Monday, September 14, 2009

Back to the ER

They called Sandy from the hospital this morning to schedule the lung scan. At first, they asked her to be there by 11:30. Then they called back and said there was a cancellation. How soon could she get there?

I dropped her off at the front door and then took the van over to Bell Park where I parked in the main lot, watched a squirrel gather nuts and read a magazine. She called me after a while to say that I should come over to the hospital because they had found some blood clots in her lungs.

I walked the quarter mile to the General where the security person ushered me into one of the examining rooms. Sandy was there waiting for a pharmacy to get back to her with regard to starting Warfarin treatment. Warfarin is an anti-coagulant more commonly known for its use as a rat poison, but it has beneficial medical treatments as well. Dosage is critical to avoid excessive bleeding, so they don't just give you a prescription and send you away.

While we were waiting, this cute young female doctor asked if one of the medical school interns could practice on Sandy with a small ultra-sound unit they use in the ER. They came in and he did a bunch of scans, pointing out the various internal body parts to the approval of the young lady supervising. Then they went away and we got moved to the internal waiting room, much like the Group W Bench. We had fun meeting new people and talking about Life, the Universe and Everything.

We had been there quite a while when I grabbed the orderly acting as the traffic director. I pointed out that we were supposed to be waiting for pharmacy and, if they screwed up, we could be here forever since the ER wasn't tracking us. He left and the doctor came in, surprised we were still waiting. Then we were called to a phone to talk to someone from pharmacy, who said we should have been sent up there. They booked an appointment for the next morning but said we could come up to the 6th Floor and get some literature on the treatment.

When we got to the pharmacy, where they operate an Anti-Coagulation Clinic, the young lady said maybe we should just go ahead and do everything right now. That sounded good. We spent quite a while going over the nuances of blood thinning. Bottom line was that they would give a dosage of Warfarin for a period of time, Sandy would then have a blood test to determine her INR. INR stands for Internalized Normalization Ratio, a measure of the blood's ability to clot. Normal is between 0.8 and 1.2 but they want hers between 2 and 3. After the test, they will contact her to adjust the dosage. Until the Warfarin kicks in, I will have to give her daily injections of Lovenox, , a Heparin type drug, injected subcutaneously in the stomach. This should only go on for a short time.

After the Warfarin dosage is stabilized, Sandy will be handed off to our family doctor for the rest of the treatment. He will attempt to determine the cause of the clots and future strategies will depend on what turns up.

With all the information in hand, we stopped at the drug store and picked up the needles (all set in ready-to-go packaging) and the meds and headed home.

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