Sclerotherapy Part 1

 Tomorrow I go in for my first treatment for this monstrosity on my back. They call it sclerotherapy. Basically they stick you with a bunch of needles and inject in a variety of things that cause the malformation to become inflamed and harden. I hope that is a good thing. I'm assuming it is, even though it sounds really yucky and I've never heard of inflammation being a good thing. I can't remember if the doctor ever told me, but I think I have an arteriovenous malformation. In a language I understand, it means there are abnormal connections between my arteries and veins, causing a high flow, pulsating collection of blood vessels. AKA a strange mass in my chest cavity and back.
 The way the doctor explained it is the arteries and veins couldn't make up their minds what to be, so they decided to be something in between the two and start a pool to hang out it. Like all lazy beings, they decided to recruit others surrounding them to do their work, or fill the pool. Only problem is the greedy little things keep trying to expand the pool and steal the supply to normal, helpful parts of the body.
 Luckily for me, it has not adversely affected any other parts of the body. (Unless you count my brain, which has not has a whole lot of sleep in the past few months... for further explanation, see earlier posts about planning a wedding, having my back sliced open by a crazy butcher doctor for no reason, and sleeping next to a man who snores and tries to carry on conversations in his sleep. I sure do love that man though.) So we are going to start therapy so it doesn't decide to do so.
 I have been asked what this procedure entails and what it is all about, so I am writing a blog to give you the basic scoop.
 Here are the highlights according to John Hopkins:
-Arteriovenous malformations may cause pain. They are also more stressful on the heart because of the rapid shunting of blood from arteries to veins. Depending on their location, they may also result in bleeding. * I am not bleeding, so this is very good news!*
-Although surgery is sometimes useful, it is usually difficult for surgeons to completely remove vascular malformations, which will return if not removed completely. *Found that out the hard way* A nonsurgical method of closing down the blood or lymph flow into the malformation is done by interventional radiologists, who treat patients with image guided procedures. Vascular malformations are treated by embolization.

The AVMs can be closed by advancing a tiny plastic tubing, no larger than a pencil point, into the feeding artery to the malformation. This can be done without incisions or stitches, and with only mild sedation. Medical glue or alcohol or small beads are then floated into the malformation until it is full and no longer has blood flowing through it.

The VMs and LMs are closed by injecting alcohol into the sacs filled with venous blood or lymph until these sacs collapse and no longer fill. 

- The recovery time varies. The arteriovenous malformations can be treated with a one night hospital stay. There is usually minimal discomfort for one to three days. 
*If however it is a mix, which the doc thought it may be* The venous and lymphatic malformations also require one night in the hospital. These malformations swell after treatment with alcohol, and the swelling and pain may last for 3-5 days.  During this time, we give patients medication for any pain or swelling they may have. The full shrinkage of these malformations may take four to six weeks. *Also I was told I should be able to go home without a stay overnight- your prayers are appreciated in regards to this matter*

-AVMs are more difficult to treat since they tend to pull in new artery feeders from time to time. However, embolization is very effective in blocking abnormal artery feeders while preserving normal arteries. AVMs may require a series of treatments to block all of the abnormal feeders. *Lucky me, mine will haha*
Venous and lymphatic malformations respond well to alcohol embolization. These may also require a series of treatments about 6 weeks apart to block all of the abnormal vessels.
All vascular malformations require long term surveillance, so that if there is any change, such as pregnancy, they can be monitored for symptoms that may warrant rechecking and possibly retreating. We monitor PAVMs over time to be sure they collapse and do not refill. 
-Since congenital vascular malformations are relatively rare, it is probably advisable to obtain treatment at a major center that sees many patients. *Hence my lovely ongoing battle with Anthem and Duke every day to try and get my procedure covered.
 So there you have it folks. It should be no big deal, right? I am just amazed at the whole process of how the human body develops and how things can deviate from the normal blueprint of body functions. And furthermore, that doctors have developed ways to combat and fix so many problems when bodies don't function the way they should. It's pretty amazing to think about.
 I am going to try and sleep now. I doubt I'll get much tonight, but I think I'll feel much better once N gets home and I have someone to snuggle with. Wish me luck everyone!