-Tracy Chapman, Give Me One Reason
There is just ONE reason that we're still here ... coumadin. Or, more accurately, the fact that Jay seems to be hiding his coumadin in his armpit. It takes a while for some people to get to a theraputic dose, but apparently he is immune to the stuff. They have been giving him coumadin every day for at least 3 weeks ... or maybe it's been 4. (Things are starting to run together as we enter our SIXTH week here at CHOP. Oh my...) I'll go with 3 since it makes me feel better.
So, yes that means that every day for the last 3 weeks our friends (cough, cough) from phlebotomy have come in at 6:30 a.m. to draw blood. How's that for a fun way to start your day? Every single day? (They start early so that the INR level is back by the time they do rounds.) They are aiming for INR between 2.5 and 3.5. So far, Jay hasn't broken the 2.0 mark. Until he's in that range, he has to stay on Heparin, another type of blood thinner.
Problem is that Heparin leaves your system very quickly, so he has to be on a constant infusion. So we drag around the lovely blue pole with one little pump of Heparin everywhere he goes. And while I'd love to be able to drag that pole right onto the airplane and figure it out at a hospital closer to home, so far they aren't going for that idea.
They idea that they are now willing to consider is also not particularly fun. Starting tonight, Jay will start on Lovenox shots twice a day. They will give him those tonight and tomorrow, then check to see if he's theraputic on yet another anticoagulant. (Third one's a charm, right?!) THEN they'll decide if we can do those shots on our own. At H - zero - upside down W - letter on the eye chart. (While Derek has mentioned heading to the H-place publicly, I'm not saying the word until we've got the boot!)
I can't tell you how frustrating this whole enterprise has been. I am starting to feel like a hostage here. This morning, I just wanted to scream, "Why are we continuing to do the same thing and expecting a different result?! Why are we throwing larger and larger doses of medicine at the problem with no improvement?! Why can't we work this out in NC?" But a blood clot on the shiny new mechanical valve would be bad. Really, really, really bad. Like surgery to replace the valve bad. So, I am digging very very deep in my well of patience to try and suck it up another few days. But that well is running awfully dry.