Rat Killer is Awesome, so I take it every day!

So a while back I explained my experience having my DVT clot, and my Heroes mutated condition, homozygous factor five leiden, that makes me "super clotting girl." Although most pain from the clot subsided after 7-8 months, the main difference in my life was my new friend,...the rat killer, coumadin.

After doctors discover that anyone has a clot, the nice doctors make you take blood thinners. Beginning blood therapy is the desired first round of treatment for a DVT clot, despite any genetic disorders one may have. The blood thinners will hopefully slowly break down the clot until it all but dissolves. I say hopefully because some clots get worse before breaking down and must be injected with a special protein that rapidly breaks down a clot. Unfortunately there are only 5 -7 of these special proteins that rapidly break down blood clots. Therefore, beginning on blood therapy first, is the desirable approach, barring any emergencies. So, like with most, my doctors began my treatment to break down the clot with the blood thinners.

To begin the blood thinning therapy, first you inject yourself into your stomach with heparin. You may have heard of heparin as the medication that has recently been on the news because of its accidental overdosing of infants in the hospital. Dennis Quade's twins were given to much heparin after their birth and almost died. Heparin, itself sounds dangerous enough, but after the heparin, comes the coumadin.

But wait, after they begin you on the injectible medication and the coumadin, they also torture you by taking your blood, first every other day, then every two days, then twice a week, and finally once a month. I don't know if you know this, but taking blood thinners (which, heparin and coumadin both are) you tend to bruise, very easily. So having your arms, hands, wrists, etc. stuck with a needle to draw your blood for a test leaves your arms looking lovely. The blood test that is necessary to measure what I like to call my blood's consistency, is called PT/INR.

As I said, like others with a DVT clot, blood thinning therapy is the way to go. However, after the doctors realize that you have my factor five leiden mutation disorder, they decide that you get to take coumadin FOREVER, da, da daaaaa. That's right rat thinner and monthly blood tests are my way of life. Plus side, I am over my fear of needles. The initial injections I gave myself and the blood tests make me hardly even flinch whenever I see a needle. Negative, taking rat poison has, as one may think, lots of side effects.

Side effects page from the pharmacy is seriously two pages. They include things like, bruising, dry mouth, excessive sweating, chills, blood shot eyes, hemorrhage, and that I eating Vitamin K enriched foods will cause the medicine to work less effectively. Vitamin K enriched foods include all dark green vegetables, like broccoli, spinach, kale, green beans, lettuce, etc. You try dieting, while being sure to limit your lettuce intake.

Not only is my vegetable intake affected, but as you can imagine, taking blood thinner also affects your alcohol intake. However, with this new drug and its interactions and blood tests, also comes with a special doctor, the hematologist. Luckily, my awesome hematologist showed me that I can do lots of things on my rat killer, like balance my Vitamin K greens to the medicine; meaning that I must maintain a weekly steady amount of greens every week and allow the medicine to adjust to my intake. Like with the greens, I balance the intake of alcohol over the week and have the medicine adjust to this intake. What is hilarious is that I have to drink alcohol consistently if I am going to drink at all. It has to be a balanced amount. My friends find it hilarious that I have to drink alcohol consistently with the medicine so not to mess up my PT level. I just find it fabulous.

In this vain, I have learned to balance the rat killer with the amount of alcohol that I have. More greens make the blood more thick, if I drink more alcohol. I would definitely not recommend this kind of balancing act, but it has been working for me. My PT/INR tests have been very steady and luckily I have made it through almost 2 years straight of taking the rat killer without any complications.

By the way, when I call it a rat killer, I am not exaggerating. My always truthful friend, Wikapedia says it all: Coumadin, that is also known as, "warfarin was first registered for use as a rodenticide in the US in 1948, and was immediately popular".

For more information on yours and my favorite rat killer, see the US Dept. of Health and Human Services information link: http://www.ahrq.gov/consumer/coumadin.htm

Long Stories...that make me feel lucky

Earlier today, I was speaking with someone about how I used to love the weather in San Diego. I always used to joke about how that was the one and only thing I liked there. While that is not entirely true, it was one of the best things about living there. The awesome weather allowed me to walk outside nearly every day and I even joined a half marathon training program to prepare for a 16 some odd mile hike. However, as I've told this story many times...my wish to complete the long race ended one morning with a swollen leg.

On an early Tuesday morning, I woke up with awful awful pain in my left leg. I thought maybe I had pulled a muscle or something. I had after all been training for the half marathon and had done a 5k (with the puppy) the week before. I decided to drag myself out of bed and head to the bathroom for a bath. When I got to the bathroom by crawling across the floor, and turned on the bright lights, I made it to the toilet just in time to puke. The leg was causing even more pain because I had made an attempt to move.

I thought at this point about starting the bath and continuing to heal the pain via the hot bath, but then I looked down and began examining my leg. My leg was swollen and purple looking. It reminded me of the crocodile hunter getting bitten by some kind of freakish bug, out in the bush, that caused massive discoloration and swelling. I had after all, been walking the trails throughout San Diego with my dog in preparation for my race. So, of course, I called my friend in med school, because that is what I do when I have any health, science, or medical-like issue.

All right, so I called my friend at like 7am, feeling a bit guilty about the early wake-up call, but I thought my leg was going to fall off, or an alien was going to be born out my knee. At this point, I was nearly hyperventilating because the pain was excruciating. I told her what the leg looked like and was ready to text her a pic, but fortunately, she had an idea of what was wrong. This I tell you is a direct quote, well as best as I can remember,..."Well, you know how you have been smoking and taking the birth control pill. The combo of those two things can cause blood clots, which it sounds like that is what it could be. But I don 't really know. That kind of thing is more clinical, which we don't cover until next year." Her next piece of advice, speaking from someone who has known me for over 10 years, was, "Don't wait, Janet. This is not something you wait for. Go to the doctor NOW. If you can't drive, call the ambulance."

Without any hope for a ride, with me in no position at all to drive, having puked a couple more times, I decided to make that call to 9-1-1. When you are younger and you first learn about the magical 911 number, you think how cool it would be to call. Many children actually call 911 after learning it just to see the police or cool fireman come to their house. However, when you are faced with actually having to call, and for yourself, because you are stuck at home alone, there is nothing to accurately explain how weird and uncomfortable it is.

So, I made the call, still hyperventilating after my friend's scary advice, explained that I think that I have a blood clot in my leg and that I needed an ambulance. They asked me my age, my address and quickly got off the phone. I thought this was odd, because on TV and such, they stay on the phone until the ambulance comes. I guess the operator did not want to hear my heavy, crazed breathing. Anyway, after I hung up and realized that I would have to get the door open and have someone come over to let the dog out, I decided to call my apartment neighbors who had recently had a baby. Of course I did not want to rely on them to shuffle me to the hospital because of the new baby and all, but I thought that the neighbor could help me with the dog and maybe help me get myself together and some socks on before the ambulance came.

She came over, despite the early hour, in like two seconds. I guess she heard the desperation in my voice. She helped me get into some clothes and get some socks on and not soon after we heard the ambulance down the street. The paramedics came in and started asking me lots of questions, and of course took off the socks I had put on to look at my foot and leg. They asked if I had been injured recently, or if I feared for my safety at home,like i dozen times. I had to say no.

They of course took me in their ambulance to the Naval Hospital in SD. Not a bad facility, but nothing like Bethesda Naval. On the way I was given morphine and later Valium. I was of course starting to feel nothing but fog. However, when I got to the hospital, there were more questions. This time, they still asked the "safety at home" question, but also asked the typical military treatment facility question of, "how would you describe your pain on a scale of 1 to 10, 10 being the highest?" I told the nurse, that I had not had a baby, so I would not say 10, but that I would go with a 9.

After the check in and more questions, which are considerably difficult to answer while heavily intoxicated. I was taken to get an ultrasound of the leg. Barely awake on the hospital, wheelie bed, the tech began using the machine and its cool jelly to examine my left leg. I somehow heard through the drug induced fog, "How old are you?" The tech said it again, and I answered. She left the room and got the doctor that reads the ultrasound (whatever they are called). But next thing I remember I was being checked into the hospital room.

Now, with a three doctor team, they asked more questions about whether I was sedentary, whether I had been on long plane trips, or on long car rides. The answer was, of course, No, I was training for a marathon, no and no. Well, it turned out that I had a massive deep vein thrombosis clot in my upper left thigh. The clot began about 5 inches above my knee and stretched to the top of my thigh, almost in the groin area. Apparently, having such a condition, where the individual is not sedentary, and without the long car or plane trips, is pretty rare, even with the birth control pills and smoking combo. After a barrage of blood tests they found the culprit.

It turns out that I have a genetic blood disorder/mutation called Factor Five Leiden. Apparently 20% of Caucasian persons in the world have one allele or are heterozygous factor five. I on the other hand have two alleles, from each parent or, I am homozygous factor five. Less than 1% of everyone in the world has the homozygous factor five mutation. I am apparently terribly lucky.

The truth of it all, the end of the story, is that I am actually very lucky. If I had not gone to the hospital in time I could have had other very bad complications. Often many people have a pulmonary embolism, where the clot breaks off and goes into the lungs. Or the clot could have broken off and gone to my heart or even my brain. I am very lucky that I received the fast advice of my unsure, but totally correct med school friend. Sometimes when I tell this story, as I often do, I forget how close I could have came to death. I am very lucky.

See link for more information in my favorite mutation condition that I like to pretend makes me like one of the Heroes from the TV show. I am supper clotting girl!:
http://www.fvleiden.org/