DVT

At the end of February, six months post chemo I joined a gym class to get back into shape. I started going to Barre classes in the evenings after my day long Kaplan lectures. These workout classes were intense, I was doing push ups, squats and other crazy movements. I finally felt like I was back to my old self. After a few classes, I felt a new lump in my unaffected, and only breast (the left one). From my previous experience, I of course began to worry about a new “visitor”.

About a year ago, I was doing the same thing, going to intense aerobic classes for workouts and ended up with a lump in breast that turned out to be cancer. This lump, however was different and was located a few centimeters under the scar left from the mediport. I decided I would wait a week or two to see if there would be any changes with the lump. It was small and was not painful, unless I poked at it. After my experience with breast cancer last year, my anxiety level regarding any changes in my body have drastically increased, so I needed to be seen by my doctor ASAP. I did not want to wait a few days to be seen at the breast center, so I drove down to Buffalo the day I had off from my Kaplan course. I first called the center in the morning, hoping someone would call me back but 2 hours later decided to go into the office myself and be seen.

I am well-known at the clinic, since there are hardly any 20-something year olds coming in for breast cancer treatment. Luckily, I was told that I could be seen that same day, I just had to wait until a physicians assistant was available. I don’t remember how many hours I waited but I was seen. From what the NP could feel, she wasn’t suspicious of cancer. Since the lump was directly under my scar she figured it was just scar tissue. My father told me this, multiple times after I would express my concerns about it to him. That day I was sent for a mammogram and an ultrasound of my breast. The mammogram showed normal results and the ultrasound, performed by the radiologist, showed nothing suspicious as well. So, with this news I felt better and less stressed.

A week or two went by and I would feel heavy pressure in my breast and in my armpit but again my father had an explanation… It was hormonal. During this time, however, I started feeling something new. My left arm started to tingle and it felt as though it was swollen especially when compared to my right arm, it did not look like it though. This started to really scare me and again I drove down to Buffalo to be seen by my doctor. After telling my father my symptoms, he thought it would be best if I went to a vascular doctor.

With the help of my father, I went to see a vascular surgeon doctor that he has worked with a few times in the past. I explained to the doctor my symptoms and he sent me straight for a venous Doppler of my neck, because from my history of having a mediport, I was showing signs of a venous thrombus.. a blood clot. The breast discomfort, however, he could not explain.

Sure enough, the test showed that in my right jugular vein, the biggest vein in the neck, was partially occluded with a thrombus (blood clot). When I went home that evening, I did some research and freaked myself out. I couldn’t understand why it took six months for the symptoms of the clot to surface. So I went to google and looked up the relationship between venous thrombus and breast cancer. What I ended up reading was that the blood clot could be due to the cancer, a metastatic form. My worst fears went through my head and I was in tears all evening. I would later find out that was not the case for me. If I could recommend anything from this whole experience is not to look up diagnoses on the internet, even if the sources are research papers. Listen to your doctor and if there are any questions, your doctor is the best person to answer them… NOT THE INTERNET.

Back to my blood clot..I was prescribed a newly released blood thinner, Xarelto, by the vascular doctor. This drug unlike heparin and warfarin, does not require frequent blood tests to monitor my blood. In fact there were no tests necessary at all for this drug, which made it extremely convenient for me since I was staying in Toronto. With this blood thinner and like with any other I had to be careful not to cut myself or hurt myself. I had to stay away from intense exercising to limit my risk of falling as much as possible. For the first two weeks, I was to take the drug two times a day to build up the dosage, then for the next four weeks I was to take on pill a day with a smaller dose. The drug is generally expensive, but I qualified to save a good deal of money on the drug because the drug company was offering a special discount. I just had to call the company and give my information.

I did not get many side effects from Xarelto, other than the expected easy bruising. I was getting muscle cramps when I first started the drug, mostly in the big muscle groups like my legs and arms. Apparently this is not a common adverse effect, but everyone reacts to drugs differently. I was getting over a cold so maybe that caused the muscle cramps. I read that periods might be more heavier but I did not notice anything unusual.

I took the drug daily for six weeks and I am finally drug free. It has been a little over a week since I stopped taking Xaretlo and I feel normal. Before getting Xarelto, the vascular surgeon told me that there would be two options in treating this blood clot. The first one, and the one he preferred was to take a blood thinner. The second was to go into my vein and scratch out the blood clot. If the drug did not work, we have to go with the second option because you can only take a blood thinner for so long. My arm is not bothering me at all and I am confident that the blood thinner did its job. I have a venous doppler test scheduled in 3 weeks to see the actual results. As for the lump in my breast, I had a biopsy done and the results came back benign. 🙂