Let It Bleed

I blew a 3.4 last week.

It wasn't a breathalizer and so "blew" isn't the correct verb, but alcohol was definitely a factor. I was testing my INR aka my coumadin level. DUN DUN DUNNN....

INR- International Normalized Ratio (for blood clotting time)

coumadin- a blood thinning medication used to prevent clots

So, FYI, you shouldn't test your blood twelve hours after you have two gin & tonics. It's just not a good idea. You also shouldn't take your coumadin after you have two gin & tonics. Oops. Monday was rough. So Tuesday morning at 7 AM, I used my home self-tester, did the finger stick and got a 3.4. For most people with a mechanical heart valve, the normal range for INR is 2.5-3.5. But I'm a bleeder, so my range has been lowered to 2.0-3.0. Double oops. I was wondering why I was getting all these bruises. But the solution was easy. At the suggestion of the coumadin nurse, I skipped my coumadin that night, took my regular dose the night after and then tested my blood the following day. So last Thursday my INR was 2.1. Perfect.

I think my thoughts on coumadin are best summed up in a haiku that I wrote yesterday.

Devil and savior

Watch out clotters and bleeders

Oh, coumadin

I haven't written a haiku since the fourth grade. I think you can see why. My lacking poetry skills aside, coumadin is tricky drug. It can really help and it can really hurt. It's a balancing act. Your blood can't be too thick or you'll get a clot. But your blood can't be too thin or you'll bleed too much if you get hurt. Alcohol is also a blood thinner. Vitamin K (found in green vegetables) helps your blood clot. You have to watch what foods and liquids you put into your body as well to keep the balance.

I test my blood monthly (okay, sometimes every other month) but I make sure that it never gets too out of control. Clots have never been a problem for me, but clotting is another issue. I've had four-hour nosebleeds. I bled non-stop for three whole days after I got my wisdom teeth taken out (P.S. Worst idea ever). I've gotten huge hematomas at my incision site after two different device surgeries that required me to be readmitted to the hospital and then cut open again to "evacuate" the collection of blood. All those stories will have to be told in much greater detail another time.

To sum up, it's a love-hate relationship. One that people with tissue valves don't have to deal with. But their hearts don't make a clicking sound. So booyah.

Doll Parts

My family has a beach house that we rent out during the summer. The main living room as two sofas that are pretty comfortable, except for a couple of the arms. The cushioning has disintegrated and you can feel the hard wooden structure beneath the the blue and green striped fabric. Don't tell anyone.

I bring this up because almost eight months post-op, the swelling has subsided, but the wires are poking through. The third wire juts out right along the new scar and then disappears under the my chest muscle and sternum and reemerges on the other side. I feel like a doll or a stuffed animal who's exterior has been worn down to the core. My stuffing as been slowly seeping out and my wires are protruding. Even though the wires are new, it makes me feel old, like I'm falling apart and here are the nuts and bolts that are holding me together.

As of right now, I have four different metal devices keeping my heart working: a biventricular ICD, a mechanical aortic valve, and two titanium VSD occluders. Not to mention the three wires.

VSD occluder- a small metal device used to plug up a ventricular septal defect

ventricular septal defect- a defect in the septum between the right and left ventricles; commonly called a "hole"; most common heart defect in a newborn (www.americanheart.org)

Sometimes I just feel like a robot.