“FEARLESS is not the absense of fear. It's not being completely unafraid. FEARLESS is having fears. FEARLESS is having doubts. Lots of them. FEARLESS is living in spite of those things that scare you to death." - Taylor Swift

Wednesday, September 17, 2014

Cryoablation Experience

September 9th I had my cryoablation procedure done at Children's Hospital Boston. It is a fairly new form of treatment of FAVA and is done primarily from one amazing interventional radiologist. It is a non-invasive procedure guided by ultrasound that involves freezing the mass using needles and cryotherapy techniques which will eventually kill and shrink the mass. This treatment option was first introduced to me last December but it was quickly declined for my case because of the characteristics and location of the FAVA. The team decided that it was more dangerous than a cutting surgery because the masses were too close to the skin and they feared of breaking the skin, ultimately creating an open wound and severely damaging the nerves. At this time, I would have been the second person to receive this treatment in the United States and they didn't have enough practice to feel comfortable doing the procedure at the time because of its proximal location to the sciatic nerve. However, 9 months later, after I had a large cutting debulking surgery, the mass grew back and the vascular anomalies team felt that the cryoablation procedure would now be the best treatment option. Now, they had done 13 of these treatments to which they deemed 11 of them to be successful. They felt like they had better control of the freezing device in case the freezing got too close to the sciatic nerve or too close to the skin since discussing it last time.

So, how did it go? Did it work? Well, I had this procedure done exactly a week ago and there were definitely pros and cons to it like all the previous surgeries I've had. With any procedure or surgery I have, I generally determine it at least partially successful based on pain control and this time my pain was definitely successfully controlled! But, time will tell if it actually worked or not. They found some abnormal and enlarged veins in my upper thigh which might require some sclerotherapy in the future if they cause any pain but I'm staying hopeful! As predetermined, I was going to get a nerve block  specifically for pain control. I was under general anesthesia for this procedure and the nerve block was put in at the beginning of the procedure to ensure quality pain control. They told me multiple times what to expect and how I wasn't going to have feeling in my leg. However, it was definitely an odd and uncomfortable feeling. At first, it didn't bother me because I knew without it I would be in an enormous amount of pain but I soon started to hate the feeling. My leg was so heavy trying to move my dead weight around my bed to reposition myself. I was only in the hospital for one night and my abs got the biggest workout I ever had those two days! Trying to pull myself around my bed to avoid my right healthy leg from hurting was definitely an undesirable challenge!

Like I said, I had no pain or very little pain while on the nerve block and was on very little IV pain medication as well. I was so happy because I could make the best of the situation by using my phone or watching TV and talking to people without feeling nauseous, dizzy, or drugged. But like always, I got a  horrible night's sleep that night due to being uncomfortable, repositioning, and being woken up every few hours for vitals. However, I was extremely pleased (although my boyfriend won't be ;) ) to have a young, attractive, male as a nurse that night to distract me from being uncomfortable. Sometimes you just have to make the best out of some situations! So generally the nerve block wears off 2-6 hours after it is removed and it finally wore of 8.5 hours after; it was dreadful waiting. I couldn't wait to finally feel my leg again not to mention simply wiggling my toes! Once the nerve block wore off and I successfully switched to oral pain medication, I got the choice to be discharged (which I took)! One night in the hospital for a procedure was definitely a record!



Recovery went well for the following three days after discharge with mild pain until I ran into my first small complication. I woke up with the biggest migraine I ever could have feasibly imagined. My head felt like it was over 3 times the size and my brain was throbbing with intense pain. Migraines don't run in my family and I've never experienced one until this day. I pulled all the blinds closed, pulled a blanket over my eyes, laid in bed and slept for over 24 hours. Every time I got up to use the restroom, I vomited whatever was in my stomach. I couldn't eat even a cracker, drink any water, or take ANY pain medication for over 24 hours. We called Boston Children's Hospital and reached the doctor on call since it was on a weekend and they said it sounded like a migraine from the nerve block (spinal) and that it should dissipate within a day.

However, my doctor called me back on Tuesday saying that she heard about my migraine and looked into it. Apparently the team who did the nerve block said that they didn't put the nerve block in through the spine so they are almost 100% sure that the migraine didn't come from the nerve block. Anesthesia couldn't think of a reason either for the cause of it. Once again, another mystery is present in the life of having FAVA which only brings on more confusion and concern. Since they are concerned about the migraine, I'm still awaiting a probable cause. But the good news (even though I have no choice due to stomach issues) is that I'm off of all pain medication except nausea medication! Of course, I'm still in a lot of pain but it is manageable and I'd rather have clarity than try to take them and essentially probably throw them up again.

This was my experience with the cryoablation procedure and I'll be posting results at a later date. I  also attached some pictures of my upper thigh post-procedure. This is my first time uploading any photo of my vascular anomaly. The large scar is from my previous cutting surgeries.

-becca


7 days post-procedure, lots of bruising 



A few days after the procedure 

The day after the procedure - still in the hospital 

Still in the hospital - the freezing came close to the surface of the skin here which is why it's red. It didn't break through the skin and this was not an injection site.



Day after in the hospital 

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