18 March 2010

Looking Good

When I picked Ford up from work this evening, I asked how he was doing. He quickly replied: "BYU won in double overtime and I am off the Lovenox injections." Enough said?

At his appointment with Dr. Alward, his INR was a 2.1!!!! Dr. Alward checked him out and looked over all the reports. He commented several times how good Ford looked. He does not think that either altitude or exercise had anything to do with the drop in Ford's INR. He didn't venture to explain what he thought it was. Ultimately, the important part is that the INR number is back up into the normal range. The next check with Dr. Alward is 6 months, all things being normal. He also did not seem to think that radiation was an option for Ford, given his history. Radiation is what Dr. Glenn was suggesting will happen if the PET scan in April turns out with good results, good results meaning that there is no sign of the Diffuse Large B cell Lymphoma and that the MALT has stayed in the stomach area.

One step at a time. For now, that completes all the checks and re-checks for this month for Ford.

Whew, it is barely half way through and it has already been a long March.

Think 2

Tuesday Ford has his INR checked again. His number was up to a 1.8. Hoorah! This afternoon is his 4 month check with Dr. Alward. We are all concentrating on thinking 2, the magic number that will let Ford discontinue the Lovenox shots. His stomach is already rainbow colored with a lot of purple, blue, and yellows. He says that it doesn't hurt, it just looks really bad. So today, please think 2.

13 March 2010

Downer

Ford's INR went down between the Tuesday to Friday check: 1.4. There is another adjustment to his Warfarin and he will continue the Lovenox injections. His stomach seems to be adjusting.

11 March 2010

Side Effects

Tuesday morning Ford mentioned that his stomach was not doing well. He wasn't able to describe much of what was wrong, just that it wasn't right. He decided to go to work and see how things went during the day. He came home early and went to bed. My mind is racing through a list of things that might be causing this upset (flu, ulcer, constipation, food poisoning, or the MALT [the cancer that is slow growing, non-curable, centered in the stomach, and possibly what spawned the second form of cancer with which Ford was diagnosed). "A pain, but not really" and "it is more of an off taste" and "food makes it feel better" are descriptions that I had to go on. I could feel his frustration at not being able to give a more accurate account. Since stomach issues are one of the Red Flags that our doctor at the Huntsman said to watch for, I contacted the nurse we work with up there. After a few questions, she said that with such a general description, it really was a "wait and see what else happens." She did agree that the increase in exercise could cause an increase in metabolizing the Coumadin. Best guess is the stomach disturbance could be a side effect of the Lovenox. Our eldest daughter needed to take Lovenox during her last pregnancy (she inherited her dad's Factor V Leiden) and she remembered that it made her stomach sensitive for a while.

Yesterday Ford took things pretty easy. With his diagnosis last year, it was recommended that he visit a dermatologist regularly because his risk of Melanoma has gone up due to the cancer and chemo. Yesterday was one of those full body checks. Except for one tiny spot that needs to be observed over time, he passed the exam.

He is slightly improved today. We are praying for an increase in the INR enough to be able to discontinue the Lovenox.

Part
of me (the cynicism/irony/sarcasm part) says that "Of course he will be able to come off the Lovenox." That will happen just as the 30 day supply finally arrives. You see, Lovenox is very expensive, approximately $113 for five syringes. If we coordinate through Medco/Acredo (DMBA's mail order pharmacy), the cost drops to $85 for 30 syringes. Dr. Alward's staff began the process with Acredo early last week. A fax, a phone call, another fax, many more phone calls, another fax, and practically the whole day Tuesday on the phone--being helped, being transferred, on hold, awaiting a return phone call, to infinity and beyond.....No one at Acredo was able to find a doctor's prescription in any form. Because of regulations, they would not approve using the prescription that was on file with 10 more refills that we were using last year, because after three months, it is no longer valid. When were the three months up? The middle of February, of course. Finally, last night the call came that the Lovenox would be shipped Thursday (today) via overnight delivery to arrive on Friday.

Ford will have his INR checked Friday morning. Honestly,
even after all that process, I would be delighted if his INR is a 2.0 or greater.

As I look back and take a deep breath, I am grateful for the patience and kindness of all those people at Acredo that I interacted with on Tuesday. Dr. Alward's staff is amazing. And, we are blessed that there is such a thing as Lovenox that will help prevent Ford from having blood clots which could be fatal. We are thankful that we have insurance that helps cover medical costs and for Ford's employment. There is no doubt in our minds or hearts that God is gracious, loving, and generous. Each day of life is an incredible opportunity. All is well.

09 March 2010

Coincidence?

Seldom do I believe in coincidences.

Since both Ford and I are on Coumadin (actually we are taking the generic Warfarin), we both get our INR checked. We get it checked in different clinics. It did not take too long for me to get in a good range when I began the Coumadin. My number has been fairly consistent between a 2.4 & a 2.6. So consistent that the interval between checks has been a month to a month and a half. My INR check was yesterday and the number was a 1.3. ???? That is a tremendous drop. Just like Ford's was a significant drop. I am positive that I did not exercise 3 hours a day while on vacation. No, we did not change our diet. The thing that we have in common is the vacation. Coincidence? I think not.

So today at Ford's check I asked if altitude changes make a difference. "Of course," was the response. So far food, sleep, exercise, and altitude can change the levels. Oh, and the fact that using a generic brand instead of the true blue Coumadin can make a difference.....makes me wonder what other thousand things in the universe can have an affect on the INR level that we are not aware of.

The real question for me is: "Is there anything that we can personally do to help Ford maintain his INR in the level necessary to prevent blood clots?"

BTW, his INR today was up 1/10 to a 1.5. Still creeping upward, but causing a quandary with the doctor's staff.

06 March 2010

Going Up

The INR check on Friday was up .2 to a 1.4. We continue with the Lovenox until back in the normal range.

Ford is settling back in to a less rigorous exercise routine of about an hour and a half workout instead of the three hour workout he had enjoyed while on vacation.

All is well.

03 March 2010

March-ing

When the number came up for the result of Ford's INR check, I thought for a moment that I might be dyslexic. I blinked and asked if that really was a 1.2 I was looking at. The nurse was also surprised at the number. Does going on vacation result in a drop in the INR? Ford has been very diligent in taking his blood thinners. His diet has not change significantly. Why the drop? The only thing that he has changed in his routine is exercise. The whole time we were on vacation he worked out for about three hours total: running/walking (training for the half marathon), throwing and catching frisbees on the beach, and time on the stationary recumbent bike. Guess what. That can create the change. Who knew.

Well...it is back to the Lovenox injections until his levels improve. He is a trooper. He does not complain. He simply complies. I have no doubt that his visit with Dr. Alward in a couple of weeks will be interesting.

In the meantime, we are doing incredibly well, the glass is half-full, and we are tremendously blessed. We have been awed by the beauty of God's creations. We so are grateful for the generosity of my dear brother and wonderful sister-in-law. We have had so much fun being with them. Mahalo!