said was caused by the port. So they postponed my 3rd round by 1 day while I got the port removed and they started me on twice daily injections of a blood thinner; I had to give myself these sub-cutanous (not intravenous) injections for the next 3 months. So I was bummed out to lose the port and I was bummed out to have to give myself all these injections.

I forget how we managed the 3rd and final round, it must have been intravenous again and I think it may have been on an out-patient basis. Anyway, we got through it; then they gave me a few weeks break before starting the chemoradiation treatment (CRT).

I pushed to get the PEG installed as soon as they started CRT. I wanted it in before I needed it so that I could practice using it. That turned out to be a good idea because I had become comfortable using it by the time I needed it. There were three ways to use the PEG: (1) in the "bolus" approach you put the liquid into a huge syringe which you attach to the PEG and "push" the liquid into our stomach; the first time I did this too fast and went into a cold sweat - I had to lie down for the next few hours; (2) I soon learned to use a gravity bag; you just hook a tube from the bag to the PEG, place the bag on an IV pole, and fill the bag with liquid... then I would go lie down and let the liquid flow into my stomach. This was the method I used for all my nutrition for the next 3 months. (3) I heard about, but never tried, a 3rd method similar to the gravity bag but it uses a pump rather than rely on gravity.

During Induction Chemo, I lost 25 pounds because I never wanted to eat anything but the biggest problem I had was dehydration. The dehydration would weaken me to the point where I could barely stand up. So I was going to the hospital almost every day to get fluids pumped into me via IV. It was common that they would wheel me into the hospital in a wheelchair (because I was so weakened by the dehydration) but, after 4 hours of getting fluids pumped into me, I would bound out of the hospital feeling filled with energy.

During CRT, the PEG helped me keep hydrated and I never again needed to go to the hospital for hydration. I would typically mix 1 can of the nutritional fluid (called Jevity) with 1 can of water and I would do this 6 times a day. I didn't lose any weight and I never got dehydrated. By comparison to my experiences in IC, this was great. I finished CRT on 26 August and had mostly weaned myself off use of the PEG (and back to eating orally) by 30 September... which is when I returned to work.

I still have the PEG in place, but I haven't used it at all for over a month now. The only reason I haven't had the PEG removed is because I'm now about to undergo surgery (neck dissection) and there's a chance the PEG may be useful during my recovery from the surgery.

So I highly recommend both the port and the PEG. They are very useful.

Hope that helps, Rob