Jan 26

Clot, Part Deux!

Saturday, 1-26-02, and it appears I spoke too soon in my last update.

On Thursday evening, 1-24-02, after I’d posted my last update, I started to feel something in my left leg. Not really pain; More like pressure. I could tell it was associated with the Deep Vein Thrombosis (blood clot). That night, as I slept, I tossed and turned as the pressure turned into pain, increasing in intensity until I could no longer just lie there anymore.

Finally, I got up Friday morning at 6:AM with a terrible pain in my left leg, just like when I first experienced it at the beginning of January, when it was first diagnosed. This time however, it was a pain that went all the way from my groin to my foot, instead of just to the knee.

The Ibuprofen hadn’t worked the first time this happened, so I didn’t bother trying it this time. And my doc had told me to lay off the Vicodins recently, so I didn’t take any of them either. Instead, I put up with the pain and anxiously awaited 9:AM for my doctor’s office to open so I could make a phone call to let him know I was in trouble again.

They asked if it was red, warm or swollen. I reported that it didn’t look red, didn’t feel warm, but was more swollen than my right leg; A sign that blood was not flowing properly and the pressure was building. They told me to come in as soon as I could get there, so I called mom next and told her what was going on. She said she’d come get me as quick as she could get out the door.

We made the trip to Ann Arbor and I hobbled in, grabbed a wheelchair, and rolled on over to get my blood drawn first, per the doc’s phone call. The nurse had a little trouble finding a good vein in my right arm, and said that arm was getting kinda tired of getting poked, so I offered my left arm. She found a vein right away and the juice flowed like water from the tap.

Next stop was the doc’s office, which is right across the hall from where they do the blood draws. I announced to the nurse at the admissions window that their friendly, neighborhood Buckster was there, and she laughed and said she’d let the doctor know. I was still in a lot of pain, but you have to make the best of things, so I try to keep smiling if at all possible.

While we waited for my turn with the doc, I decided to snack on some Skittles I had in my coat pocket. They’re my favorite snack candy these days, and I’d gotten a few really big bags of them from people at Christmas. I thought the bag in my pocket was still unopened, and whipped it out, but I was mistaken and a rainbow of little candy dots flew up in the air and landed all over my lap and the waiting room floor! LOL!! Mom and I had a good laugh following the initial surprise, and she busied herself picking them up while I sat in the wheelchair clutching what was left of them and popping them into my mouth.

A nurse came out and said the doctor was ready to see me, so we went in to one of the examination rooms. A few minutes later, the doc came in, but it wasn’t my regular Oncologist, Dr. Eisenburg; It was his wife, Dr. Eisenburg. Hehehe! That was kinda cool, I thought.

Anyway, she checked out my leg, asked a few questions about the pain I was in, the meds I’m taking and all that, just to be sure that everything she was seeing in my chart was up to date. She said the blood draw information wouldn’t be ready for a while yet and that she wanted another “Doppler” (ultra-sound) of my leg done. She’d already set up the appointment with the office that does the Doppler scans, but the soonest they could get me in was 1:30, about an hour and a half from then. She told me to come back after the Doppler scan, and by then she’d have the blood results.

To kill the time, mom and I decided to visit her sister, my aunt Aggie, since she lives pretty nearby in Ann Arbor. We drove over, had a nice little visit with her and then drove back to the hospital to get the Doppler scan done.

The Doppler Tech was the same woman as last time, with the same sense of humor, and she said she was glad I was there because she ‘needed’ a blood clot! We laughed and she explained that once a year someone comes in from some agency to make sure they’re doing everything by the book, and she needed a blood clot to scan, so they could see that the particular test was being done the way it’s supposed to be. I told her I was glad to help out and we had another chuckle over it.

She scanned my leg all the way from my groin to down below the knee, and said it looked about the same as it did last time I was there, which is why I was having the same kind of pain as last time I was there. We looked at it together on the computer screen as she scanned it, and she showed me an interesting thing I didn’t see last time. The main vein in my leg is the one that’s all clogged up with this clot. Up near my groin, another, smaller vein joins it in a “Y” shape, like a branching tree. We could see on the screen exactly where the clot ends, just below that “Y”, which was interesting in itself, but it made me glad to realize that just another inch or so of clot would have blocked off both the main and lesser veins and REALLY given me a fit!

Basically, it’s like the following illustrations. The blood is trying to flow “up” and out of my leg, back to my lungs to replenish with oxygen, then on to the heart for another circulation through my body. With the main vein all clogged up, the smaller veins in my leg have to compensate for it and do all the work. The problem is that they simply aren’t big enough to meet the demand. The gray area with red speckles in the close-up on the right is the clot.

image of major veins and areriesimage of clot in vein

I got dressed again, got a piece of paper from her with the results on it, and we headed back over to the doctor’s office to see what would happen next. Just like the first time, I was hoping I wouldn’t end up in a hospital bed, and figured maybe we’d just start me back up on the Lovenox shots to deal with it.

That’s exactly what happened. The doc had the blood and Doppler results now and wrote a prescription for more Lovenox. I reminded her that the pain was really intense and I needed something to control it till the Lovenox and Coumadin start working their magic again. She asked me if I had anything for pain and I told her the Ibuprofen didn’t seem to work for this pain, though I have some Vicodin left but her husband had told me to lay off them. She said the Vicodin would be fine to take as long as I don’t overdo it. She advised me to take them as needed, but not more than one every four hours. She said that if that didn’t do the trick to call her back and she’d get me something a little stronger to deal with it.

I remembered to tell her that two of my daily my prescriptions were almost empty and that I only had a couple of Vicodins left. All three of them say on the bottles that there are no refills left, so I’d need her to write new prescriptions for them as well. She asked what the other two drugs are and I pulled them out of my pocket. She checked them out and said that they generally only have a patient do the Allopurinol (Zyloprim) for 30 days, so when I run out of them I’m done. She wrote new prescriptions for the Furosemide (Lasix) and Vicodin, I thanked her, and off we went to the pharmacy to get some drugs.

A few weeks before, I dreaded giving myself that first injection. This time, I knew it would work toward relieving this terrible pain I’m in, and couldn’t wait to get home so I could shoot up! LOL! I still had one syringe left over from the last time I was doing the Lovenox injections, so I used it first, and made plans to start doing the two a day at 6:AM and 6:PM starting Saturday morning.

Saturday morning, my Palm Pilot woke me at 6:AM to tell me to take some drugs, and I opened the fresh box of Lovenox syringes. Something was different about these though; The syringes were black instead of the orange color of the last ones I’d used. I checked the prescription label, and it said 80 mg twice daily, just like the last time. I looked closely at one of the syringes and it was filled to the 100 mg mark. I looked at the box they come in and it clearly said they were 100 mg syringes.

I deduced that there must have been some kinda mix-up at the pharmacy. Hmmm… what to do? Maybe more Lovenox would mean faster relief? In the end though, I decided not to second-guess the doctor’s prescription, squirted out 20 mg from the needle to bring it down to 80 mg, did the alcohol swab bit, and plunged it into my leg.

It’ll likely take a few days for the pain to subside again, just like the first time I went through this, so I’m back in the wheelchair again and eating Vicodins every few to several hours to keep the pain down to a dull roar.

They make me even more groggy than usual, and I had to edit this several times to clear up all the typos and grammar mistakes, and I’m now ready for a nap, just 4 hours since waking up after sleeping all night. Still, it’s better than the painful alternative!

So, at this point things could be better. But ya gotta look at the bright side of every situation, which in this case is: Things could be worse! I know that as each day passes, the pain will be less and less, and I’ll get through it fine. A few days from now the pain should be about gone and I’ll be back out of the wheelchair and walking around again, so things are looking up!