Saturday 10-14-2006

We all got up and had another wonderful breakfast together. I made waffles and ended up packing away 3 myself (go appetite). I noticed that my right calf was hurting a little and ended up showing my father. I had been having cramps in my calves over the last couple weeks, but this was definitely different. The veins on my muscle of my right calf felt like my veins in my arms after they harden up post-infusion. When I would stand, I could feel the blood sort of fill up in them and it was pretty painful. My dad took a look, thought it might be a little clotting in the superficial veins and probably nothing to worry about, then thought maybe we better be safe and have it checked out. Later he told me he has had to change his thinking when evaluating me. He still sees me as his 25 year old, fit, healthy, male son and evaluates me accordingly. He reconsidered having me checked when he thought about what he would have done if somebody had presented a leg like mine in his office (he would immediately have sent them for an ultrasound). He sort of realized that, at this point, he needs to look at me as if I were a little old lady and I think I will get all the better care for it.

Anyways, he arraigned for me to go into the hospital and have an ultrasound done on my leg to determine whether or not the clotting was superficial or if it had entered the deep vein system. I have to say, it is nice to have a doctor in the family as I basically got to go right in to be evaluated (after the usual admitting paperwork and whatnot). Well, there was a significant amount of clotting in the muscular vein system (which is what I felt) and it had entered the deep vein system in the vein directly behind my knee. The deep vein thrombolitis (DVT) was just a short segment (maybe 1.5cm) but none the less, it was there. Well, sh*t. I asked the guy what my options were and I could either be admitted and monitored there at the hospital or start on blood thinners as an outpatient treatment. I got my oncologist on the phone (Way to go Dr. Isacoff for being reachable within about 5 minutes for a patient on a Saturday! Again, I feel I am getting awesome medical care) and he put me on lovenox (a blood thinner). He also said to elevate and apply heat to the leg. The pharmacists were very worried when they saw that my copay was going to be about as much as a 50 inch plasma but at this point it is just another drop in the bucket. Besides, it is still cheaper than a hospital stay and, if you do not have the little morphine button, hospital stays are not all that fun.

Well, I drove myself home and filled Eva and the mothers in on what was going on (they had also been getting phone updates but now got the whole story). The DVT is a little interesting because it is not really noticeable (aside from the pain in my calf which is other clotting and not even the actual DVT) and yet it can be pretty serious. The threat is that it will break away in a big enough piece that it will cut off the blood to your lungs and cause a pulmonary embolism (leg clots in your veins go to your lungs where as clots in your arteries go to your heart or your brain) which could be potentially fatal. Don't worry, I am still very emotionally stable, but in one sense, it sort of feels like someone has a gun to your head and could squeeze the trigger at any moment, or not at all. I am figuring on not at all and now that I am on the blood thinners, I have my leg wrapped and elevated, and I have cut out physical activity, the chances of the clot causing any major issues have been greatly reduced. At this point it will just be about waiting for it to resolve on its own which could take a few weeks or more.

The fun part about the blood thinners is that the medication comes in pre-loaded syringes and I actually inject them into myself twice a day. I had my father do the first one when I got home from the hospital and it was a little bit of a scene with Eva and my mother watching. Luckily, I have a 3" by 4" area on my belly that has no nerves so the first once was painless. The needle is only about 1.5 cm and the injection is supposed to put the lovenox just below the skin's surface and sort of raise a little bubble so that it can be absorbed into the bloodstream. Even though the first injection was painless, it was still a little trippy. I cannot wait to do it myself. When I think about it, I have been getting poked so much recently that another couple times a day should be no big deal.

We wanted to take Eva's parents out for a good time so we picked up some Kings tickets for the evening. I didn't want to miss anything so I asked my father if I could still go with my DVT. He said not to ask, so we just got ready and went. I wrapped my leg with an ace bandage and just tried to take it easy. At the game I would elevate my leg by resting it alternately on my wife and then my mother. The game was really fun, I love going to sporting events. The Kings got whooped but there was still a bit of decent play and even a pretty good fight. Eva thinks the fighting is the main reason anyone watches hockey in America. We all had a wonderful time and I managed to survive a hockey game with my DVT (we are still celebrating small accomplishments).

When we got home, Eva gave me my second injection and did a good job. We went back to the numb spot just to make it easy for both of us though I will need to sort of rotate around my belly as continue to receive the injections. This looks like just another bump in the road. The bummer about this one is the limit on the physical activity. I was just starting to pick it up again a bit and even regain a little muscle mass but now I will need to stay off the leg for a while. Otherwise, I feel really good. I am towards the end of my week off and getting ready to start another cycle. The rash is still going strong, my weight is good, my stool is good, I am sleeping well, and my energy is pretty good. Again, if they didn't tell me I was sick, I do not think I would know.
-TN