Tag Archives: heparin

Land of transfusion

Lucy’s hemoglobin was at 6.0 and her platelets were at 50,000. Dr. Nashawaty had rounds this weekend and he mentioned the irony of keeping Lucy on heparin but also having to transfuse platelets. Her Alimta treatment probably caused the platelet count drop and to her low hemoglobin level.

On the plus side, her heparin is in therapeutic range. She will be in the hospital until at least tomorrow. One of the criteria for release is getting her off IV heparin. Our guess is they would also like to see any risk of infection in her leg eliminated and a noticeable improvement in her leg. It appears her leg is getting a little better. Like her last hospital stay, this will be a day-by-day event.

Today saw a steady stream of nurses and nurse’s assistants in and out of her room. Lucy said one of her arm blood draws was at 3:00 am this morning. Her port has heparin in it so certain blood tests must be done via her arm.

Lucy’s appetite is still good. I went to the cafeteria and picked up a grilled chicken sandwich for lunch. She asked to sample it and wound up eating the whole thing.

Steve and Liz came by this morning and brought cookies. Suzy was by this afternoon and left a stuffed snowy owl and a couple of magazines. Julie called to see how Lucy is doing. We also appreciated all the great notes from everyone. Lucy and I do read the comments left in the group or in the blog, and we thank everyone for their words of encouragement.

We’re hoping her heparin stays in therapeutic range tomorrow. That will put her one step closer to going home.

scrub top

I found this scrub top in the gift shop. Lucy wants to see it when she is more mobile. I’m sure she will get one.

snowy owl

Suzy brought along a new friend for Lucy

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“There will be Blood”

This morning started with a 75-minute nosebleed. Lucy was to start using Afrin nasal spray but her bleeding started moments after the first spray. She then switched over to a saline gel. Diane visited Lucy this afternoon. It really helped Lucy’s mood. Diane can get Lucy laughing which is really needed now. Thank you, Diane! She also suggested the title for tonight’s post (it was originally “Let It Bleed”). Between the nosebleed and the blood draws, Lucy could have supplied the blood for this season of “Dexter”.Lucy is still running a temperature of around 101°F. They are running an IV antibiotic and she is getting Tylenol for her temp. They also drew blood to see if her blood thinner dose needs adjusting. Blood thinners are very touchy. Then they drew blood again looking at her Heparin Factor A, and then drew a third time for blood cultures (again). She also received two large heparin bolus doses.

It sounds like Suzy is going to visit Lucy tomorrow. Unfortunately, when Suzy called tonight, Lucy had a lab tech wrapping a tourniquet preparing for a blood draw and two nurses reviewing the heparin bolus double-check and co-signing procedure. Things do get a little hectic in the hospital.

Keep Lucy in your thoughts and prayers tonight. Thank you for all your support!

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Mondays are supposed to suck, not Fridays

Lucy’s leg started getting worse this morning. She called Minnesota Oncology and they set up an appointment for 2:00 this afternoon.

Her nosebleed started at 1:30 and finally let up around 3:00. The nurse practitioner at Minnesota Oncology helped Lucy with her nosebleed. Anticoagulants are so fun. Dr. Thurmes also contacted her while he was at Fairview Southdale on rounds.

She was admitted to Fairview Southdale as a precaution. Lucy also had some extra blood work drawn along with blood cultures. They need to wait 18 hours after her Lovenox injection before they can start IV heparin. That means she will get awakened at 4:30 am. She just had completed an IV antibiotic because they suspect cellulitis. An ultrasound of the left leg found that the clot in her groin was solidifying. We are hoping she will not need a TPA catheter tomorrow. In the past few hours, she started running a fever, which is at about 102°F right now. The Tylenol will help reduce the fever.

It is frustrating that this clotting problem flared up again. More than likely, she is here until Sunday. We were looking forward to a nice quiet weekend at home and having her leg continue to heal. Now it’s back to a wait and see mode. Keep Lucy in your thoughts and prayers this weekend. It helps us get through these setbacks.

At least I don’t have to play Nurse Ratched with the Lovenox while she’s in the hospital. See, I did manage to find something positive.

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“Going Mobile”

Discharge day! We’re thrilled! The post title is an appropriate song by The Who. Today’s events went like this:

10:45 am: It sounds like the doctors are happier with her heparin blood level. The heparin IV could come out today. Because her Chromogenic Factor X test takes several hours, we will not know if she can go home. If she does stay, she will move to a different room on 8th floor. Fairview is stripping and cleaning the floors and performing maintenance checks on the rooms. “Hurry up and wait” is the theme for today.

2:00 pm: The expectation of a hospital stay is for the patient to focus on recovery. Fairview Southdale has been exceptional in that regard. Certain administrative obligations pop up detracting from recovery, like dealing with the short-term disability people. “Benefits coordination” is an oxymoron in that company. Lucy got passed to three people so far and each of them asked the same questions. They were just as clueless after her surgery nearly two years ago.

3:00 pm: Lucy’s Chromogenic Factor X result was at the midpoint of her therapeutic range. Her Coumadin dose is set and she has her instructions. The IV lines are removed and she is dressed. Everything is loaded and she has her walker. All that remains is waiting for the pharmacy to fill her prescriptions.

5:30 pm: The pharmacy finally asked for her prescription insurance card. She has a new drug plan this year and the old information was still on file, and there always is a delay when painkillers are involved. Lucy is moving with more confidence after the IV tree went away. Her friend Diane called while I was loading the vehicle. Lucy also called her siblings during the wait. The sunset was nice.

6:10 pm: Lucy headed home wondering what sort of mess waits after me having full run of the house for the past eleven days. She didn’t cringe after touring the house, so I think I did all right. I think the chicken strip dinner I picked up for her at Dairy Queen also helped.

Our house is a rambler with a basement. The basement has a rec room, a laundry room, an office, a ¾ bathroom, and a storage area. The bedrooms are on the main level. One of the guest rooms is now an office for her. She doesn’t need to go downstairs until her leg is better. Most of the main level has laminate flooring. She is navigating the walker quite well in the house.

I picked up some of the wet wipe style washcloths hospitals use for cleaning up a patient in bed. I also picked up a couple of the shower caps that have the shampoo in them. Lucy does not have to worry about slipping in the shower.

Lucy’s next blood test is Thursday. Next week she will get a PET scan since it has been about a year since her last one, see Dr. Thurmes about her leg, and see Dr. Boente about her next Alimta treatment. There is a possibility she may need a break from chemo until her leg fully recovers. Even though her medical leave got extended until February 13th, she may need another week added. Her next assessment may not happen until after that date.

We’re happy being home and are grateful and humbled by the outpouring of love and support you have given us through this ordeal. Thank you!
I picked up some of the wet wipe style washcloths hospitals use for cleaning up a patient in bed. I also picked up a couple of the shower caps that have the shampoo in them. Lucy does not have to worry about slipping in the shower.

Lucy’s next blood test is Thursday. Next week she will get a PET scan since it has been about a year since her last one, see Dr. Thurmes about her leg, and see Dr. Boente about her next Alimta treatment. There is a possibility she may need a break from chemo until her leg fully recovers. Even though her leave was extended until February 13th, she may need another week added. Her next assessment may not happen until after that date.

We’re happy to be home and are grateful and humbled by the outpouring of love and support you have given us through this ordeal. Thank you!

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“Sunday Sunday”

Lucy's birthday gifts

Lucy’s birthday gifts

The yellow bouquet is from Steve and Liz, the elephant is from Diane, and the pink rose bouquet is from Anh-Thu and Karen. And yes, the flash on my phone camera stinks. Motorola puts a 5-megapixel camera on the phone and uses a kid’s toy LED for the flash. Go figure.

Today’s post title is an obscure song by Blur.

Lucy had a chorus of nurses and nurse’s assistants come in and sing “Happy Birthday” to her this morning. That was really nice! Steve and Liz brought a strawberry tart cake. Julie and Suzy came by for a few hours, so Lucy had all her siblings here. Everyone got to see Lucy go for a walk with the Occupational Therapy person. Lucy also had someone from Physical Therapy come by. They worked on some exercises and Lucy has some new ones to add to the mix. Lucy’s dad called to wish her happy birthday and see how she was doing. Lucy didn’t wear a hat or scarf today so everyone got to see how much hair she has. I think that is the first time she went “topless” since she lost her hair in the first cycle of chemo.

Suzy and Julie did get to see Lucy’s leg uncovered and it may have been a bit unpleasant for them. Lucy assured them it was a lot worse and much more painful eleven days ago. Her leg looks like it had sunburn with a little peeling in a couple of areas. There are areas on her lower leg where the color is getting towards normal. Her leg is slightly warm to the touch rather than hot. She has full sensation in her leg and it is not painful to touch it.

Dr. Singh came by to check on Lucy’s progress. Lucy’s Chromogenic Factor X reading today was in therapeutic range. She will have the heparin drop through the night and will have blood drawn for another test tomorrow. The results will be back in the early afternoon. If the Chromogenic Factor X test is in the therapeutic range again, Lucy could get discharged. The transfusion last night took her hemoglobin up to 10.7. It’s been awhile since it was close to normal.

We will have some questions for the discharge meeting. There will need to be some appointments set up to test her blood. The hospital will lend her a walker for a week or two. We will also need a list of symptoms that would necessitate calling the doctor or a making a trip to the hospital. It is very possible Lucy will need to extend her disability leave another week.

There is a minor issue with pain management that still needs a resolution. Lucy knows that she will not be totally pain-free tomorrow. It will take a week or two for her leg to get back to normal. Her pain increases when she puts weight on her ankle. After she sits down, the pain starts subsiding. It sounds like the pain increase is not much. She describes it as annoying when she walks. It does not keep her awake at night and it does not distract her when she is sitting with her leg propped up. Lucy has been fortunate to have never required hospitalization until her surgery in April 2010. She has never broken a bone or needed stitches. All the stuff she is going through is uncharted waters to her. It’s hard for her to describe what type of pain, or how much pain she feels. Now that she has told them when she feels an increase in pain and when it starts to diminish, some of the concerns have abated.

We’re cautiously optimistic about her going home tomorrow. It really depends on the blood test. Please keep your fingers crossed for her!

Thank you for all the birthday wishes today for Lucy! Lucy is lucky to have such an amazing group of supporters!

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