The ER doctor walked into the room and said, “You have a clot,” as though he was saying something like “The cafeteria has flavored coffee today.” He stood next to the rail of the hospital bed I was in, and looked at me. I started shaking a little, and I was trying so hard to keep it together. Like my favorite fake boyfriend, Sheldon, I am not big on emotional outbursts.
I looked up at his tired, expressionless face, and my stomach instantly tensed. I replied, “I do?” I kind of knew that this would be the diagnosis, but I was still in denial. I had been hoping the doctor would tell me that I did not have a clot, and that I was just a crazy hypochondriac who needed nothing more than muscle relaxers and a heating pad. I had calf pain for the previous five days. It hurt so bad to stand on my left leg that I was brushing my teeth in a flamingo pose, keeping all of my weight on my right leg. I was trying to tell myself that I was just having muscular pain after being in a walking cast for a tendon injury for the past month, but somehow I knew it was more than that. Also, I had seen the sonogram technician’s face.
Technicians aren’t doctors, and they are not allowed to give you a diagnosis, but they do a lot of exams and they know when something is wrong. I saw it in her face. The sonogram technician started with my thigh and spent about two seconds there. She had a sort of normal “just doing my job” look to her face. Then, she moved to the back of my calf and she slowed down when she got to the back of my knee. Her faced changed. Chris, my husband, was looking over her shoulder at the monitor. He started to look concerned, too, even though he has no sonogram experience. I turned and looked away from both of them to avoid getting more stressed. I did not want to cry in the ER. I heard a lot of clicks, and I felt some pressure and tenderness behind my knee. I felt nauseated. I was hoping I was wrong, but I knew that I had a DVT.
So, when the doctor came back in to deliver the news, I wasn’t shocked; I was disappointed. The doctor asked if I had a local doctor. I explained that I am originally from South Florida, but I currently live in Ohio. So, I had no doctors in Port St. Lucie, where we had been visiting my in-laws. At this point, the doctor wasn’t sure whether to admit me to the hospital or let me leave with medication. He left for thirty minutes to “consult with colleagues.”
The doctor finally came back and told me that they would be letting me go home, or back to the hotel in my case. He let me know that I could just give myself shots in the stomach and then take Coumadin pills, with the same flavored coffee in the cafeteria tone. WHAT? I started shaking A LOT then.
“Shots in the stomach? There has to be a better way.” I got teary-eyed then.
He ignored my tears, and said, “Trust me. You don’t want us to keep you here on IV’s. You don’t have a local doctor. It just doesn’t make sense to keep you here.” I know now that he was right, but this doctor had the bedside manner of a Taco Bell employee. It was like giving myself shots to the stomach would be as easy as adding guacamole to a burrito. The doctor left the room again.
The nurse came in to give me my first of five, which later turned in to ten, Lovenox injections. That’s when I cried. I cried over having to give myself shots in the stomach, and also because I would have to take Coumadin. My cousin died from falling while on Coumadin. She bled out in her abdomen. I could not stop shaking and crying. I apologized to the nurse for my melt down. I despised myself for having one. I hated that I could not control my emotions.
The next morning, my husband went to the pharmacy near our hotel to pick up my pre-filled Lovenox syringes and Coumadin. While he was gone, I sat on the hotel bed and had a toddler tantrum. I cried so hard I thought I would puke. While I was crying, I texted my son, who was two hours south of me with his father and step-mother, a nurse. I asked him to ask his step-mother to give me these shots. We were headed to South Florida later that day. Due to her work schedule, she could not give me the shot at the time I needed to receive it. The injections are supposed to be given twenty-four hours apart. I thanked my son for asking, and her for being willing to do this, and I put down my phone and went back to my toddler fit.
My husband came back to a blubbering version of his sarcastic, micro-managerial wife. “I can’t do this. I don’t want to give myself shots or take Coumadin. How do people live like this?” I kept saying, between nose blows. I knew that LOTS of people, including some of my friends and family, had given themselves injections, but I had no clue how I would do this. “We have to just go to a clinic, like the nurse said. I can’t do this.” I cried more and grabbed more tissue. Then, my husband made everything a little better.
“I think I can do it,” he said.
“What?” I pulled my face out of a hotel grade Kleenex.
“I can do the shots. I watched the nurse, and it didn’t look that hard,” he said. He went on to tell me about a diabetic friend he had when he was a kid. She had told him that she had to learn to give herself shots by jabbing an orange. Chris remembers odd things like this; I’m glad. So, he had an idea of how much pressure to use. I was relieved that I wouldn’t have to do it myself, but still upset that it had to be done and that I had to take blood thinners at all. I was terrified of bleeding out like my cousin. I still felt really queasy about everything, but at least I would not have to go all Pulp Fiction on myself.
My husband and I spent another 3 days in Florida, visiting with my mom. We also stopped by to see my aunt, cousin, and my cousin’s daughter. It wasn’t the best visit ever because I was constantly preoccupied with blood thinners and the clot in my leg. Chris gave me the shots every night, and he did a good job. The shots stung, but they weren’t as painful as I thought they would be. The pain in my leg got better a little every day. So physically, I was getting better, mentally I was still anxious. Between friends on Facebook telling me horror stories about Coumadin, and thinking of my cousin, I was a nervous wreck.
I had another meltdown once we got home. I had to see the nurse at my doctor’s office for a PT INR test. I will have these regularly while I am on Coumadin. Basically, they are a finger prick blood test to be sure you are in the therapeutic range for Coumadin, which is between 2.0 and 3.0 for me. My doctor was out of the office that day, so I asked the nurse if it was OK to ask her some questions. She, of course, agreed to help.
So, before she even did the test, I dug out my plastic baggy of medications from my purse. Coumadin interacts with nearly EVERYTHING, or so it seems. I already knew that I could not take my birth control pills or eat a lot of green vegetables, and I knew that aspirin and ibuprofen were out of the picture, but I wasn’t sure about acetaminophen or my assorted IBS medications. As I started to talk to the nurse, I started crying again. Holy instability, Batman. This was getting old. As I cried to the nurse, I apologized for crying. She tried to comfort me, and she told me that what happened to my cousin was very rare. She also told me that it was OK to take Tylenol and my IBS meds as needed. So, I stopped crying and let her do the test. My result was 1.5, which meant I would need more Lovenox shots. Ugh!
I saw my doctor the next day, and told her about my cousin and asked her was there no other treatment that I could possibly do. Dr. R. said that this was the best one for me, explained why, and offered to send me to a hematologist if I wanted another opinion. I really just want to stay with MY doctor. I’ve only been her patient for six months, but she has a way of calming all of my anxieties and explaining medical things in real people terms. I’m quite sure if celebrities found out about her, Dr. R. could be a super rich doctor to the stars.
Dr. R. spent about thirty minutes talking to Chris and me. She assured me that I would not bleed out from shaving my legs, or most things that could possibly happen. She assured me that we would be keeping me in the therapeutic range. She also told me that I would only need to take Coumadin for six months, not for life. Since my clot was “provoked” by the cast, the original injury, and the birth control pills, it was probably not caused by a medical issue. Dr. R. also said that she would order blood work for me at the end of all of the Coumadin to make sure that everything was normal.
I’m still not thrilled about taking Coumadin, or that one more injection I have coming my way this evening. I can’t have Cosmopolitans, red wine, or any alcohol until July, when I am off of the medication. I also have to pay attention to how much spinach, broccoli and other vitamin K rich foods I eat. If I get a headache, I can take Tylenol, not Motrin. Plus, there will be regular PT INR tests. So, it’s not how I saw myself spending the first half of 2013, but I suppose it could be worse.
Every night, for the past few nights, I have been writing in my journal, which has a famous anti-suicide quote on the cover. I have been listing everything good that happens each day. I’m always amazed at how MANY things I can list. They are the little things like “got to have Chinese food today” or “chatted with Alli and Pam today.” Then, there are the bigger things like, “My son is home from Florida” and “I got to spend the whole day with Chris.” Good things happen every day. Like many people, I sometimes forget that.