2/9 and 2/10 - More Complications and the ICU

2/9. Dr. Arata came by fairly early this morning to see me in the hospital bed and told me how the procedure went. He said it was cleared and all went well, with the blood flow looking good. He confirmed they did indeed do the flossing action to break up the scar tissue, and that he and Dr. Harris were able to work through it together quite well. He told me they would do an ultrasound of the area later in the morning to establish a baseline to compare against in a few weeks, and I could then go home.

About an hour later, the ultrasound tech came by and began the relatively simple test. We found it had clotted up overnight despite the use of the blood thinner Lovenox that I had been on for 2 weeks and also had been on overnight. I guess for some reason my body doesn’t thin with this particular medication.

Dr. Arata was called with the test results, and it was time to another proedure. I went off food again for the day, and I was scheduled to go in later in the afternoon to re-clear the now clotted vein. So to summarize up to this point, my vein was narrowed, opened, clogged with scar tissue, opened, and now clotted. It was pretty clear this vein wasn't going to open without a fight.

At about 5:30, Dr. Harris arrived to do the procedure, where he rooted out the clot. The procedure was the same as the day before, with the exception that he went in the left groin and he cleared out a blood clot as opposed to a build up of scar tissue. He didn't do the floss trick this time; I felt what seemed to be a long drill with sandpaper running up into my jugular. Once again it was clear as I returned to the room.

2/10. I didn’t sleep at all last night, but arose in a bit of a groggy state to talk to another Ultrasound tech who checked me again for blood flow. Once again, my vein clotted up overnight, much to my and Dr. Arata’s disappointment. OK, again back to the NPO (no food or drink) and into the Cath lab at about 5:30. This time, Dr. Arata installed an infusion catheter from my right groin leading up to my left jugular. An infusion catheter is a bit like a garden soaker hose that will distribute medication directly to the area it’s needed. The medication is TPA (Tissue Plasminogen Activator), which is a blood thinner that not only prevents clots, but actually melts clots away. TPA is usually used in stroke patients to help melt clots. It's a powerful medication, but the bad news was it has to be administered in the infusion catheter which required I keep my leg straight and not lift my head. Furthermore, TPA is so powerful and the risk of bleeding so profuse that I had to be placed into the ICU and not move for what ended up being 45 hours.

Almost two days not moving was interesting. I have to admit, this simple procedure of opening my veins to allow the healing environment for MS is beginning to feel like more than a simple procedure. What the heck is next?

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