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.