Can you say UEDVT???

A few weeks ago I had a conversation with my poison man that went something like this:

"Are there different types of mediports, say some that are less prone to produce blood clots? Because you know, Dr. V, that I have had so many issues with thrombophlebitis whenever they put anything into my veins..."

"No, they're all the same. Blood clots or thromboses really aren't a big issues with mediports. We hardly ever see them."

"But what if I get them??? I'm pretty worried that I will."

"Don't worry, if you get them we'll just treat them."

Fast forward approximately two months to last week. I have had a harder time with the third round of chemo as it has upset my digestive system. On top of it all, I started to develop a strange pain in my right arm on Thursday. I had trouble lifting things, as any exertion caused me pain. As I looked at it and compared it to my left arm, I also noticed that the right one was sort of grayer and more splotchy looking than the left one. So I waited until DH came home and asked him to compare the color of my arms, just to be sure I wasn't hallucinating. He agreed there was a noticeable difference. Phew, at least it's not all in my mind...

On Friday morning, I didn't feel so hot at all (well, at least I didn't have a fever...). Since I wanted to call the oncology nurse anyway because of my continued GI issues, I also mentioned the pain in the arm to the secretary that takes the messages and passes them on to the nurses or doctor. Well, I never even got to talk to the nurse, as based upon my message, the secretary called back and told me that I need to come in ASAP to have my veins scanned "just to reassure me and make sure I don't have any clots in them." Of course that made me really worried.

I didn't feel well enough to drive, but DH had needed to make a quick trip to work and was still on his way back. So I got myself ready and awaited his return so we could hurry out to the Cancer Center. An hour later we got there and checked in -- except they couldn't find the prescription my doctor's office had supposedly faxed over. Lovely. Half an hour later, that issue was sorted out, and we began what ended up being a two hour plus wait. They had a full schedule, and we were an "add on" which meant that we needed to wait to be squeezed in. I didn't really mind that much, although the wait was not all that comfortable. But I was just glad that they could squeeze me in. An elderly gentleman who had waited two hours when we got there, however, was not as patient. Maybe his complaints explain why the manager ended up taking me back while apologizing profusely. 

In any case, the doppler ultrasound vein scan itself was an experience. Thank goodness it's noninvasive and does not involve any needle sticks. But even though the technician did not have to use needles, she had trouble finding my veins! Now that explains a thing or two about why the people with the needles always have such a hard time... The scan began at the jugular vein, which thankfully was clear. As the tech got to the subclavian, however, she started taking lots of pictures and mumbling something about "you might have a tiny clot in there..." Oh great. And as she went scanning down my arm, she stopped talking to me altogether and snapping lots of pictures instead. I figured that wasn't a good sign. So it turns out that I have some pretty massive deep vein thrombosis in the upper arm, more specifially in the subclavian, axillary, and brachial veins. In the world of medical acronyms, this is known as UEDVT, or "upper extremity deep vein thrombosis." Supposedly, these are not as likely as their lower extremity counterparts to lead to the dreaded pulmonary embolism that can be fatal, but according to at least one study I found, it is quite common in patients with UEDVT.

Ugh, this is not good. I wasn't exactly itching to get another complication. But I suppose things were just going to well to be true. My doctor decided to put me on low molecular wait Heparin to prevent further thrombus formation. This means that for the next two weeks I need to give myself two daily heparin injections, and then only once daily heparin injections for a "few months" after that. Now, I don't normally mind subcutaneous injections into my belly that much. I did plenty of them during our fertility preservation IVF cycle. However, these heparin shots HURT -- much more so than anything else I have had to inject myself with before. Plus, the frequent injections -- with a blood thinner!) are starting to give me lots of tiny bruises on my stomach. Yikes. I'm supposed to be doing this for how long???

This weekend thus brought lots of rest for me, some distractions, as well as time to process Friday's diagnosis. On Saturday I got some welcome distraction when we doggie-sat Mr. Shnubbins for a few hours. On Sunday, DH took me to the movies and then out shopping for a new pair of earrings. All of this was nice, but unfortunately my arm still hurts. Actually, it seems to be getting worse and traveling down my arm, now also affecting my ring and little finger. This isn't funny any more. I guess tomorrow I'll need to make yet another call to the oncology nurse.

On Wednesday morning the fun continues as I go for a chemo port dye study to make sure that my port still functions in the first place. If it doesn't, I'm in trouble for my next round of chemo, currently scheduled for Thursday. But it just doesn't sound like a good idea to put those caustic chemo meds into some other vein in my arm given that the veins are irritated by the DVT already. So if my port no longer works, those doctors had better figure out something quickly...

Keep your fingers crossed for me...