Despite not having confirmation of a bed, I turned up in the radiology day case unit at 8am on Tuesday for my microwave ablation of the liver. A familiar place, it’s where I had my portacath fitted, and where I had my previous (unsuccessful) microwave ablation process on the secondary tumours in my liver. The liver situation is more promising this time - my period on Pembrolizumab caused a lot of shrinking, and they have essentially remained dormant for the last 5 months despite stopping the immunotherapy treatment.
A bed is a pre-requisite, as you have to spend 6 hours flat on your back afterwards, and then remain under observation for up to 24 hours. I can hear the staff continually ringing the various bed managers and it’s not promising. By 10am, oncology are a definite no, but liver services are saying they should have one, they just can’t confirm when. The interventional radiologist decides to proceed on that basis, as we will time out otherwise.
Into their specialised operating theatre, same anaesthetist as last time, we go through the usual rigmarole for putting me under. It doesn’t take long, and next thing I know, I am coughing and spluttering in recovery. This is the first GA with pneumonitis and I certainly felt the difference.
Shortly afterwards, the interventional radiologist came to see me. “We had a bit of a problem”. It would appear one of the probes, designed to go over 100c, got quite a lot hotter than that, and melted. Essentially the casing came off the device and left the needle inside me. I asked how he knew - sounds of an explosion followed by an intense burning smell, and a retracted device missing its needle. He was hopeful the needle was under the skin and not in the liver, in which case it would be possible to retrieve it. The plan was to get me thorough the 6 hour / 24 hour recovery protocol and then have a CT scan.
The procedure itself is at best uncomfortable and at worst, very painful. Pain reverberates up the shoulder and into the neck. The abdomen is sore and it’s difficult to bend or twist. Getting to lie flat, or get up from lying flat, is a horrible process. I spent the night working through a number of members of the opioid family. Codeine seemed to provide the right sort of balance.
The following morning, I have the CT scan. As I reverse back out of the machine, the image is clearly visible on the machine’s small panel. I can see the needle, sitting laterally across the ablated area, broken into several pieces. A couple of hours later, the interventional radiologist pays me a visit with formal confirmation of that news. He had spoken to the manufacturer who said it was a 1 in a 1,000 occurrence. I am getting a bit fed up of collecting these supposedly rare events. Removing it is not an option as that would require major liver surgery
it rules out having MRIs unless they are essential, as I could get burning. He didn’t seem too bothered with that, as he thinks he can monitor from CT alone. The plan seems to be to keep on ablating me, unless the cancer goes wild again, on the basis I can’t go back in on immunotherapy, and the other options for TNBC are either awful or non existent. 2 weeks in 3 ill for a 4 month life extension anyone?
Back home now, with codeine and antibiotics, and lungs full of grot that I can’t currently cough out because of the pain. Looking forward to a couple of nights on my recliner as getting in and out of bed is a non starter. Wondering quite how many low frequency risks I can accumulate. I am sure there must be more.
