Tag Archives: heparin

by | February 4, 2012 · 8:38 pm

“A Room with a View”

Stained glass panel at Fairview Southdale

This stained glass panel is next to the admissions desk at Fairview Southdale hospital.

During Lucy’s hospital stay, I have parked in the Skyway Ramp and I walk past this stained glass panel every day. The flash on my phone’s camera causes a lot of flare. The gnome is not lighting flatulence (though he looks guilty) and the owl is not looking for the culprit.

I believe Lucy saw the movie referenced in the post title. The book it was based on was an optional choice for my World Literature II class at Augustana College. I didn’t read it because it was optional.

Lucy took a short walk this morning. It helps clear the fog of the pain pills. Her leg color has gotten noticeably better in the past day. Her right calf circumference is within 3 cm. (about 1.2″) of her left calf. She says that her ankle is stiff but is getting a bit more range of motion. Lucy has worked on her physical therapy exercises. Her Braden risk bracelet got removed because she is more active and her skin can air out.

Dr. Singh from Minnesota Oncology came by. Lucy moved back to 8th floor this afternoon. Her hemoglobin dropped after yesterday’s increase so she will get a two-unit transfusion. This means the four transfusions she has had since admission have required eight units of blood. She will be here until Monday at the earliest. The rest of the blood work sounded OK. Her Coumadin dosage got dropped to 2.5 mg and they did not have to administer a quick “blast” of heparin (called a bolus). We hope this means she is getting close to removal of the IV heparin and her Coumadin dose is getting set.

I did get to take Lucy to the Meditation Sanctuary before she moved to 8th floor. We used a wheelchair because it was a quick trip. She liked the fireplace and water feature. Changing her scenery also helped.

The view from her room is great. For those of you in the Twin Cities area, she overlooks Crosstown Highway and France Ave. The fog lifted and the sun came out and we can see all the way to Highway 100.

Lucy’s birthday is tomorrow and she will be spending it in the hospital. I’m grateful for getting to celebrate another birthday with her! I do wish she were released today. Comments are working, so please feel free to send her birthday greetings tomorrow. Thank you so much for your support!

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by | February 3, 2012 · 9:55 pm

“The ankle bone is connected to the shin bone…”

The ankle is more complex than a single bone and “Dry Bones” was not intended as an anatomy lesson in song. It is somewhat applicable because Lucy is walking better. Her ankle is pointing forward (12 o’clock) instead of away from her body (2 o’clock). Yesterday she would walk mostly on the ball of her right foot. Today she can get her foot flat and bend it forward towards the ball. She is getting the hang of it. Today she managed to use the bathroom. Two days ago, she couldn’t walk but half that distance. The walker will be temporary.

Her hemoglobin went up from yesterday. It is now at 8.7. It’s been a couple of months since her hemoglobin has stayed steady or has risen a couple of days after a transfusion. Her platelets were 212,000 and her white count was at 5.6. Those counts have vastly improved from when she arrived nine days ago. It sounds like she is in “therapeutic range” for her INR. The Chromogenic Factor X test result was not quite in therapeutic range. Dr. Thurmes came by and explained the results. His feeling is Lucy will be in the hospital until at least Sunday now. Lovenox injections might have been an option, but Lucy was on those for her clots. The heparin is working and they monitor and adjust the dosage as needed.

Lucy managed a walk of about 100 feet tonight with only a small stop to turn her walker around. The Physical Therapy people commented on how pleased they were with the distance. She got her exercise in tonight. There is a Meditation Sanctuary on this floor that she wants to see because of the water feature.

In addition to the various hospital staff in and out of her room today, Lucy had some visitors. Her supervisor and supervisor’s supervisor came by for about 45 minutes. Anh-Thu brought in a beautiful flower arrangement that she had designed. Lucy has some really great co-workers!

Lucy’s sister Julie came by tonight for a couple of hours and brought us some lemon chicken from Leeann Chin. The hospital food is all right, but has a limited menu selection. Lucy does not have dietary restrictions. It was really nice seeing Julie!

Lucy is staying positive. She does get frustrated at times, and so do I. We know this journey will be a battle and there will always be unknowns. That is why the victories both large and small are cause for celebration.

Thank you, everyone!

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by | February 2, 2012 · 9:43 pm

“Eight Days on the Road”

There was a little extra news from last night that didn’t make the post (and I was too tired to do the update). Lucy sat on the edge of the bed last night for almost a half hour. I gave her a long back rub, which helped her relax. Her calf diameter went down another ½ cm. Her pain level has stayed the same, but it is significantly better than a week ago. Her blood work is showing normal values except for her hemoglobin being low. Adult women should range between 12.1 and 15.1 grams/deciliter (g/dL). They want Lucy’s hemoglobin to stay above 7.5. If it goes below that, she will get a transfusion.

It’s ironic the title of today’s post is a song by Foghat. This morning was incredibly foggy. It has been a very mild winter here unlike last year’s near-record seasonal snowfall and unusually cold temperatures. We earned a break after last year. I normally can drive from home to Fairview Southdale in about twenty minutes for the six mile trip. France Ave. has a bunch of unsynchronized stoplights once I cross into Edina from Bloomington. Today I needed fifty minutes. There is a large lake and marshy area near Normandale College at 98th St. and France Ave. The fog in that area reduced visibility to about fifty feet. Even the inside of the hospital’s parking ramp was a bit foggy.

Dr. Thurmes stopped by to see how Lucy was progressing. Her Coumadin dosage still needs a tweak. She had noticeable improvement in her hemoglobin after yesterday’s transfusion, rising from 6.1 to 8.4. Lucy will probably be here until Saturday at least. Dr. Thurmes wants to see two consecutive acceptable results before disconnecting the IV heparin.

Lucy had the PT and OT people here today. She ran through her exercises and has a walker to use. She can get out of bed without needing a handrail. Her right ankle is still very stiff. She walked close to one hundred feet in total today, half with the walker, in four walking sessions. Now she has a recliner to sit in so she spent most of the day in the chair. It still takes her a moment after she stands up before her ankle loosens up enough to work slightly.

Thank you for taking the time to read this and for your concern for Lucy!

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by | January 31, 2012 · 10:11 pm

Slowly becoming untethered

Lucy is continuing to make progress. Her calf diameter is another ½ cm. (0.2″) smaller. She no longer needs her pain pump and is taking oral pain medication. Her hemoglobin dropped very slightly from 8.1 to 7.8. However, her white count is now in the normal range. She still needs assistance getting out of bed and cannot walk more than a couple of steps on her right leg. Physical Therapy will be by tomorrow to see what else they can do. Lucy would like more mobility. She has always enjoyed walking for recreation and exercise.

Lucy’s friend Diane visited us this afternoon and brought a little stuffed “Hug Me” elephant. That really brightened Lucy’s day. Yesterday’s delay in Lucy’s procedure precluded her sister Julie from coming to visit. Julie and Lucy have been on the phone a few times. Those calls also brighten her day. We know her sister Suzy is under the weather and we hope she feels better soon.

We don’t have a firm idea of when Lucy can go home. The two main milestones are getting her off IV heparin and they would like to see her calf less swollen and red. Her Coumadin restarted yesterday. Since the INR test will not be accurate, they are using a Chromogenic Factor X test instead.

Molly and Dr. Nashawaty from Minnesota Oncology checked in on Lucy this afternoon.

Lucy has a “Braden risk” bracelet. That means she is at risk for pressure ulcers (“bed sores” is the archaic term). She tries to change her position in bed regularly and so far has no signs of pressure ulcers. The risk will vanish when she is more mobile. It is not a cause for alarm.

Cellulitis is a concern. She is still getting Levaquin once per day as a preventative. And yes, the medical term for “preventative” is “prophylactic”. Lucy is not showing any symptoms of cellulitis.

That’s all for tonight. We’re very touched by the number of people reading the blog. It means the world to us!

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by | January 27, 2012 · 8:22 pm

Clotbusters II

Lucy’s procedure finished around 1:00. She moved down to the Surgical Specialties unit on third floor, so there goes the view.

They gave her a pain pump and she is already noticing a decrease in pain. This is the first time this week where her pain self-assessment went down.

The clot treatment consists of a “clot busting” drug (alteplase) as well as a blood thinner (heparin). Alteplase is the activator and the procedure is formally named “Tissue Plasminogen Activator” or TPA for short. The hardware looks impressive: seven infusers and a pain pump. Two of the infusers got shut off after a couple of hours, one managing the clot buster and the other administering the blood thinner. We’re hoping this is a good sign. Lucy will have the catheters moved tomorrow and her hematologist will be by on rounds, too.

Lucy changed rooms twice today. She is in a bigger room. The care providers have some elbow room now. She actually had some time to herself tonight. The fast-paced choreography of this morning has slowed to a graceful ballet. Now she’ll get more of a chance to relax.

This does it for tonight. Thank you so much for your good wishes for Lucy!

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