Monday, July 30, 2007

this is your body on blood thinners

Look closely at the photo. But ignore the fact that every year of my age that doesn't show in my face shows in my hands. Please ignore it. Pretty please.

Remember when I said that all my blood draws in the hospital had to come from the back of my left hand, because the IV drip was in the left arm and the clot was in the right?

Well, if you look closely you can see bruising on my left hand, going up to my wrist, from all those sticks. It's been a week, but it's still there. Rugrat took this for me last night, to 'remember.' As if I'll be forgetting anytime soon.

And actually, if you look even more closely, you might be able to make out the more swollen veins on my hand, and the big lump on my right arm, just above the wrist (go straight up from the forefinger), that is one of the more swollen veins and bothers me the most. I am a major klutz, and I keep bumping that freaking spot on everything.



I had a date saturday night

Ha! Made you look. I had a date with the rugrat. Things have been just as crazy for her the last couple of weeks as they have been for me.

Think about it -- she's 17, we live clear across the country from every other relative, her boyfriend of a year and a half is here, as is her chance for a specialized high school fashion design program (not a lot of those in Washington State). And mom is in the hospital, and may never leave it. What's a girl to do? She would wind up living with her older brother if something happened to me, which would mean moving away from everything here that she's known since she was 8 years old.

Well, despite how she may have been feeling, she really stepped to the front on this one. Brought me odds and ends I needed for the hospital, visited every day, bought me dinner in the cafe downstairs so I wouldn't have to eat the hospital meals, brought me magazines and wordsearches when I was bored silly.

My last full day at the hospital, she took the bus to visit me for dinner. We sat together over my bedside table, and after dinner, she crawled up into bed next to me and we lay together watching a sitcom and doing a wordsearch puzzle.

When I came home the next day, she had tried to be sure some of my least favorite tasks had been done. She'd done the dishes, vaccuumed, and mopped the kitchen floor. Granted she had piles of her own junk laying around all over, but she had done the things I hated the most.

She confessed this morning, after a few days of light bulbs burning out this weekend for no apparent reason, that she'd kept every light in the apartment on while I was gone because she was scared to be alone in the dark.

I blogged a week or two ago about her getting a second job. She had a (day) camp counselor job from 9 am to 3 pm, and she had been looking for pt job to replace it when it ended. She is doing a 2-week trial at a shop in a mall, one she wanted. It's under the table, she's not even on the employee list, until she completes the 2 weeks and they decide if they want to keep her. But last Friday, she put in a 12 hour day between the two jobs: 9-3 at camp, a quick wash-up and drive to white plains, and 4-10 pm at the hopefully new job. And she didn't get a break at either job.

So I told her we'd go see a movie Saturday, after work (yes, she put in a 6 day work week between the two jobs). We hadn't seen Harry Potter yet, so we got junk to eat and watched the movie. Then we came home and she asked me to watch another movie with her -- something called Daddy's Little Girls I think. I didn't think much of it, but it clearly had meaning for her, so I didn't say anything negative about the movie. We sat together on the sofa till it was over.

Sunday her reward was a major driving session. She needs to get driving-ready quickly for that new job, and we couldn't drive last weekend while I was out of commission. So yesterday, she drove us clear to kmart, back down to yonkers, and over to her boyfriend's house so they could see the simpsons movie. She's a good driver, I didn't panic once the whole time, lol. The goal is to have her driver-ready when school starts, so she can go straight from school to work, and then home, and I won't have to go out late on work nights to pick her up when the bus doesn't run.

My rugrat is turning into quite the young woman.

Friday, July 27, 2007

oxycodone fucking rocks...well, except for a few minor side effects

It's amazing how much ongoing pain can affect you physically, mentally, and emotionally. You get to the point where you can't even make a simple decision, because you can't think straight anymore.

So I took the pain killer last night about 10:30 and was out by 11. Slept quite well, for the first time in a long time. It doesn't quite take all the pain away, but you feel so good the remaining pain doesn't have much impact.

I also took today, after getting the blood draw early in the AM, on another dose of the oxy and bed rest. OK, sofa rest. I only got up to take the rugrat to work, and will again later to pick her up (bus doesn't run late enough).

Only today, there were a few side effects I hadn't felt last night: some nauseau, dizziness, and itchy skin. Yes, I know antihistamines help with the itchies, but I'm not taking anything without checking with the doc. I'm too afraid of the blood thinner.

In fact, I was still so tired that I decided not to take one in the afternoon, even though it was allowed. Right now I'm at the point of needing one, the pain's getting dicy, but I don't want to take one when I have to drive to pick up rugrat soon. I'll take one tonight, though, as soon as we get home.

My arm is still swollen in places, and it still hurts like hell, but rest and the oxy are making it much better, improving my morale. So don't expect any more maudlin posts like the last one, ok?

Related thought of the day: People who have difficulty with that whole empathy thing should not ever -- EVER -- consider becoming a phlebotomist!

Thursday, July 26, 2007

in our last episode of 'how the blood clots'...

our heroine, Spring, was still reeling from the diagnosis of a blood clot in her arm and a surprise four-day stay at the hospital.

Today we watch her visit her doctor 2.5 days post-hospital, during which her doctor notes the following:

--the upper arm muscle ache (where the clot is) has expanded to include her entire shoulder, nearly to the collar bone

--the swollen vein at the inside of her elbow is still swollen and prevents full arm extension

--the large swollen vein on the side of her arm almost at her wrist has become much bigger and the slightest touch sends excruciating pain through her arm

--there is a tiny, bead-sized lump just at her wrist of the back of her arm that can't be seen, but which is impeding her ability to manipulate her wrist

--there is a huge lump, starting at the inside elbow and moving halfway down her arm toward her wrist, on her OTHER ARM

Yes, I said the other arm -- the one that housed the Heparin IV drip while she was in the hospital. Did you know that it is more common to get a clot from a Heparin drip than from an injection? And that they are more serious than other clots?

The doc wasn't ready to concede that this may be another clot, not when the swelling just started this morning. But it is a distinct possibility.

The doc gave her a stern look when she admitted, upon questioning, that she'd gone back to work the day after leaving the hospital. Well, the doc hadn't said not to. And what the fuck was she supposed to do, anyway? She'd already missed two days of work, and she had to get all her work done before leaving in a few weeks.

On the bright side, the doc acknowledged the pain she must be in and prescribed some wonderful, wonderful percoset. And ordered her to get another blood draw first thing in the morning. Another fucking needle stick.

She took her prescription to the local walgreens, only to be told that her doc hadn't included the strength of the dose in her prescription. Motherfucker, she thought. Now she had to drive back to the doc and have her fix that, then go back to walgreens again. She was clearly just about at her limit, as she drove back to the doc's.

Tears began to fill her eyes, and she blinked them back quickly -- she was in public, after all. And they sat there, unshed, closing her throat. She couldn't have spoken if she'd wanted to.

On the drive to the doc's, she let her mind wander in an attempt to ignore the pain. She was tired of being strong for the rugrat, for her job. Putting on a smile through the pain and pretending she was fine.

What she wanted...what she really wanted...was to be greeted at home by a wonderful man who cared about her. To be guided to bed, where she could slide in between clean, smooth sheets. To lie there and shed a tear or two, while he held her. For him to wrap the heating pads gently, tenderly, around the worst of her lumpy veins to alleviate some of the swelling. To feel him stroke her hair and whisper in her ear 'it will be just fine.' And for it to be just fine. Miraculously fine.

And then she was abruptly slammed out of her fantasy as she pushed the lever to put the car into 'park' and sucked her breath in through her teeth against the waves of pain that one simple act forced through her arm.

Back to reality. To the pain. She mentally shook herself, and remembered that life goes on. And so must she.

She arrived home at 9 that evening, looking very much forward to the percoset.

Stayed tuned for the next episode of 'how the blood clots.' Coming soon to a blog near you.

Wednesday, July 25, 2007

DVT ME, YEAH BABY!

So if you've been reading my posts about the pain in my arm, you know something's up. I had pain in my arm after an injection of dye during an MRI with contrast; the MRI was three weeks ago. I've been in some pretty severe pain since the day after the MRI, getting steadily worse with time.

I went for an ultrasound Friday afternoon, and they discovered I have a blood clot. The tech found it, called the head of radiology to come have a look, and he agreed with the diagnosis. They called my doc, who ordered me to the ER, who quickly had me admitted to the hospital. It all happened very fast; I arrived at 1 PM for the ultrasound, and was in a hospital bed about 5 PM.

The whole thing was a bit of a shocker, and it didn't help that no one explained terms to me (for example, DVT stands for Deep Vein Thrombosis). Nor did anyone explained that a clot in my arm wasn't as serious as a clot somewhere else. My knowledge of clots was that they break apart, get into your lungs, and cause a deadly pulmonary embolism. So for the first two days in the hospital, I thought I was going die in that place. Kind of does something to your mind, you know?

I had to stay in the hospital to get onto anti-coagulants, or blood thinners. It's a process that requires an intravenous drip for a minimum of three days, so while I had thought I could just get meds and go home from the ER, once I got there, I was told I wouldn't be leaving. A bit of a shocker. That left rugrat home alone and just as afraid as I was. It also left me with no personal items (like my eyeglasses) to get me through my time in bed.

Getting a clot from an injection is fairly rare, and it was apparently the talk of the hospital. Various staff, from nurses to phlebotomists to the person who changes the bed linens, could be heard commenting about 'the patient who got the clot from an injection, as they walked by my room.) Later on I might go into some details about my 'vacation,' perhaps tell you some little tidbits about my 'roommate,' but I'm keeping it to the basics for now.

Being discharged from the hospital doesn't mean the clot is gone. It's still there. It just meant that the medication level in my blood was at optimum level and I could be taken off the IV drip (Heparin) and allowed to go home and take the Coumadin daily. I still have some swollen veins from the clot blocking the vein. Think of it like a clog in a drain. Some water gets through, but if you leave the water on, it'll fill the sink and overflow. The clot is in the vein leaving the arm (makes sense, as the injection was intended to send the dye to my brain).

But blood continues to come into my arm, and is supposed to exit my arm through that vein. The pain in my upper arm muscle is the clot, and the swollen lumps in my lower arm are the veins leading into the clotted vein. They are backed up with blood circulating my arm, and they are swollen, hard and lumpy. Those backed up veins are even more painful than the clot itself.

I was discharged yesterday, and drove directly to the neurologist's office for a previously scheduled appointment to get the results of the tests (including the one that caused the clot). The encephalitis all those years ago did not cause any damage; or if it did, it was reversable damage and my brain has recovered. All brain functions are normal, I'm not having seizures, and I can rest easy knowing that I won't likely have any. Those memory blackouts are not seizures, and they don't appear to be serious. I'm fully functioning during them, and there have only been three. So I have to look on the bright side -- despite the side effect of the clot, my brain (and for that matter, my heart, based on tests done in-hospital) is A-OK.

Monday, July 16, 2007

don't know if I should laugh or cry

I just made an emergency appointment with my primary care doc. You see, I had that MRI about three weeks ago, 'with contrast,' which means an injection of dye.

The injection site was the inside of my elbow. The injection itself went well, I barely felt a thing, except for the coldness of the dye as it entering my blood stream.

But the next day, I began having a bit of pain around the injection site. No bruising, or redness, or heat that would indicate an infection. Just an achy sort of pain.

I let it go, because I assumed it was just an internal bruising or something.

But it kept getting worse, instead of better. Major pain when I tried to move my arm, and the pain moving from just above the injection site to further and further up my arm. And a certain 'hardness' to the muscle in the arm, even when not flexed. It didn't hurt constantly, as in 24/7, but it hurt often enough to not forget it easily, and to try pampering that arm when it came to lifting or other work.

Last week, I called the place that did the MRI, and they connected me with one of the techs who does injections. She asked a lot of questions, but my answers didn't apparently provide her with any clues. She told me that if it didn't go away, I could see my regular doc if that would give me some peace of mind.

Yesterday AM, I woke up to serious pain in that arm that radiating all the way up to my shoulder and halfway down my lower arm. In the inside of my elbow, there was a suspicious lump that hadn't been there before, right at the spot where one of the big veins are that are used for blood draws and injections. I don't know if it's the one he used, as I have two really good veins there.

It was horribly painful most of the day, and I considered going to the emergency room 'cause the lump had me scared. But it started feeling a bit better, so I let it go.

This morning, the lump seems worse, and there seems to be a lump further up my arm in a really sore spot. And the whole upper arm muscle just seems to be one mass of aching muscle. And there seem to be flickers of numbness on the body side of my shoulder joint.

So, I'm headed to the doc. God I hope this is nothing.

+++++

UPDATE: So, my blood pressure is a bit high (not surprising, since I've been in pain); my ekg was ok; the lumps (yes, there's more than one) have been confirmed by the doc; I get a blood workup in the morning; and I get an ultrasound on my arm as soon as I can schedule it. That's all for now.

now *that's* the way to get a job!

So I took rugrat to the mall by her school Saturday to look for part-time jobs. Her current job as camp counselor will end after the first week in August, and she doesn't want a break in her income.

The plan was to pick up apps at a bunch of stores, fill them out over lunch, and take them all back completed and with a resume attached.

So she goes into one store to get an app, and the clerks at the counter are busy ringing up purchases, so she stands a bit to the side, out of the way, till a clerk is free. While she's standing there, a customer comes up with some jewelry she's thinking of buying, and asks rugrat what she thinks.

Rugrat responds genuinely that 'it was cute and she looked great.' After all, the store is one of the ones she likes to shop at, and she knows the merchandise. And the woman bought the items. What rugrat didn't know was that one of the employees at the counter was the hiring manager.

Nothing was said about what rugrat did, she just asked for the job app and left. But when we went back an hour or so later, the hiring manager was still there. So when rugrat handed over the completed app with resume, the hiring manager spoke with her and did a brief interview on the spot.

And then she gave rugrat her business card, shook her hand, and told her to call back on Sunday so that she could find out what her training schedule is!

So, apparently all you need to do to get a job is sell the store's merchandise right in front of the person who does the hiring!

Wednesday, July 11, 2007

the best health care is reserved for congress

I just yesterday read a blog post about the movie Sicko, by Michael Moore. Now, I'm not a Moore fan simply because I'm not a fan of any extremist left or right. The message gets lost in the rhetoric and name-calling with the extremist tactics. But I do think Moore at least makes an effort to bring things to our attention and makes us think about them.

Ironically, today I read an excerpt from chapter two of a book titled Practicing Medicine Without a License! The Corporate Takeover of Healthcare in America, by Don Sloan, M.D. Yes, it's still liberal-leaning, but not in an extremist way. And the comparison data from the World Health Organization puts it into perspective quite nicely. It's a long excerpt, but please consider reading it through -- I think it is so well written.

Tuesday, July 03, 2007

overheard

Overheard by rugrat at summer camp yesterday:

6-year-old girl: I'm having a birthday party, and only rich people are coming.

6-year-old boy: Yeah, and I'm coming 'cause I'm rich!

Ah, the future of America in action...