Tag Archives: Coumadin

One small step for Lucy…

She still hasn’t had the giant leap towards going home. Dr. Rousey (hematologist) stopped by this morning. He and Dr. Thurmes are still digging though research studies to see if Pradaxa will be the drug of choice, with Arixtra as the runner-up. Pradaxa apparently has a shorter half-life, which is helpful in case of a complication. Lucy likes the fact that it is oral and not an injection (OK, so do I!). Neither drug will need as frequent blood testing as Coumadin requires. I think it is because both drugs manage specific coagulation factors while Coumadin takes more of a “scorched earth” approach.

The IV antibiotics are still going. Right now, she gets Vancocin (vancomycin) and ampicillin, and both are available orally. While the hematologists are researching Pradaxa, Lucy is still on IV heparin. She has not needed a blood test because she hit the therapeutic range.

Julie stopped by this afternoon and really made Lucy’s day! It was nice having nearly no interruptions while Julie was here.

Lucy took two walks today. The first was about 50 feet. Her second was close to 150 feet. She would go farther when they finally disconnect the damned IVs. Her left ankle is loosening up a little. On her second walk, she was able to get her heel on the floor while walking, at least for a few steps. There was still discomfort walking, but she was not wiped out afterwards. Like last time, her pain started decreasing when she sat down.

Dr. Thurmes will be on rounds tomorrow and said he will stop by. He’s been so good to Lucy through this ordeal. He might have the home care anticoagulant and antibiotic choices tomorrow. If so, she could be released tomorrow.

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March came in like a lion (in a good way)

Lucy had a very busy day with all the people in and out to check on her.

Dr. Dettis (infectious disease) was by and told her he was better than 90% certain her fevers and leg redness were solely from the clots, but he wants her to be on antibiotics for another day or two. That was reassuring for her to hear.

One of the hospital chaplains stopped by, and then Dr. Thurmes (hematologist) was by to see how she was doing. Unfortunately, her hemoglobin was at 7.1 so she received one unit of blood just before going to IR. He feels the Coumadin and Lovenox are not working and had two other anticoagulants in mind. One is Pradaxa, which is a pill. The other is a once per day injection which she couldn’t remember. We are hoping Pradaxa is a workable solution. Dr. Thurmes had a couple of areas he needed to research first.

Her TPA procedure got delayed because of a couple higher priority cases. She was originally scheduled for 8:30 and finally went down at 12:45. The procedure completed by 1:15. She no longer is on TPA and they can stop doing the neurological tests in another four hours. She should get more sleep tonight and have fewer interruptions.

She did have to have her arm IV access changed. Getting a different one in was very problematic. Her arms have really been poked. Certain drugs cannot be administered into a port, and her antibiotics are all incompatible with heparin.

Julie called tonight and like last night didn’t get much time to talk to Lucy. The arm access IV adventure was just beginning then.

Lucy got to sit on the edge of the bed for over a half hour. She even managed to stand up before getting back into bed. Tomorrow she will get out of bed and go for some short walks.

Getting the TPA catheter removed is a step towards going home. The next two steps are getting her off IV heparin and letting her leg heal a bit more. Getting the heparin level in line will probably be the most difficult given her experiences. We still don’t have a firm release date.

Keep your fingers crossed, and thank you for all the thoughts, prayers, positive energy, and good wishes!

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Tomorrow will be a better day

Lucy couldn’t visit her dad today. Her thigh was too painful. This happened the last time she had a clot in her left leg. The good news is her calf diameter was almost a full centimeter smaller and the erythema is almost gone. Her right calf diameter also was 0.8 cm smaller.

It is astonishing at how painful a blood clot is. Her clots are maybe the diameter of a single piece of couscous. At times, she rates the pain as worse than her post-surgical pain. I’m hoping her leg pain is better tomorrow.

I visited her dad today. On my way there, I saw three bald eagles soaring over Highway 100 at Minnehaha Creek. He’s in pretty good spirits and enjoyed having company. Suzy and Steve also came by. Lucy’s family has treated me so well through the years and I enjoy being with them. I’m very lucky because I know too many people who have issues with their in-laws.

Her first Lovenox injection went well today and her second one was OK. I am either getting the hang of it or she’s learning to lie really well (just kidding!). I picked up one of her favorites from Qdoba on my way home tonight. That helped brighten up her day.

Lucy’s next blood testing will be on Tuesday. She was originally scheduled for one test on Monday and another test on Tuesday, but the two blood tests are combined now. We can’t wait for Tuesday because that is when her Lovenox cuts back to one injection per day. It appears she will be receiving injections for at least 30 more days. I do hope that she eventually goes back on Coumadin.

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Stop me if you’ve heard this before…

We fretted about today’s oncologist visit, but Lucy’s left leg stole the spotlight. We did not even get a chance to discuss the PET scan or CA125 level. Her rash is an erythema and is a sign of a blood clot. Her leg also ballooned up this morning.

Lucy did get her Alimta treatment, so something went right. She can take her multivitamins instead of the prescription folic acid since the multivitamins contain the requisite 400 micrograms folic acid. Lucy’s next vitamin B12 injection will be during her next treatment in three weeks.

She was supposed to visit Dr. Thurmes tomorrow, but he saw her while she was getting chemotherapy. Lucy had an ultrasound on her left leg at Suburban Imaging at 6:30. As a precaution, Lucy will be getting twice-daily Lovenox injections for a week followed by daily injections for around six months. Her Coumadin was stopped immediately.

We had about 45 minutes between the end of chemo and the ultrasound, so we had a quick dinner at Leeann Chin’s about eight blocks from Southdale Medical Building. The Heartland Cafe in the medical building closed several months ago and a Subway is supposedly going in to replace it.

The ultrasound confirmed multiple clots in her left leg. However, she was not admitted to the hospital. We’ll find out more tomorrow. Apparently, the belief is the Lovenox will work on the clots such that she won’t require hospitalization or TPA catheters.

I will be administering the injections. It looks like the syringe has a short small-bore needle. Lucy has no abdominal fat remaining because it got removed in her de-bulking surgery. The “tummy poke” is best for her, so I must be careful. It’s funny, I could probably give injections to anyone else, myself included, but the thought of giving Lucy a shot worries me. I know it’s irrational.

So yes, you’ve heard the blood clots stuff before. Believe me we hate reruns, too!

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Happy Valentine’s Day!

A PET scan might not have been the most romantic way to spend Valentine’s Day, but battling cancer sometimes causes inconvenient lifestyle changes. The scan took almost 90 minutes overall at Lifescan Minnesota in Edina. An hour was spent for prep and the scan was about 20 or so minutes. The results will be available to Dr. Boente tomorrow afternoon.

Lucy had a bit of an upset stomach today. We’re both apprehensive about Thursday’s appointment. Lucy has had a series of set backs since November. Her CA125 level has been slowly increasing which necessitated stopping the Taxol/Avastin treatments. The waiting is the hard part.

For the positive news of the day, she did get the latest Coumadin dosing for the upcoming week. She is on a three day cycle of 5 mg, 5 mg then 2.5 mg until next week’s blood test. We did not get her hemoglobin level in the voice mail message, but there was no mention of a transfusion.

Tomorrow will be a test of how well Lucy can maneuver a walker. I’ll be taking her to the Bloomington Deputy Registrar’s office to get her driver’s license renewed. Maybe she’ll feel up to a belated Valentine’s Day lunch or dinner. I did pick up some carnations for her tonight. She likes carnations because they last a long time.

We hope you had a wonderful Valentine’s Day. Take a moment to think of the people who love you and remember how lucky you are to have them in your life.

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One person’s curse is another person’s blessing

We have a number of friends who are not fond of our mild (thus far) winter. The ice isn’t thick enough on many lakes and rivers to skate on much less drive across; several drownings and near-drownings have occurred in the past couple weeks. Brown grass is not conducive to cross country skiing. No majestic icicles, very few days of watching snow slowly blanket the ground, and no fools getting tongues stuck on frozen metal objects. Boring indeed for them.

For us, the mild winter has been a blessing. Lucy has been battling leg swelling and blood clots for several weeks and didn’t have to additionally battle snow and ice. She was on a weekly chemotherapy regimen until January, and there have been a number of medical appointments we attended on dry roads. Anyway, last year we had nearly double our seasonal snowfall and had some brutal -20°F mornings. Maybe Mother Nature was tired from last year? Today’s snowfall was little more than a dusting, but at least our neighbors could have a bonfire without burning down the neighborhood.

Lucy’s aunt and uncle, Ardelle and Dale, were here for a visit yesterday afternoon. They brought some stew Lucy’s sister Julie had made plus a couple other goodies. It was nice seeing them!

Lucy’s left leg is puffing up very slightly and she has a rash on it from the capillaries under the skin ballooning up. Her right leg is almost the same circumference as her left leg and the reddish hue is fading. The skin peeling has almost completed. She is able to walk a few steps without her walker albeit slowly and with some discomfort. Her right ankle still does not have full range of motion and may not for another few days. One of the catheters inserted into her leg was inserted in her ankle. There is still some bruising in the area which is probably the cause of her ankle stiffness. As such, driving is still out of the question for her.

The rash and swelling is not a set back. She had a lot of fluids pumped into her during her hospital stay. Now that she is moving around, those fluids are getting flushed. Lucy still is not as physically active as she was, so there will be some lymph pooling, too. She is maintaining the physical therapy exercises she was doing in the hospital and moving around the house as much as possible.

We are noticing Lucy’s energy level is decreasing and she’s puffing a little after walking around. That usually indicates her hemoglobin count is dropping. She had her blood work done for the Coumadin dosing and was told to stay the course. A Complete Blood Count (CBC) is also drawn. Since nothing was said about her hemoglobin, so we’re assuming it is above 7.5.

Today started the busy week of appointments. Her other appointments are Valentine’s Day (PET scan), Thursday (oncologist and hopefully a treatment) and Friday (hematologist). At some point she needs to renew her driver’s license. That might be Wednesday.

Enjoy your evening and thanks for your support!

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Blood tests

Lucy’s other amaryllis opened while she was in the hospital. There are six flower on the stalk.
The tulips Lucy received from Annette and Al

I completely spaced out mentioning the tulip bouquet Lucy received from Annette and Al on Tuesday. Mea maxima culpa! Annette and Al own Carver Country Flower and Gifts in Carver. Tulips are so cheery and get people thinking about spring. Even though we have had an unusually mild winter in Minne-snow-ta, it will be nice getting back into the gardens soon!

This afternoon she had her blood drawn to determine if her Coumadin dose is still effective. She now has an alternating daily dose of 5 mg and 2.5 mg until Monday.

Next week is booking up quickly: Monday is her next blood work to see how well the Coumadin dose is working, Tuesday is the PET scan, Thursday is her appointment with Dr. Boente and Friday is her appointment with Dr. Thurmes. As far as we know she will get her next Alimta treatment on Thursday.

We take simple things for granted. Our bodies are amazingly complex bio-mechanical wonders governed by amazingly complex electrochemical networks. Nerves trigger muscles, muscles and connective tissues move joints, joints move limbs, limbs move the body. (Anyone who has studied anatomy or kinesiology in detail will notice this is a simplified 50,000 foot overview.) Lucy’s leg is looking less swollen and the redness is slowly turning pink. She still has some stiffness in her ankle and finds relief when she can prop her leg up. She can manage a few steps without the walker and her right ankle is more stable because of some regained flexibility. The pain level is also subsiding. She is hoping to be cleared to return to work a week from Tuesday (her company observes the President’s Day holiday on the 20th).

There probably won’t be an update until Monday. Until then, thank you for taking the time to read this and showing your support for Lucy!

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