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Monday, October 4, 2010

Clot! [Maybe...]

Ooooh. This is not very good. I awoke feeling refreshed and then stood up…. Ouch! What is going on with my right knee? It is aching like crazy. This hasn’t happened before to it. I hope the simple explanation is the right one – that I have somehow slept on it badly and it will come good later in the day.
The last time I experienced a similar thing was after the long car trip to Melbourne early this year, when we were going down for radiotherapy treatment at Peter Mac. That was my left leg, not the right – the one unaffected by the tumour. I of course could not drive – no-one with seizures as I was having could sensibly do so. That was all left to Tracey, as were so many things.
There was not much room in the car and I had sat for long periods over two days with my legs more or less locked in one position. For several days afterwards, my left leg ached uncomfortably. Then the pain receded. I didn’t think about it again – I just vowed to make sure I moved my legs around a lot more in the car on the journey home months later.
At a visit to the neurologist about halfway through the Melbourne treatment, the subject of thrombosis came up. I can’t remember exactly why, but he immediately ordered me to go upstairs after the consultation and have an ultrasound on my legs. Fairly late in the day we got to have the check done. The young guy performing it [I’m not sure of his status] was not happy. There was an AC-DC concert on in a couple of hours and he had tickets. ‘These bloody specialists,’ he growled at me – ‘always dropping these unscheduled procedures on me at the last minute – and nothing ever comes up. They’re just a waste of time.’  He started travelling up and down the bloodlines from hip to knee, watching the screen. ‘Nothing,’ he said. ‘As usual.’ Out of the blue a thought came to me. ‘I had a bad ache behind the left knee after travelling two days in the car a few weeks back,’ I told him. 'I don’t know if that has any relevance for you but I just remembered it.’ Suddenly the AC-DC concert was forgotten and he got very interested. ‘Let’s have a look.’ Immediately he struck clot gold. There was a small but significant mass in the channel. Blood was pulsing past it so there was no immediate danger of blockage. Straight away, he called in the specialist to look at it.
One of the great virtues of Peter Mac – THE Cancer Centre of Melbourne and probably the best in the country – is that the right specialist can be called in at a moment’s notice because they are all located in the one building. 
The specialist studied the clot carefully on the screen as the junior staff member passed the instrument over it and pushed it around slightly. ‘Clexane,’ he said. ‘that should do the trick. I’ll write a script for injections. Leave it alone! [to his young colleague, who was looking a little pleased with his discovery]. You don’t want to dislodge it, for God’s sake!’
The young guy now looked somewhat abashed. He had, after all, discovered that things ordered by neurologists aren't always pointless - and he still had time to go to his concert.
We picked up 20 sharps [needles] loaded with the blood thinner Clexane. Twenty, I groaned, to be injected into the stomach. Three weeks of injections. I don’t like this much… but - better than the alternative.
Little did I know there would be over a hundred Clexane injections over three months before the clot disappeared.
So what now?…. We know that clotting is one of the possible negative side effects of Avastin. Do I have a clot behind the right knee? It doesn’t seem to have improved in an hour. I guess we will have to check it out. Today is a holiday – a long weekend for Labour Day. Tomorrow it will have to be. Even if the ache disappears I can’t afford to ignore it. Dammit – I was looking forward to a peaceful week.


  1. Dear Blogger

    The reason they ordered the ultrasound was because, as she couldn't be there on that day, your incredibly bossy boots wife wrote a list of about ten things to ask the chemo-oncologist and one of them was to check your leg!


    Your bossy, loving wife :-)

  2. True. And as you say, it wasn't the neurologist, it was the chemo-oncologist. I did remember after posting this that we told him about the swollen ankle and that's why he ordered the ultrasound. Hey if I get the details a bit wrong, don't forget that I had 60+ blasts of radiation into my poor old brain over 3 months - the max I can have in my life!


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