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Chemo 2.8 – Synopsis

February 19, 2009 Leave a comment

I have now officially finished round 2 of chemotherapy. That makes 1/4 of the way through all 8 rounds. This particular round was land-marked by the incident of thrombosing internal jugular veins, and the surgery required to get my portacath removed. Apart from that, I would not say that this round has been any worse or any better than the 1st round. All the symptoms were more or less the same, the only difference being that they tended to kick in a little sooner and last a little longer, specifically the oxaliplatin induced neuropathy.

So now I get a week for my body to detox, before Thursday next week when it gets flooded with toxic chemicals again. I’d like to take the opportunity to thank all those who have helped recently with bringing over of meals etc. They have been really good particularly while I was in hospital, and also when I cant do much more than move from the couch, it means Hannah doesn’t have to cook all the time :-).

On the whole, I have to say that I’m not particularly looking forward to the next 6 rounds, but that is life, and I have to deal with it :-). Peace out.

What is The Internal Jugular Vein?

February 17, 2009 2 comments

I thought I would briefly explain what exactly the Internal Jugular vein is, and why I had problems with it.

Anatomy of the Neck with the IJV highlighted

Anatomy of the Neck with the IJV highlighted

The Internal Jugular Vein (IJV) is one of two major veins that drain the deoxygenated blood from the brain and head back down to the heart so that it can be sent to the lungs for oxygenation again. Each person has two IJV’s as well as two External Jugular Veins (EJV’s), and these are the main tributaries for blood to return to the heart from the neck upwards.

What happened with me was that my portacath, a tube that ran from my chest to the heart, makes it’s way to the heart by inserting in the IJV, then follows the IJV down where it joins the brachiocephallic (this vein drains the arm), which then joins the Superior Vena Cava, which then drains in the Right Atrium of the Heart. At the point of insertion into the IJV, this is where a clot started to build up. Clots generally can be caused by a number of things, but having foreign body in your blood vessel can be a cause, also, in my case, having cancer is also referred to a ‘pro thrombotic state’, as well as the chemo drugs I’m on [For the medical students: Capecitabine is pro-thrombotic, yet its dose-limiting side effect is thrombocytopenia.. any ideas?]. This all added up to a reasonable risk, one doctors and myself were willing to  take, to causing a clot.

So the clot started, and once it starts, unless you take away the source of the clot, it will continue to grow. The major risks of having a clot there are mainly that fragments could break off, flow downstream and into the lungs, block off the lungs, which then stops me from oxygenating my blood and causing me to die from oxygen starvation. This is called a pulmonary embolism.

The portacath was removed with surgery to prevent the clot growing, and I was also placed on regular clexane injections in order to assist the prevention of further clot formation. The body will do the breaking down of the clot in its own good time.

And THAT is what last weeks drama was about! 🙂

Round 2 half time update.

February 9, 2009 6 comments

I have starts writing this post in hospital while waiting for an ultrasound scan of my neck. Yesterday morning I awoke with a sore neck which I put down to the way I slept, however, over time it got worse. By last night, there was also swelling which I chose to ignore and went to sleep. This morning when I awoke, it had neither improved or got worse, but it had become apparent that it needed attention. The swelling is located right at the point where my portacath inserts into the sublcavian.

So, long story short, I’m awaiting an ultrasound to work out whether or not my portacath has clotted up or not. Let’s hope it hasn’t.

Continued….
So it turns out I have thrombosed of my internal jugular vein. The consequences of which are that my portacath will have to be removed. So I am currently being admitted and then being put on a surgical list for the removal.

I’m not looking forward to infusions of oxaliplatin thru the arm veins!!!

I’ll try to keep this updated as things happen.