Thursday 16 February 2012

The Long Two Week Roller Coaster Ride

Quite a bit has happened since my last posting on here...

After my last "mega-chemo", my arm with the PICC line started to hurt.  I had pain radiating down from the PICC which extended right down to my fingertips.  I dismissed it initially as perhaps I slept on it weirdly.  Well, after a few days, that was no longer a valid excuse.  So, I called my clinic nurse on Monday.  She in turn checked with my oncologist who said that it was likely a blood clot and I was to come in right away to have the PICC removed.  A blood clot?!?

I duly arrived at CancerCare and had my PICC removed.  (It comes out quite readily; you just literally pull it out.  Kinda gross and a bizarre sensation, as there are just enough nerve endings inside the vein to feel it sliding out - ICK!)  I needed an ultrasound to confirm if there was indeed a clot.  The ultrasound was the next afternoon (Tuesday).  The tech spent about 1/2 hour going over my whole arm from neck to wrist.  The results were looked over immediately and YES I had a clot (a.k.a. DVT deep venous thrombosis).  I went to CancerCare with the results in an envelope and then met with my oncologist and the nurse and the pharmacist to discuss the treatment for my blood clot - blood thinners.  [Aside from the arm pain, I had no other symptoms of a clot (no noticeable swelling, no colour changes etc.) which is another reason that I didn't call the nurse sooner.]

So, I'm now on a blood thinner (dalteparin) which I give myself via injection once a day.  This needs to continue for 3-6 months.  Geez.  Interestingly, the blood thinner doesn't actually resolve the clot; your body does that itself.  The blood thinner prevents more clots from forming.  Turns out that omega 3 assists your body in dissolving the clot, so I have been taking flax oil as well.  NB:  fish oil is a superior form of omega 3, BUT that is contraindicated for my condition.

The next evening (Wednesday) I was reading on the couch.  As I was able to really pay attention to how I was feeling, I realised that I just didn't feel well.  It was hard to put my finger on what was wrong.  I just really didn't feel myself.  I had the sensation that someone was sitting on my chest.  It was very weird.  I sat up for awhile trying to evaluate what the heck was going on to make me feel so unlike myself.  The feeling didn't feel worsen, so I went to bed as chemo was the next day.  I figured I could mention the chest pressure thing to them whilst in the chemo ward.

So, at chemo while getting my "chemo-lite" I mentioned how I was feeling.  After answering a few questions, they consulted with my oncologist who ordered an EKG (!!!).  The EKG tech showed up very shortly, hooked me up to the machine and got the print-out.  (It takes longer to hook you up to the machine than the actual test, haha.)  My doctor looked over the results and they weren't normal.  I was flabbergasted.  He asked me more questions about how I was feeling and then had the nurse give me a dose of nitroglycerin.  This was a surreal experience - nitroglycerin!!!  I knew that it's used to prevent/treat heart attacks.  WHAM - there was my mortal existence staring me in the face.  Really, up until that point, I've never felt seriously ill.  But talk of heart problems was flat out scary.

So, from the chemo ward I was transferred to the ER.  So, there I sat, and sat, and sat.  I presumed that since I had heart attack symptoms I would be seen without too much delay.  Nope.  I wasn't seen for nearly FIVE hours.  (Was that because I already received nitroglycerin?  Because my EKG wasn't too bad?  I don't know.)  I understand that the sickest people get seen first.  But 5 hours with those symptoms?  (Quick aside:  In 2008 when I went to the ER with a high fever and was getting ready for chemo I was seen in under half an hour.)  Anyways, so I was hooked up to a heart monitor, had another EKG (normal) and a chest x-ray.  After another 3 hours I was sent home (it was 1:30 AM).  What a looooong day. 

The next few days I felt unusually tired.  I didn't have much energy at all, and felt slightly winded after going up a flight of stairs.  So, I took it as easy as possible and rested whenever I could.  Fortunately, after several days I felt a lot better.  I am waiting for an appointment with a cardiologist, which should happen in the next few weeks.

That was a very difficult week indeed.

Aside from all that, I met another doctor from the team and got to ask more questions about the upcoming transplant.  The day of the DVT ultrasound, I received an information package about the whole bone marrow/stem cell stuff.  The title on the binder is "Autologous Hematopoietic Progenitor Cell Transplant - A Handbook for Patients and Families" or, as I like to call it, "The Binder of Depression".  It outlines the procedure for the stem cell collection, what happens in the hospital, all the possible side effects of everything, and how your life will be for about 6 months after the transplant.  What heavy reading material - UGH.  I never viewed the transplant as something to take lightly, but having the whole procedure spelled out in front of me was a grim reminder of what a journey is still to come.  (Since the Binder of Depression has to cover off all possible side effects/scenarios, it definitely is depressing.  It's to enable informed consent, but geez

There was the possibility that the blood clot/heart issues/referral to the cardiologist would have delayed my next round of chemo.  Fortunately that is not the case.  I go for my "mega-chemo" today.  I pray that there are no complications with this round...