Hospital Diary #12 – (Dis)Charge!

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INR 2.8 +0.6 ☜ In range!

My INR is in range and Judy and I are waiting for my official discharge. I’ve been disconnected from the IV, the EKG leads have been removed in what was not unlike a scene from the “40 Year Old Virgin” and we are just now waiting for infectious disease doctor to give us the final “okay-doaky”. Because I’d been seen by so many doctors during my medical Odyssey hunting down the signatures for discharge is taking time. I’m not getting my hopes up until I’m home and the dogs are slobbering all over me.

Hospital Diary #11

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INR 2.2 +0.2

I’m still in the hospital and look to be for at least the next few more days unless I check myself out. I had to fight tooth-and-nail to get the pharmacy to increase my dose of Cumadin and even then they wouldn’t increase it high enough. They are making the classic mistake of treating the protocol instead of the patient.

The snow has started and, thanks to Judy, I have a front row seat. She arranged for me to be switched to the bed next to the window. I really like being able to see outside – there’s a world out there. The windows aren’t insulated so I threw on an extra blanket. After my sponge bath I’ll put on my heavier sweats for good measure.

So today should be interesting. I’ll need to contact my professors about the makeup exams I was supposed to take tomorrow. I’ll also need to see what is supposed to happen next week and make sure I don’t get behind in my readings. I’m feeling fine – it’s time to get back into my old routine (albeit, a routine in a hospital tethered to an IV drip).

Thanks for all the prayers! Keep Judy in your prayers, too. Once again I’ve given her a handful.

Tom IV

Hospital Diary #10 – Groundhog Day

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INR 2.0 –

On Tuesday I told the doctor here (among other things) that keeping me on 4 mg of Cumadin will take a week to bring up my INR to 2.5. Turns out that might be optimistic. While furious I’m not surprised – at home, being active and bouncing around my day-to-day life my maintenance dose is 4 mg. So, not surprisingly, in hospital I’m maintaining at 2.0. I’m hearing rumors they will up my dosage tonight – three days too late in my view. Not sure where to go from here – it seems that shaking a physician until their brains turn to malted milk is illegal in Ohio.

I certainly have been spending too much time on the Internet – that will rot your brain almost as much as TV. On Facebook someone asked what my high school’s motto (Qualis Fiam Talis Iam Fio) meant. Given my complete lack of school spirit and… indifferent study habits in Latin class it is the height of (non-Socratic) irony that I would have the answer. And it wasn’t even correct; I left high school much the same being as I entered. My personal growth didn’t occur until much, much later. What can I say? I’m a very late bloomer!

Even with all the time on the Internet I’m ignorant as to many of the developments, both political and sporting, in the world – I haven’t had the focus. Now I’m trying to get as much studying in for my exams Monday and I’m “Thinking the Unthinkable” (Herman Kahn reference intended) – I may not be out of here before Monday. I will handle that if it happens – I own enough trouble without borrowing any!

Hospital Diary #9 – Two steps forward; Two steps back

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INR: 2.0 –

My INR didn’t budge overnight so I’m here another day. {Insert Favorite Expletive Here} I was worried this would happen. So many variables that go into what makes the blood’s INR level that managing it is seems sometimes more art than science. So I’m here another day.

Tommy had tubes put in his ears today. He has the same problem as his Uncle Jason – the area behind his ears don’t drain properly so mucus begins to accumulate behind the ear drum. Judy tells me he did fine and the doctor drained a huge amount from behind his ear. Poor guy! The world will seem much different now that he can hear properly. Judy sure has her hands full this week – I sure love her!

I’m still not sleeping so I’m going to try and wheedle some coffee out of the kitchen. The longer I’m here the more long-term factors begin to hamper my recover.

Tom IV

Hospital Diary #8

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INR: 2.0 +0.5

My INR came up surprisingly well during the (sleepless) night. I haven’t been sleeping here but My roomie didn’t have a good night last night. I hope he pulls through.

Hospital Diary #7 – Papers are not in order

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I’m still in the hospital and it looks like I may be here for a few days more. I think the steam from my ears set off the local smoke detector (though, with all the beeping around here, who would have heard it?) To understand why requires a little background information.

A Little Background Information

People with coronary artery disease should always know their cholesterol levels. Diabetics should know their blood glucose levels. And people with heart valves and other cardiac prothstetics need to know their PT/INR number. In the early days of artificial heart valves (way, way back in the 1960s) researchers were finding a statistically significant group of patients were “stroking out” – dying of strokes – caused by blood clots forming on the artificial material. By prescribing blood thinners these strokes could be strongly mitigated (but not completely eliminated). This is serious stuff – it’s not like not taking your Viagra. If a clot occurs on the valve you might get enough time to say “good bye” (then again, you might not). The measure of how “thin” the blood is called the “PT/INR” or usually “INR” for short. The target range is set on an individual basis by one’s doctor from 2.0 to 3.5. My personal range is from 2.5 to 3.5. For those who are interested, “PT/INR” stands for “Prothrombin Time and International Normalized Ratio”. (hey, you asked)

For my medically inclined relatives and friends a good paper describing the need for anticoagulants is here.

Surprise!

This morning I was informed that my INR needs to be in range before I leave; it was 1.7! As a precaution I was taken off my blood thinners when I came in through the ER incase surgery was indicated. The infuriating part is that they are being very, very, very conservative bringing it back up to a normal level. I could be potentially be here another four days doing nothing but waiting for my blood to thin – a prospect to drive anyone around the bend.

To Pass The Time

Installing the PICC line

As you can see by the look on my face I’m feeling like my old self again.
Picture by Judy Lillis

I had the PICC line installed today. All that meant was they snaked a tube in my vein from my arm to just above my heart so I can get daily doses of IV antibiotics for the next four weeks. It took them three tries until the doctor was satisfied (the same doctor that announced my incarceration this morning). We will be having a “home healthcare aid” give us instructions on cleaning and use of the PICC line when we get home. Judy has graciously allowed herself to be deputized to hook it up.

Sheesh! The things I do to stay alive!

The Punchline

I’m otherwise feeling really good. Lots of energy and anxious to get back to my schoolwork. I spent much of today catching up with homework and writing and hope tomorrow to do some studying for next week’s exams (on the hope I’m sprung by then). Thanks for all the well wishes and I hope to see you when I make parole.

Tom IV

Hospital Diary #6

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I’m feeling better but am in a “holding pattern” with regards to discharge. Last night was another one of little sleep. It turns out my roommate has a wife – she visited yesterday. A very, very nice little woman, very worried about her husband. He’s still in rough shape medically (though that doesn’t keep him from snoring!) I’m glad he has loved ones, though.

Today barring setbacks I’m supposed to get a PICC line and be discharged but as with any large bureaucracy these things happen in their own time. I’m trying to generate as much normality as I can to keep my sanity. Despite the lack of sleep I was up a my usual 7 am, had breakfast, then jumped into school work. Luckily, my professors have been very helpful so I haven’t lost too much ground in my classes. My real worry is that something medical will destroy the semester for me but, as I’m feeling better physically, this seems less of a real concern and more like borrowing trouble. I will NOT, however, be trying out for the Ohio State Rugby team anytime soon.

Thank you for all the well wishes. I hope to see everyone soon.

Tom IV

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