On Thursday the 11th had an appointment with prof. Vogl (a.k.a Dr. Pain) for a third Trans Arterial Chemo Embolization (TACE) treatment. Lulled into a false sense of security by the last procedure, where the pain was almost bearable (with morphine), I willingly climbed onto Vogl’s operating table for the third time. The man lived up to the nickname that I had given him. The pain was exquisite. What can I say? The man is a true artist! A minute after the chemo agents were injected I was writhing in pain. Covered in cold sweat, shaking, griping the edges of the table while at the same time trying very hard not to throw up and move my leg. (That is bad when your femoral artery is cut.) It seemed like an impossibly long time for the morphine to kick in this time. I knew it would only take the edge of the pain, but anything that relieved the agony just a little was most welcome. They increased the pain med dose and eventually the pain became tolerable.
Usually the TACE procedure takes just minutes and goes very smoothly. This time was different and I spent at least twenty minutes longer than usual in the operating room while a nurse applied pressure to my groin. Under different circumstances this would have been quite pleasant. 🙂
I took a look at my groin area where my femoral artery had been cut just a few minutes before. That was a mistake. I’ll spare you the gory details, but needless to say I will not be sneaking peeks again. (As a Dexter fan, it reminded me of a scene from the show. Ok, say no more.)
Typically when the catheter is pulled out of the artery, a special sealant is applied which closes the wound. This advance allowed TACE to become a routine procedure; done on outpatient basis. Before, the procedure required several days hospitalisation I believe. For some reason the sealant did not hold this time and they had problems sealing the artery and stopping the bleeding.
They eventually wheeled me out with a special pressure tourniquet that looked like a weird half diaper. It was very uncomfortable. This was another first for me.
I was dismissed later than I anticipated and missed my 3pm local hyperthermia appointment at the Sibenhuner clinic. The clinic was very accommodating however and they were able to squeeze me in even at the late hour. I like the idea of TACE followed straight after by local hyperthermia. At that time most of the chemo drugs should still be locked inside the liver. The high temperature stresses the cancer cells and also helps to dilate the capillaries, giving the chemo agents better access to the cells.
After all the problems there was a silver lining. After TACE, my liver swelling reduced significantly. The liver stopped pushing on my stomach and this caused my nausea to go away. For the first time in weeks I could also eat a normal meal, so I took full advantage of this. I still had pickled herrings for dinner however. Go figure. (Read next post to understand the herring comment.)
I had a chance to talk with prof. Vogl for a few minutes just as he started the procedure. (He is still a man of few words). He mentioned seeing a very active tumour on the MRI which he believes was the source of all my recent swelling and associated problems. He said that he would focus on this tumour during this treatment. Later his official report for the prior month would say a mixed response with stable disease. Stable is a relative term and in reality I had further progression, just not enough to officially qualify as progressive disease. The rate of growth did slow down however, which means that I’ll be around for at least another month. WoooHooo! 🙂
It has now been almost a full week after the TACE. I still feel quite good. In fact 100% better than before tace. Some liver swelling returned, but its not as bad and I have no nausea. I can eat pretty much anything and everything at the moment. Trying very hard to regain some weight, but not having much luck with that thus far.
My leg is giving me problems. For the first four days I could not walk for more than a dozen steps before my right leg just ran out of energy. I think the artery is blocked or obstructed and this has reduced the blood flow. I can feel a sizeable hard lump in my groin, which I think is a blood clot as I did not have this the last two times.
Last two days the clot got smaller, but newly developed pain now makes it very hard for me to move about. I am expecting things to get better by the end of next week; based on my prior experience.
I am booked in for another Vogl TACE next month. Great!!!