That's what I feel like after bouncing from one specialist to another for
what seemed to be the entire day today.
My INR level is entering into the therapuetic range at 2.1 after more than
a week of medications. I was at 1.4 on Friday and 1.7 on Sunday.
We're shooting for[masked] to prevent clots but low enough to not cause
cranial bleeding and death at 7.0
I met with the pulmunary specialist from 9 until 11 and a vascular surgeon
from 2 until 5 today.
The pulmunary guy talked about the blood thinners, we'll meet again
tommorow (I have to have my INR tested again) and I'll ask about my lung
The vascular guy did another ultrasound of my clots to determine risk of
more emboli and what the treatment options are. Only three clots left
completely blocking 3 of the 6 viens in my lower leg, each for about 1" in
length. It looks like maybe my white cells are nibbling them away, but I'm
not really sure. I don't like the idea of a 50% reduction in capacity for
my blood flow. According to the studies a Dr friend in Iowa sent me, this
can increase the risk of adverse health events in my leg, such as ulcers,
etc. So we discussed systemic TPA, localized TPA as well as mechanical
methods for breaking up the clots, as well as filter installation in the
groin to catch breakaway clots. I'll go into more detail on this in
another email, as I'm fading and need sleep.
We also talked time frames for healing and for various activity levels
based on the risk of new clots forming as well as of existing clots
breaking loose. Swimming yes, kayaking yes, rugby, no ;-). More news
I'm out of the hospital now ;-)
Thank you Corina for schlepping all my stuff from the room back to the
house, and for giving me a ride as well.
Even with Emily and Jil bringing some great home made cake and Brian
bringing home made pie to the hospital yesterday, home is still much nicer
You can visit me at my house in Kenmore, I have plenty of food to share.
I'll be home and glad to take visitors most of the weekend, but I do plan
on heading to Costco to buy bananas for smoothies and to the pool for a
swim, and maybe to the Lake for a paddle, so calling first may be a good
Since I didn't meet the conditions originally described as being required
for my release, my guess is that it was more of an insurance issue, and
possibly due to too much talking coming from my room(and that was without
Ara visiting ;-) . I need to hit an INR of 2.0+ to be considered
therapeutic and safe and was still at about 1.4 when they checked me out.
The Dr. said my body seemed to be fighting the drugs pretty well, so they
gave me a massive self injection kit, told me to keep taking pills and
injecting the shots into my belly fat (plenty of that after a week of
laying in a bed and eating) and come back on Monday for more testing.
On Monday I meet with the pulmonary specialist who agreed to take the case
with the complications of my leg clot and manage my blood thinner therapy
(warfarin/Coumadin - aren't you glad that their are other uses for
warfarin than just as the active chemical in rat poison ;-) until it's
stable enough for me to fly back to San Diego, he thinks 1-2 weeks,
compared to the hospital Dr's 2-3 weeks. He?ll also go over the lung rehab
with me, which will be very extensive.
Also on Monday, I will meet with a vascular surgeon who did some of the
clinical trials on a device used to clear clots from veins. My reasons are
twofold. I have less of a chance of clots breaking loose if they're gone
and my leg will probably heal faster if it has a blood supply and doesn't
have to grow a new one, which due to the extensive clotting in my calf is
probably the case. It will be challenging enough to get the muscles and
bone healthy without starving them for blood at the same time. The
hospital Dr. thought I'd be wasting my time, but I am pretty driven to
give my body the best chance to be healthy that I can, I'll leave it to
the vascular surgeon to let me know what he thinks and go from there.
Hope to see all of you soon - Saul
> Subject: Saul's medical health status update
> Date: Fri, 24 Oct[masked]:24:33 -0700
> Message-ID: <[address removed]>
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> I'm feeling a lot better and will probably be released in the next 24 =
hours, once my clotting factor index gets higher, it's at 1.3 after 4 days
> of Heparin and Coumadin (Warfarin) and needs to stabilize between 2 and
> 2.5, once it gets there even paper cuts or bruises will require a trip
> the ER. I'll wear a medical alert bracelet. 1 of the drugs, Lovenox, I
> to self inject, arggh, thunk, Saul's passed out, the other, Coumadin is
> tablet, yeah.
> Other damage, heart, lungs, brain/mind. Evidence of a heart attack that
> appears to have been weeks or even years ago. Lungs, I lost a lot of my
> lung capacity and have a lot of dead tissue that should grow back. 10
> on crutches or 20 feet in a wheelchair leaves me winded and panting with
> racing heart for minutes. For someone who had the highest max VO2 ever =
tested at the lab where I trained when I was racing, this is as much a =
pysychological blow as a physical one, but I'll be back ;~)
> Brain/mind, everything seems fine, but a game of Scrabble requires a nap
> two midway as I find it incredibly fatigueing to think that hard, I'll
> keep pushing there as well. While the weakness in my body is new to me
> a bit saddening and scary, I'm elated to be alive (Monday, I had serious
> doubts), to see another sunrise, another sunset, to climb another
> to paddle to another beach campsite, to catch another fish, to lead
> group ride or paddle, to cook another dinner for my friends, to be
> by a bear or a bison,to see everyones smiles, to share laughter, love
> hugs (and in 6 months to share another beer, risky before that, due to
> interaction), life is still with me, so are my friends, so it's = great.
I am now in a room with WiFi so I'll be able to log into my work = email.
> Here's the questions I had for hospital Doctor (Dr Gowri) assigned to =
> Q~ Will we dissolve the clots in my leg before I'm released?
> A~ no, your body will absorb them over the next few months
> Saul's thoughts ~ I have three major veins in my lower leg, clotted from
> end to end, isn't this risky as more clots break off, the technology
> to remove/dissolve the,clots, ultrasonically or mechanically, I will =
probably go to a Dr that specializes in that after I'm released.
> When will it be reasonably safe for me to fly to San Diego?
> 2~3,weeks, not days as I thought I'd heard in the ER.
> To Korea?
> Months, Dr doesn't think they can do my weekly required blood testing =
there, but if the trip is under a week long or if they can do the blood =
> tests, then in 2~3 weeks may be possible. Basically she's punting to the
> blood Dr.
> Q~ After my leg heels up and I am using it so blood doesn't pool up, How
> long do you think I'll be on Coumadin?
> A~ 3 to 6 months.
> Q~ Any precautions I should take when I ride my bicycle to work once the
> bone heals if I'm on Coumadin?
> A~ Don't crash
> Q~ What about surgery on my labrium(shoulder) ?
> A~ 3 months
> So that's where I'm at. thank you everyone for visiting, thank you
> for pushing me to find out what was wrong on Monday when I was blowing
> the symptoms and for holding my hand nonstop the first 48 hours when I
> scared about dying, for your emotional support and love and for driving
> hours each day to keep me sane, thank you Corina for driving me to the
> and for bring my stuff from the house, thank you Mom and Dalia for
> the nurses move stuff between rooms. thank you Sue, Scott, Carly, Ara,
> and all the others at Hamilton Sundstrand for the flowers, cards, =
magazines, phone calls and help navigating the insurance, thank you Rebecca =
> for the visit, the magazines and the dumbells so I don't get too soft =
;~),thank you Geoff and Roseanna for visiting each day, thank you Lidia for =
> the visit, the food, the conversation (even after I greeted you in
> rather than Polish, by mistake), thank you Viktor, Angela and Bob for
> a good brother and family and visiting each night, thank you Pam and
> for calling everyone to a party in my room last night and for buying the
> pizza, thank you Dan for your visit and conversation, thank you Regina
> your visit, your conversation and chocolate for bribing nurses with,
> you Judy and Randy for your entertainment (and the "it's a boy" balloon,
> thank you Jimmy for keeping my family engaged in scuba stories. Thank
> Emily and Jil for the visit, the home baked goods, Thank you Martin for
> discussing kayak trips, training and blood clot treatment equipment.
> you Sandra for helping me understand how the treatment is supposed to
> so I could ask better questions of my Dr.
> Thank all of you for being such good people.
> Saul Kinderis
> [address removed]