Thalidomide & Filters & Clots! Oh My!

It was just about a year ago (April 09) that I found myself at home recuperating from my first autologous stem cell transplant (ASCT). Performed in Little Rock, the transplant procedure was, from my perspective, a piece of cake.  Well, maybe not like cake with frosting and sprinkles and little candles, but it wasn't too bad.

We harvested 24 million of my hematopoietic (blood) stem cells in December 08 and my UAMS transplant team transfused 6 million of those handsome, robust, hopefully over-achieving stem cells into my left arm in late February 09. I visualized them swimming toward my battle scarred bone marrow, triggering a microscopic parade filled with the deafening cheers of a gratefully rescued blood system. Hail the conquering heroes!

For the next three weeks, fighting nausea, no apetite, fevers, sleeplessness, and gastrointestinal hyjinx I'd rather not describe, I waited and watched my blood counts reach  levels sufficient for me to go home to Missouri for a much needed rest. I'd been away for nearly four months and now I was going HOME! What a great concept: Going Home! I missed my kids, my dogs, my wife, (not in that order!) my church, my everything from my normal life. I was looking forward to a couple of weeks R & R.

While I was at home, I was put on 'Bridging'  medications consisting of Thalidomide and Dexamethasone. And then it happened. One Friday evening, my left leg felt 'tight', like I couldn't 'stretch out' the muscles well enough. On Saturday it was a bit worse and on Sunday a mild pain started. By Monday morning  my leg was swelling,was warm to the touch, the pain increasing markedly. I high-tailed it to the local hospital's satellite clinic where my GP practices and he quickly asserted that 'You have a blood clot!'

A blood clot! So much for R & R! Though I'd never had one, I knew that blood clots can be extremely dangerous, even fatal. 

I was immediately admitted to the hospital and technicians performed an ultrasound STAT to assess the situation. Yep! Blood clots in my left leg, right leg and a small pulmonary embolism in my right lung. This might be bad. A doctor came in and suggested that we implant a filter in order to stop further blood clots from going to my lungs and heart and killing me.

Not killing Sean sounded like a good idea.

I remember the surgeon describing how she'd implant the filter, carefully trying to allay my fears of the 'going-through-the-groin' part. Thankfully, it doesn't mean what it sounds like. The catheter goes in through the femoral vein. Basically they snake it up through a blood vessel and deposit a metal, weirdly shaped filter into the inferior vena cava.

As she told me not to worry, that it doesn't hurt much, I began to laugh. Confused, she said everyone reacts differently in these  of kinds of situations. She assumed that I was just nervous. I went on to explain that I'd been through a lot of bone biopsies and bone marrow aspirations with nominal anesthesia, that I had a bunch of fractured vertebrae and other bones, that while pain wasn't my friend, we were kissing-cousins. All that aside, let's get the Save Sean's Life Show on the road!  The filter's implantation wasn't a big deal.

I remained in the hospital for four days and went home to my family not much worse for the wear, except that I now had to give myself Lovenox shots in the stomach every day. Fortunately I had  a big target!

As it turns out, conjecture has it that it was the drug Thalidomide that caused my blood clots. The product literature and side-effect cautions said that it might, and doggone if they weren't right. Probably.

Thalidomide has been instrumental in my Multiple Myeloma treatment. It appears that it also just about did me in. Sometime soon we'll talk about the strange history of this good news/ bad news wonder drug.

Thalidomide & Filters & Clots! Oh My!

Regards from Myelomaville!  Never Give Up!