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Hubs in the hospital...

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Randy called this morning to wish me happy birthday. We were hoping that he might be able to come home on one of our birthdays, but as I said in my last post, he can't until his INR is up. The doctor told him last night that he wants his INR to be at a 2 for two days before he'll consider sending him home. He said maybe, and emphasized the maybe, this Thurs. or Fri. But when Randy called me this morning, he told me his INR is still at 1.6. 

He was a bit down about that, because it threatens the possibility of his coming home soon. And I was already a little weepy when I woke up this morning. I think I might be trying to come down with something. Ugh.

Randy said he won't be eating salad at night now - he's been ordering a small salad with his dinner. But lettuce does have Vit. K in it. So he's going to stop that in the hopes that it might help a bit to get his INR up. No dissolving can be done unless his INR comes up. 

He is improving in many ways, but this DVT and the hematoma are still life threatening.  That thought still niggles at my brain...

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I'm sorry, Jim - I should have explained what INR means.  It is International Normalized Ratio. Usually a PT is attached to it for lab purposes. PT stands for Prothrombin Time. Simply put, it is  a test that measures the speed at which one's blood coagulates. The lower the number, the more quickly the blood clots. If the number goes too high (3 is usually the highest hematologists want the count to go), the blood won't clot quickly enough and a brain bleed is very possible. So the testing shows the docs where a person who is on anti-coagulants (most call them blood thinners, although the blood isn't actually thinned) sits on the INR.

In my husband's case, he inherited Factor V Leiden's. It is a genetic mutation of the Factor V gene. The FV gene is one of the genes that control the clotting process in the body, basically. Someone with Leiden's has blood that clots too quickly. Many people with Leiden's go through life and don't know they have it at all. If someone who has it does not develop blood clots, there is no need to treat. But once blood clots begin to develop, treatment for life is necessary.

A number of years ago, while in college, my husband broke his foot. That resulted in a blood clot in his right leg. To my knowledge, nobody tested him for FV Leiden, so once the clot dissolved, they did not continue the anti-coagulant treatment.  But with his DVT (deep vein thrombosis - blood clots in the veins that are deep in the body) 2 years ago being so major, they did the testing. And they found that he has not just one, but two Leiden genes.  People with one FV have a 7x increased chance of blood clots. Since he has two, his increases to 30x.   Yay, him! LOL

So he has to remain on blood thinners. There are many, and 2 of his brothers swear by the particular ones they use (both on different ones). But Randy's hematologist, main doctor, and another blood doc are in agreement that Warfarin (Coumadin) is the best for him. So that's what he'll remain on once he's out of the hospital.

Currently they have him on Warfarin orally and Heparin in the IV. Even with both of those, his INR is moving up very slowly. But slowly is most likely better than a really big, fast jump. He told me this morning that it is now at 1.8.  YAY! Only 2/10ths to go and he's good after two days! He's looking at possibly coming home Sunday if it continues moving up 1/10th a day. 

I wasn't able to visit him the last couple of days, but will be heading up in about 45 minutes. Can't wait to see him.

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I stand corrected - PT is not attached to the INR for lab purposes. It is actually a separate test to see how quickly the blood clots. But it is used for heparin. Randy is on both while in hospital. While I was there, the nurse came in to shut off his heparin for 30 minutes. Apparently the PT test showed numbers that indicated they needed to shut the heparin off and allow the body to adjust to it. When they turned it back on, they lowered the amount of heparin he was getting. That can only mean that the thinners are doing their job. =D So maybe tomorrow we will see 1.9 or even 2!

We have a guest speaker lined up for this Sunday, but Randy would be so thrilled to be back in the services.

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Randy went in for another INR this morning. It was at 2.2. He'll be seeing his primary this Friday (the next INR will be the following Friday). We'll see how that goes. He's doing a lot of walking around the house, and then a lot of resting. His pain level remains about the same.

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I haven't updated on my hubs lately because it's been pretty much the same each day. He walks a lot throughout the house. He tries to make sure he gets up every hour and walks for about 10 minutes. He's still in pain all the time, and walking increases it. But he needs to walk to circulate his blood. And walking does speed healing.

He went to see his primary doc yesterday. The doc was pleased with how things were going - he was actually a bit surprised that Randy was doing sowell. But he doesn't really know Randy. heheh Randy is determined to speed the healing by walking so much. AND - God is answering prayer as well.

So the doc said that Randy is to remain off work for at least the next 2 weeks. In 2 weeks he'll see the doc again and they'll make the decision then as to whether or not he can return to work. He is getting back into the pulpit tomorrow, and he cannot wait!

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That's a great update LuAnne, I am so glad that he is recovering so rapidly. I wonder if he may ave to have some Physical Therapy? I told you before that I fell last summer right on my knee. Then while travelling this winter I fell in it again while it had not completely healed from the first fall. After the second one I had to have therapy since it was not healing well. That therapy worked wonders and it is just about back to normal now.

Thanks again, what a wonderful feeling to know God answers all of our prayers.

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He's still in pain - the level goes up and down. It's a slow process. But he is enjoying the extra study time. We have a lot of sickness with our church right now. Over half the members are ill (and that includes myself and our son). We've sure been going through the fire since last November.

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Randy had his INR this morning. It was only 1.9. Not good. So he will be going again next Friday for another test. Please pray that his number will go up. Best is about 2.5 or 2.6. No higher than 3. Without it being over 2, it's likely the clot is not dissolving.

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Thank you for continuing to pray. It means a great deal.

Jerry, not only am I glad to see you back, I appreciate you taking the time to read this mini-book and the prayer!

Jim, I will pass that on to him. Knowing godly people are praying is the best encouragement we could get! 

1Tim, thank you. There isn't a lot of change since my last post. Except that Randy told me last night that his INR had actually been 1.8 on Friday.  His hospitalist (a doctor who works only in a hospital) told me Randy needs to get a hematologist here in the area (the one who dealt with his issues 2 years ago is in Seattle). So that's on the list. He needs one to be the best guide with his clotting issues. 

Far too many regular doctors have pushed for Randy to change from Warfarin, but Dr. Picozzi (the Seattle hematologist), Dr. Roop, and another hematologist Dr. Roop spoke with [he also talked with Dr. P] all agree that Warfarin is the best for his situation. Oftimes those with Factor V do better with another ant-coagulant (both of Randy's brothers who are now on them use different ones - and, of course, their doctors have said Warfarin isn't best LOL). But Randy has two genes of it rather than just one, so Warfarin will stay.  I'm glad - as Dr. P said, Warfarin (coumadin) is the oldest and best known anti-coagulant, and the easiest to work with in case of a brain bleed (ugh...just the thought...). 

I've learned a lot that I never even wanted to know! hehe - but I guess that's true of every part of our life's journey.

I am really thankful for the great medical care he has received. Even if I disagree with their take on Warfarin, they have been wonderful to him.

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Randy saw the doc today, and had his INR done as well. His INR is up to a 2, which is good. And his blood test (from yesterday) showed that the anemia had righted itself. Praise the Lord!

But the doc said no to work for another 2 weeks. Randy knew he wouldn't be going back just yet, though. He's had a little bit rougher time this week. He was up most of Sunday night from pain, and Monday was hard on him. By the time we were at the doctor's his pain level had risen to a 5 (normally it's been about a 2, 3 at most). The doctor told him that he wasn't surprised that Randy's not up to work yet.

Apparently a normal hematoma takes about 6 months to completely heal. He said that, with the severity of Randy's hematoma, it would likely take about a year to completely heal. He didn't mean that it would take that long before Randy could go back to work, though. 

Thanks for continued prayer!

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No real news, just pretty much the same. He's in constant pain - has had a couple of weeks of bad nights. He has tried to not take much in the way of pain meds, but he's had to up his intake (he's still below what the doc has allowed, though). The hospitalist told him that his foot would take a long time to heal. He thinks the nerves are reactivating in the foot, because he's getting sharp jabs of pain several times a day. 

He sees the doctor again this Friday to see if he can go back to work or not yet. I don't think he's going to make it yet. We had to cancel the nursing home service for this month (the first Sunday) again. Hopefully in May we'll be able to get back to it. He had me call, but the activity director wasn't in. The executive director was the one who answered the phone. When we first started, the then activity director told us we couldn't visit the residents - we were disappointed, because there was no way for us to get to know them other than just the one Sunday we are there, thus not being able to encourage folks to come to the service. 

But!! the ED told me it would be fine for  us to visit the folks who come to the service! That all we have to do is knock on their doors! AND she said we could pass out fliers. Amen! So, even with these problems, we are seeing blessings. 😊

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