3rd September 2021
Contd. from here.
DVT and complications
My father developed a massively swollen left leg by around the 18th of August. Doppler ultrasound at a major hospital’s Emergency Department did not detect any DVT. But the swelling continued, so on 28 August we got another ultrasound done at a local hospital. That test detected severe DVT in the pelvic area, leading to immediate hospitalisation in the ICU over the weekend (28/29 August). After intravenous drip of heparin for 24 hours, my father was brought back home and I’ve learnt to administer the subcutaneous injection – twice a day.
Unfortunately, after 3 injections, my father developed hematuria (internal bleeding, particularly in the bladder area) so this meant further visits to the hospital. I’ll be meeting a haematologist tomorrow to decide an optimal management plan for DVT even as the cancer treatment will continue on the side. This DVT is most likely caused by a cancerous lymph node that’s pressing on vital veins.
Neuroendocrine tumours are said to respond best to chemotherapy – but radiotherapy is first needed to shrink the massive tumour that has developed in the pelvic area. Seven sessions of radiotherapy are now over, another 8 to go. This has been a huge win, since there were too many issues (massive disruption to key blood indicators, cancer blockage in the intestines, – and now DVT) that had to be dealt with through intensive measures during this journey. It will be hard to describe the kinds of tasks involved: let’s just say these are comprehensive. Somehow, all of us combined have managed to get my father fit enough to undertake radiotherapy for seven days. If this continues we might succeed in completing his 15 radiotherapy sessions by 14 September. Radiotherapy will likely be followed by chemotherapy.
Innumerable tests and consultations with a range of experts
Cancer tends to knock off multiple systems of the body – a domino effect. No one expert can handle everything. In this case we’ve consulted around 4-5 each of urologists, oncologists, radiation oncologists, nephrologists – and now a haematologist tomorrow. Getting multiple opinions is crucial for cancer since determining the precise nature and magnitude of cancer is no trivial matter. Even now, a lot is not known. Every test and consultation adds new information to help solve the jigsaw puzzle.
Then there are a large number of administrative tasks – e.g. making appointments with various experts/ hospitals, organising a claim for reimbursement from the government health insurance scheme which partly covers my father’s costs (there are over 100 pages of documents to be organised and lodged), and responding to questions about his health from various interested people (this post will hopefully help me deal with some of those questions).
Overall, the period from 18 August has been the most life-threatening for my father (with admissions to 2 Emergency departments and one ICU) but he has come through well enough. He will get much better if all the therapies underway work out well – but a lot of challenges remain. Fingers crossed.