Wednesday, May 6, 2009

IVC filter for DVT

Sometime tomorrow Steve will undergo a procedure to have an inferior vena cava filter (IVC filter) placed in a vein in his groin area.

The IVC filter will serve as a sieve to stop a blood clot from reaching his lungs. (That would be a pulmonary embolism, and that could be deadly.)

In most cases, a blood clot like Steve's is treated with blood thinners. Blood thinners aren't an option with Steve, though, because of his need for Avastin.

Avastin is the bio-agent that has been used in conjunction with chemotherapy to stop the Damm Spot from growing. We need it to continue to extend Steve's life.

Avastin and blood thinners don't mix. The combination could cause the tumor to bleed, and that would be devastating.

So, the next logical option is the IVC filter. Its placement is not without risks, but we have to take the risks to keep the DVT away from Steve's upper body.

The procedure itself, which will be performed at Zale Lipshy, is fairly simple. It won't require general anesthesia. But there will be an incision and therefore a wound that needs to heal. Avastin slows the healing process.

The timing of this is actually as good as we could get. Steve's last Avastin treatment was two weeks ago. If he hadn't been admitted to rehab yesterday, he would have had an Avastin treatment today, making a surgical procedure much more difficult.

One of the big questions after the procedure tomorrow: How long will he need to wait until the next Avastin treatment?

The balance will be taking care of the clot and healing while also treating the tumor as aggressively as possible. Both needs are urgent.

Dr. M is in the loop with the physical rehab team and the interventional radiology team. We've defined the main goals:
1. Take care of the DVT.
2. Continue whatever physical rehab (most likely OT and upper body PT) is possible while healing from the procedure.
3. Secure another seven days of rehab at the end of this seven-day allowance.


Steve is tired but in good spirits. He's on complete bed rest at least until the procedure tomorrow. (We don't yet know what time he'll be taken to radiology.)

Almost every time a new caregiver comes in to meet Steve, they ask a series of questions including, "What kind of work did you do?" They're always impressed when Steve answers in the present tense -- he tells them what work he's doing today.

Every morning when he wakes up, he thanks God for another day. I know that he'll do so again Thursday morning, thankful the gift of another day, thankful for intervention, thankful for skilled and caring hands, thankful for you all.


DogBlogger said...

Hugs via Internet for y'all:

(((((Steve and Tyra)))))

Chitnis and Chahal said...

Tyra, you are one amazing person to be able to put all this in perspective. I can't tell how much I have been praying for Steve and thinking of you guys. I want him to be better with these immediate issues so much. God bless both of you. May you have many many days together. Sending warm wishes and positive thoughts your way.

Laura (from UM) said...

Plus, tell Steve that the Greenfield filter (the IVC filter) was developed by Dr Greenfield at Michigan- might make him feel better to know it came from another Michigan man. :)

Anonymous said...

Praying for a trouble-free procedure Thursday and speedy healing of the incision.

Mary G

한표 said...

hope you will be better soon !