In the September 2022 timeframe, I decided to get a hepatic artery infusion (HAI) pump to treat my liver metastases. At this point I had my first 6 to 8 rounds of treatment using FOLFOX with Mvasi. My first scans showed treatment was working, but my goal was liver resection. I had a long way to go on treatment to reach surgical parameters with the number and size of my liver metastases because both lobes and seven out of eight segments of my liver had tumors. My hope was that the FUDR, through the HAI pump, would help shrink the tumors faster.
The first week of November 2022 I showed up at the MSK hospital at 5am. By 6:30am, I had met with Dr. Kingham and was off to the operating room. I warned the operating room nurse I was not wearing deodorant, and I was put under. During my pre-op visits, it was 50/50 on if deodorant was allowed in surgery or not, so I went with none.
I woke up in PACU that afternoon and then was sent to my room. I had a three-inch incision just above where the pump was placed and a one-inch incision in my belly button where they removed my gallbladder. Other than that, I had some small incisions for the robot placement.
The first night was rest and pain management. I was sore the next morning, but the pain management was working. Just before early morning rounds the nurse got me out of bed and into a chair. It was not easy, nor was my first walk that morning. I found each walk got easier. I was put on a clear liquid diet for that day. That afternoon I had to do a pump study to make sure everything looked right with the pump placement. I had to lie on a flat table and dye was injected into my pump. I would go in an imaging device to check for leaks between my pump and liver. Everything looked good.
After night two I was allowed to have solid foods, and I ordered waffles for breakfast. Part of the waffle went down the wrong pipe and it caused me to cough a lot. It was very painful, and it took forever to get it cleared. Later that day I was released from the hospital and stayed in a Manhattan hotel by the hospital for two nights. I then flew back to Texas.
Flying back to Texas so early was a mistake. I started running a fever the next day and went to the ER at UT Southwestern. I went to UTSW because Dr. Yopp there has a close relationship with my surgeon Dr. Kingham and Dr. Yopp also places HAI pumps. Dr. Yopp had me admitted and ordered a full workup. The fever was likely caused by a piece of the waffle that made it to my lungs and caused pneumonia or related to a leg DVT found. I was treated for both and released the next day.
10 days after coming back to Texas, I was flying back to New York to be cleared by Dr. Kingham and to start chemotherapy with Dr. Kemeny. Every four weeks I would fly to MSK for chemotherapy and have FUDR put into my pump. Two weeks after my MSK visit I would get systemic chemotherapy and have my pump flushed at UT Southwestern under Dr. Kazmi.
This went on for months. To access my pump, they put a needle in my belly as the HAI pump is just under the skin. It hurt a little at first, but I no longer had feeling in that area from being accessed so much. HAI pumps being a little new for treatment at the time, I found some nurses had zero issues accessing it during treatments and some had a lot of issues accessing it. It is hard to say what impact FUDR had on me because I started FOLFIRI at the same time. After months of both, it wore me down a little more each treatment.
I could always feel the pump in me when I was turning a certain way or sitting forward in a chair too long. Not being able to lift more than 20 pounds was probably the hardest part of having an HAI. I will write an opinion post later about HAI benefits. If I was able to do it all over again, I would still take the same path and get an HAI pump.
