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

Hospital Diary #5 – “And the winner is…”

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Everyone get their tickets out! The results are in and the diagnosis is…

{trumpet fanfare}

Endocarditis

It was a tough call. The TEE test was negative for bacteria on my heart valves and so far my blood cultures haven’t grown. But, the symptoms are so classic and the response to treatment so dramatic that the infection disease doctor seems certain that’s the cause. The cure is four weeks intravenous antibiotics which means I’ll be playing “doctor” at home in a different way for the next month.

All winning tickets should be sent to our redemption center in Ullan Baator.

Tom IV

Hospital Diary #4 – Waiting

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I’m scheduled to have my TEE at 9:30 am. Funny, when I have a bunch of work to do I have no problems “accidentally” killing time on Facebook etc. but the one time that I should be killing time to take my mind off the procedure I find myself strangely productive. It’s true that you don’t realize how sick you are until you start feeling better.

As of now I still have a cough, slight shortness of breath and I feel incredibly grimy since I haven’t bathed since Friday. My vitals are excellent and my energy level is good. After they moved me to this “medical dorm room” I was able to get a small snack (raisin bran and a banana) and drifted in and out of sleep during the night. The sleeplessness was more anxiety than medical.

My “roommate” in the hospital is helping me keep it all in perspective. He is completely non-responsive and nobody has come to visit him. Can’t help but feel lucky when I snap on the baby monitor and watch Tommy sleeping back home.

Judy is bringing my Statistics homework and I’ll send out a bunch of e-mails in a few minutes to try and figure out how to start catching up to the school work I’m missing. I’m missing it in the sense of “not being there” and also missing it in the sense of “I enjoy it and sense its loss”. Who knew I’d be such the avid student?

Wish me luck on the test.

Tom IV

Hospital Diary #3 – Moving

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They just moved me out of Neuro-ICU into a “regular”, semi-private room. Quite the contrast! It’s like being sick in a boarding house. I’m sharing my room with another guy who was sleeping when we came in; I feel sorry for him because I don’t know how he’ll get any rest when my coughing fits start up again. It’s also hot (~72°F) in here and it feels like the germs are festering. It doesn’t help that I haven’t washed in two days!

I am feeling much better – cough notwithstanding. I’m hoping this test tomorrow will “tell the tail” so I can get back to my regularly scheduled life (already in progress!)

Tom IV

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