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Climbing with an implantable port?


Original Post
BrianWS · · Unknown Hometown · Joined Apr 2010 · Points: 790

Wish I didn't have to post this inquiry, but shit happens, right?

Long story short: I had a Bard Powerport implanted below my clavicle (right side of chest), with the catheter feeding into my superior vena cava. I will have the device implanted until next summer at the earliest, and potentially indefinitely. I have not climbed for the past 6 months for fear of damaging the port, catheter, or the involved vasculature.

The medical condition that I have which requires the port has not, and likely will not, caused any symptoms that impact my ability to climb. Likewise, the medication that I receive via the port has also not caused side effects significant enough to impact my previous level of fitness.

I would very much like to resume climbing, which has been a central part of my life for the past 10 years. Obviously, I do not intend to climb anywhere near my pre-diagnosis level -- I would likely stick to moderate climbing, avoid long reaches or lockoffs with my right side, no sick dynos, etc.

But before doing so, has anybody here had direct or indirect experience climbing with an implantable port? Or, are there any medical professionals (oncologists, nursing staff, PAs, etc) who could give their opinion on tolerated levels of activity? None of the healthcare providers that I have spoken to have any experience climbing (personally or patients), so none have been able to give a clear answer on whether or not this is a good idea.

I appreciate any and all constructive feedback. Thank you in advance.

mediocre · · Unknown Hometown · Joined Jul 2013 · Points: 0

Hey Brian,
I don't have any experience climbing with a port. I'm an RN and have accessed ports for oncology patients and other pt's with certain autoimmune conditions that require a central line to infuse medications.
That's a tough question. A lot of the patients that I have encountered are kids, who are pretty active other than when their condition flares up. That being said, I would imagine that they are running around a playground and just otherwise being kids, not rock climbing.
I am by no means an expert, but the first concern I would have would be trauma to the port. You have a catheter in the superior vena cava, and if I remember correctly the tip of that catheter is sitting right above the right atrium of your heart. If you were to whip and nail that thing on a rock there could be some movement of the catheter, and if bad enough you could potentially dislodge the head of the port, even though I think that would have to be a pretty big impact because I know those are surgically implanted. I would think there may also be potential to possibly puncture the vena cava in a traumatic event, obviously bad news.
The pressure in your chest is also going to change a lot when you're pulling down, scared shitless, etc etc. This may cause some shifting/unusual pressures on the vena cava and in turn the catheter. I have seen people go into atrial arrhythmias when central lines have been dislodged and they irritate the heart muscle if the catheter is in too far.
These are things you may have already thought of, but they come to the top of my head after reading your post. I'd be curious if you find definitive answers.
Good luck with what you're dealing with. Wish you the best.

BrianWS · · Unknown Hometown · Joined Apr 2010 · Points: 790

Thank you for your insight. Direct trauma to the port is a scary prospect -- I'd hate to expose it via abrasion. Most of the folks I know with a port tend to be older and with much more body fat than myself, and you can barely see it in some of them. Being slim and (formerly) extremely athletic, the goddamn thing looks like it's ready to jump out of my skin in comparison.

To clarify, I would be climbing *FAR* below my level of ability. I'm not even thinking about getting back to 12s and 13s at this point... or even climbing in the 5-double digits range at all. Just wanting to get some light upper body activity and air under my heels after a pretty excruciating half-year hiatus and throughout a somewhat indefinite therapy schedule.

Again, I'd plan on routes with no risk of fall, revisiting easy climbs with which I am familiar, staying off of overhangs or roofs, and so on. Following and TR would be the most likely style of climbing, with leading only with zero risk of falls.

Mark E Dixon · · Sprezzatura, Someday · Joined Nov 2007 · Points: 549

I'll see if I can find out anything.

What's the worst that happens though? You might need to replace your port.
Usually not that big an operation.
I'll bet you've reached your deductible this year too.

If the catheter irritates your heart and you go into AFib, you could be converted back to NSR, although I wouldn't wait around to get it done.

It might be worthwhile to have an idea where the tip of the catheter lies. If it really is pointing at the wall of the IVC, maybe a little more caution is in order.

People climb hard while taking anti-coagulants. That seems a lot more risky than an implanted port.

Mark E Dixon · · Sprezzatura, Someday · Joined Nov 2007 · Points: 549

PM sent

BrianWS · · Unknown Hometown · Joined Apr 2010 · Points: 790

Thank you for the feedback!

BrianWS · · Unknown Hometown · Joined Apr 2010 · Points: 790

To all the folks who left responses on this page and to those who sent PMs -- thank you all so damn much.

It's wonderful to see the all around grooviness of the climbing community alive and well on a forum that has become somewhat belligerent over the past few months/years.

BrianWS · · Unknown Hometown · Joined Apr 2010 · Points: 790

Update: went climbing at the gym for the first time in half a year - best night of my life in a long time. over the past ten years, the longest hiatus I had taken was about a week.

Despite some extremely major abdominal surgery three moths ago and an ongoing six months of other fairly body-damaging treatments, I haven't lost nearly as much performance as one would think, especially on vertical terrain and cracks - steep climbing provides a pretty quick reminder of how core intensive this sport can be, and will take a bit more work.

Now the big challenge is finding a good solution for protecting the port from impact. I built a soft protector from an old neoprene knee sleeve, foam heel inserts, some gauze, and an ace bandage. I definitely want to get something made with a high impact shelll and better system to keep it in place before I start getting back into more physical routes than vert or crack. Unfortunately there doesn't seem to be much of a market for such a device. Any suggestions?

Doug Hemken · · Madison, WI · Joined Oct 2004 · Points: 5,597

I had a catheter in that location in the mid 80s, for hyperalimentation after a long series of intestinal resections. I went climbing a few times - glad to hear you are figuring out how to work with the current reality, and getting back to the basics of enjoying climbing.

I've used hard-shell sports protectors to shield other injuries - that's going to be a hard location to stabilize anything!

So I have no real suggestions, but just want you to know that there are those of us who understand completely, and are cheering for you.

Mark E Dixon · · Sprezzatura, Someday · Joined Nov 2007 · Points: 549

How about a weight vest like this, but take the weights out.
Kind of pricey though.

sklz.com/performance-traini…

Old lady H · · Boise, Idaho · Joined Aug 2015 · Points: 290

I don't know just how much your port sticks out, or just where it is on your chest, but once you have something hard that's the right size, maybe go to a medical supply place and cruise the bandages? Might have to shave your chest for something to stick, but that seems easy to do/undo. Or, that stretchy sticky bandage stuff that's ubiquitous if you have blood drawn. Lotsa colors. Woo. Hoo.

Longer term, reusable, again, once you have the stiff bit figured out, I'd suggest going to a title nine, or some other small store that specializes in women's sportswear. Explain what you need to do, and I'm betting they'll have a plain Jane black/grey spandex crop top that zips in front, or yes, a "sports bra" that'll serve as an upper story jock strap. And be really, really pleased and honored to help you out. Then, you'd just need to sew a pocket on the inside.

Best, old lady H.

BrianWS · · Unknown Hometown · Joined Apr 2010 · Points: 790

Thank you all for your suggestions. I may try them out in the future, and report back.

In the meantime, I took a little league heart and sternum guard and redid the fastener system to allow for offset positioning.

Repurposed sternum/heart guard

There is a shallow contour which fits perfectly over the port. It's nicely padded, but I'll have a push-up bra insert taped over the port for more cushioning ( and more impressive cleavage).

Nice contour but still low enough profile to prevent snags

It seems to hold in place with regular movement and overhead motions, but we'll see how it holds up climbing. I could possibly secure it even further by putting a shoulder brace or tight tshirt on over it.

Straps could be irritating over time, might swap them out for a wider and softer material
Optimistic · · New Paltz · Joined Aug 2007 · Points: 300

My wife and I (both MD's) think it'd be a good idea to ask the surgeon/radiologist who placed it. Probably it's OK, but we worry a little about the traction on the catheter (and the catheter's connection to the port) during an overhead move. You might even just leave the climbing out of your discussion and just ask them if it's OK to do pullups.

Myself I'm not too worried about a direct impact on the port. I think anything that could injure the port that way would probably also injure you in other ways...i.e., something you were probably already avoiding!

Good luck!
David

Optimistic · · New Paltz · Joined Aug 2007 · Points: 300

Chris, I think he has a subcutaneous port, so maybe no cuff?

Old lady H · · Boise, Idaho · Joined Aug 2015 · Points: 290

BrianWS, looks like you came up with a pretty good solution! I'm curious, though. Have you asked a sports medicine type about this? You can't be the only athletic type who's had a port to deal with. My impression is that the docs aren't always the best to ask, but the rehab people who pick up the pieces and get guys functioning again.

Just wanted to add, good luck with whatever crap you're battling, and hope you manage well.

Have to say, that vertical scar made me cringe! I remember how hard it was to manoeuvre (like, getting out of bed even) with just a low, horizontal cut, not the slash straight through all the muscle.

Glad you were back on a wall!

Truly, very best wishes, Helen

BrianWS · · Unknown Hometown · Joined Apr 2010 · Points: 790

I've asked around, and nobody in my hospital system has given me a straight answer -- it's very rare for somebody my age to receive the diagnosis that I have, so the surgical and medical teams aren't used to a patient who is active, let alone a climber. Furthermore, the type of medication that I receive typically prevents strenuous physical activity because it wipes the patient out pretty badly from the systemic side effects, of which I have almost none.
I don't think an informed answer is possible here on the east coast, which is why I'm very thankful that I received numerous responses from medical professionals who live and work in areas where climbing isn't as unknown.

Lady H, the scar is about 10 inches or more. It was pretty rough sneezing, coughing, retching, and getting out of bed for about 3 weeks. Thankfully, I bounced back pretty quickly, definitely thanks to the fitness that 10 years of a fairly serious climbing lifestyle can deliver.

Also, the port protector works great. Didn't move out of position once when climbing. I got some weird looks when taping the bra insert on my chest, but whatever. Free country, and stuff...

Old lady H · · Boise, Idaho · Joined Aug 2015 · Points: 290

Hey, you're alive, ALIVE, and living. Whatever, is correct! Makes it pretty easy to keep crap and crap throwers in perspective, eh?

I work with the truly elderly, and if I whine about my 60 year old knees, or whatever, they just roll around laughing! Figuratively speaking.

Glad you're with us, and hope it continues as best as can be managed.

Helen

Christine Milne · · Unknown Hometown · Joined Dec 2016 · Points: 0

Hey Brian,

I have a question. I found that sternum cover you used. But I am having a super hard time making it work for me.

I also have a port a cath, shit happens. I get monthly infusions of a new immune system and that is going to be for the foreseeable future.

I started climbing a year ago though and I refuse to give it up. But everything I do it seems to hit it or just hurt. My doctors all told me climbing is totally fine. I just need a way to cover it because when the rope hits me when I fall or if I hit a hold it really hurts and then I am super black and blue.

I was just wondering if you could give me some suggestions on how to make this work better. I did it the same way your picture showed and I had really bad chafing under my arm from the bands.

Thanks for your post. I have been looking for help with this for the past few months.

Christine

BrianWS · · Unknown Hometown · Joined Apr 2010 · Points: 790

Hi Christine. I stopped using the hard shell cover for the same reason as you - chafing was unbelievable. I ended up buying a neoprene shoulder brace and stuffing a few bra inserts (2 or 3 layered) over the port, which are held perfectly in place by the brace. See the photo below.

Toproping is more problematic than leading. There is almost zero chance of getting whacked by the rope on lead, but can be a problem on toprope. Extra padding will help with this, as will leading instead of TR.

"My Pro Supports" shoulder brace ordered off amazon.

Good luck with your treatments. I used to resent the port more than the diagnosis or chemotherapy, but once I found out that the device (and my vena cava) could take more abuse than my oncologist first indicated, my attitude switched. Climbing has been central to enduring these treatments and dealing with a beast of a disease.

Best,
Brian
Fan Zhang · · Washington, DC · Joined Apr 2012 · Points: 658

Brian, based on that "My Pro Supports" photo, it's good to see you've become even more ripped since the prototype photos you posted last October ;-) Seriously though, I completely get what you mean about climbing being a central part of life, even without any medical issues. Best of luck with your continued treatments, and here's hoping to many more moderate classics in 2017 with lots of exposure and big holds!

BrianWS · · Unknown Hometown · Joined Apr 2010 · Points: 790

Thanks, Fan. Who knew that I would so closely resemble the product model used for the Amazon ad?

In all seriousness, these ports and their installation hold up to much more abuse than advertised. Been climbing at maybe one or two letters lower than normal on steep routes, and about the same as pre-diagnosis on vertical terrain. So far, no damage or pain from everything from deep lock offs to full dynos.

My small loss in endurance isn't too bad, considering the 6 month climbing hiatus, a major bowel and liver resection, 10 months of systemic poisoning every other week, and an impressive tumor load.

Guideline #1: Don't be a jerk.

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