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.

Under Pressure

I'm a bad heart patient.

1. I lose prescriptions for medication that I need for my heart.

2. When I finally get that prescription filled, I take it twice a day.

3. I'm supposed to take it three times a day.

4. I forget when I need to test my blood.

5. When I remember to test my blood, I forget to call the coumadin nurse to report my results.

6. I still haven't hooked up my new device-transmitter machine so that my cardiologist can read my ICD over the phone.

All that being said, I am not terrible at keeping track of my health. But I'm tired when I get home from work and I forget that I need to check my blood and make a doctor's appointment. I forget that my health insurance still hasn't sent me a new insurance card since that CVS stole and then lost my original. I forget that I need to update my blog and then I stay up way too late in order to do so when I know it'd be much healthier to get more than five hours of sleep tonight. Part of why I fail to remember all of those important things is because I forget that I'm "sick" because I feel fine.

I'm eight weeks post-op. Things are looking really good. The swelling has gone down so much on both sides. I can finally tell exactly where my ICD is. And it's either a lot bigger than my first ICD, or it's closer to the skin. I feel like this one is more visible. My lead scar is a little red, but is healing nicely for the most part. The area around it is a little raised, but I think that's how it's going to be.

I need to post some pictures. I'm going to sleep first.