Difficult Decisions

Hi all!

Well its not often these days that I blog for two days in succession, but I figured tonight there was nothing better than to draw on my wonderful fan base out there for support.

As mentioned in last night’s blog, this morning Mom and I headed off to Unitas to meet with Prof Fourie to discuss the issue of the indwelling micro-catheter that is running through my body (from my groin to my head, via the heart). From recent scans it is confirmed that it is beginning to pose a bigger problem than previously thought, and ideally it should be removed as soon as possible.

The problem is that an epithelial response to the micro-catheter is beginning to take place in my inferior vena cava. I guess I need to explain what this means. Firstly, the inferior vena cava (or IVC for short) is a large vein that travels from lower half of my body to the right atrium of my heart. Its purpose is to carry deoxygenated blood from the lower parts of my body to my heart, where the blood will be pumped into the lungs to be re-oxygenated. Secondly, epithelium is a type of tissue that occurs throughout the body; its purpose is to line cavities that occur naturally in the body.

In my case, the micro-catheter in my inferior vena cava is experiencing a epithelial response; in other words the tissue is starting to cover the catheter, and in doing so two issues occur. The first is that not does the micro-catheter occlude the vein (i.e. reduce blood flow in the vein), but through the epithelial response, the occlusion is exaggerated, as the tissue starts to create even more blockage in the vein.

Given this scenario, the most appropriate course of action would be to remove the obstruction, i.e. the micro-catheter. However, this is not as simple as it sounds, since the epithelial response has occurred, but its extent is not known. Therefore, as the micro-catheter is extracted, either via the jugular or the groin, it could snap somewhere in the length of my body. This would create an enormous complication, as it may mean the remaining micro-catheter would stay behind in my vein. This could cause serious problems for me at any point in the future, whereby the micro-catheter, or bits of it, could be flushed into my heart, or any of my other organs, with severe consequences. I’m not sure about you, my dear readers, but I would feel truly stressed going through life with the knowledge that at any minute my heart or other organs may get blocked by bits of micro-catheter.

The other scenario is that the micro-catheter remains in my body. However this scenario is not any better, nor any worse than the aforementioned scenario, as at any point in my life (it could be next week or twenty years from now), when I reach or stretch for something, or play sport, or take a tumble, the micro-catheter could be stretched to an extreme and snap inside my vein. Alternatively, if it doesn’t snap, it could unravel in my brain where it terminates with dire consequences such as compromising the occlusions that have been deployed in my vein of Galen.

From these two scenarios it is evident that we are facing a really difficult decision. It’s a situation of whether we do we are damned and whether we don’t we’re damned. The surgery to remove the micro-catheter has been provisional scheduled for Tuesday next week (12.05.2009), but as a family we’ve decided to not yet commit to this surgery. We are going to ponder the pros and cons of the various scenarios over the next 24 hours before we make a decision. Also we’re planning to do as much research as possible in the time provided, and talk to as many people as we can get hold of that can offer advice on this matter. Once we have all of this behind us, we will, as a family, make yet another incredibly difficult decision.

So please keep me and my Mommy and Daddy in your thoughts, prayers and wishes over the next few days as we face this situation.

Lots of love and sleepless nights,

Jarrod