Tuesday, November 12, 2019

Recovery is not as easy as I'd hoped


Following my adventures in hospital last week, I've been trying to get back on an even keel.  Progress has been in fits and starts, with a few more fits than I'd have preferred!  Still, I'm alive to work at it, which is a very good start.

I'm on a new-fangled anticoagulant medication, because apparently the danger of blood clots in a newly-installed stent is very serious.  I'll be on it for at least a year, and perhaps longer, depending on what my cardiologist decides.  (Affording it is going to be a problem;  it's going to cost me hundreds of dollars a month, even with my medical insurance.  I may have to settle for an older and much cheaper generic anticoagulant instead, if I can get the cardiologist to agree.)

This is the first time I've been prescribed an anticoagulant. I hadn't realized just how well they work.  I scratched the back of my hand yesterday morning - a minor scrape, leaving only a pinprick-size hole.  However, the damned thing wouldn't stop bleeding!  I went through four dressings, and I think it's finally under control, but I'll have to be careful when I take off the bandage.  I don't want to remove the scab with it, and have to start the whole process all over again.  I have some wound coagulant powder and coagulant dressings on order;  they should get here later this week.  I'm going to keep some of each in both of our vehicles, and more ready for use at home, and in a travel kit for "grab and go" purposes.  Bleeding is now a serious hazard for me.

The side effects of the anticoagulant aren't limited to bleeding.  I find myself getting dizzy at any rapid movement, and I'm very short of breath, no matter what I'm doing.  It's difficult to rest properly as a result.  I may will have to switch to a different CPAP mask, because a nasal mask no longer allows me to get enough air into my lungs while asleep, so that my mouth opens and I snore, waking my wife.  That's a non-starter.  It's affecting my writing, too.  If one's constantly tired, creativity takes a knock.  I've written quite a bit since last week, but the quality isn't good enough to satisfy me (or my readers).  I'll have to see how this develops over the next few weeks.

Still, those complications are relatively minor compared to what might have been.  At least I'm alive to complain!  There's a lot to be said for that.  I'll be starting a cardiac rehabilitation program soon, and that should help to stabilize things even more.

Last night, with an Arctic cold front sweeping through and the temperature outside well below freezing, Miss D. and I decided to treat ourselves to extra heat.  We lit a fire in the grate, and I cooked up a thick and hearty beef vegetable soup that warmed us from our heads to our toes.  There's something sybaritically luxurious about sitting in front of a fire, enjoying each other's company, imbibing rich, tasty homemade soup, and looking at a frosty, freezing world outside.  We were definitely on the right side of our windows and doors!

Peter

26 comments:

  1. Sounds like all our prayers were answered. Another thing to be glad of; you're no longer a member of the most uncomfortable order in existence, the Nights Hospitaler.

    A hearty beef vegetable soup sounds like an excellent idea, as that front keeps dropping farther east. Time to get out the Dutch oven and let one simmer most of the day.

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  2. Mom is diabetic and on anticoagulants and I have a tourniquet, a quikclot kit and Celox powder at arm's length all the time.

    Just don't mess with that

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  3. Good to here that you are on the mend....I always tell my patients to go to the manufacturers web site. Some of them have coupons that you can down load. They will give you a discount if you have commercial insurance.

    Steve

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  4. As the Brits used to say "keep a stiff upper lip" this too shall pass.Some of us are just too ornery to give it up. I have survived 3 heart attacks, two 'mini strokes' and having a knee surgery go so bad I ended in a 'medically induced' coma for five weeks. Sometimes we just can;t give up.

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  5. Any head trauma when on blood thinners can be VERY serious. A subdural hematoma is almost guaranteed. Take care.

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  6. In addition to what Steve posted about coupons from the manufacturers, the last insurance I had before retiring recommended that place called GoodRX. You may have seen the ads. They're legit. You search on the drug name and they give you coupons the local pharmacy stores will accept. My CVS takes them, and puts them in my account so that the next time I need that non-covered medication, I still get the good price.

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  7. If it's Brillinta , you can get a coupon that brings it down to about $20 a month . I don't know why the doctors wont tell you about these. Like it's coming out of their pocket.

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  8. Wayne is right about the Brillinta. That's what I took after a big a$$ stent was installed and the price of the drug was pretty high even after the insurance until I got the coupon.......

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  9. Regarding the anticoagulant, they are an issue. I'm on them, and about six months after I went on I grew a beard.

    When I'd take a nick out of myself with a razor (once a week or so, typically) I'd wind up with a bandaid stuck on my face for at least 12 hours to get the bleeding stopped, and shaving the next morning was going to get it re-started about half the time. I finally got tired of going to work that way.

    We won't even talk about what happens when I have to deal with a disgruntled cat.

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  10. VERY glad you're around to tell the tale. Let's keep that up, shall we? There's a good lad! :^)

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  11. I sympathize with all who must take these thinners. I have personal friends and relatives who do so. Actually, being a naturally born bleeder (not hemophelia though), I can emphasize. Things such as auto wrecks, severe burns, broken bones, getting shot bring a new meaning to the emergencies of life (I enjoyed a rather 'come what may' younger life even though my blood pours like vodka through a drunk). Even minor incidents that most people totally ignore become a major point of attention.

    I don't understand this coupon nonsense, even though I make use of them for glaucoma medicine. It is as though; "We will charge whatever we wish unless you jump through some just for fun hoops we designed for you -- but first you must find them". Makes me realize that I'm in the wrong racket.

    Hope you can get off that stuff Peter, and all of you for that matter. Meanwhile, the above advice is well taken. Take your bandage kit with you, where ever you go and everywhere you go.

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  12. When they put me on Xarelto the doc said to let them know if they tried to charge 3 or 4 hundred a month and they could try some sort of special pleading with the insurance company, and failing that they could supply me out of samples. With Medicare and a part D plan I get it for $110 per month. Still high but not as bad as it could be.

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  13. When hubby was on so many heart meds we ordered many from Canadian Pharmacy's making sure to find the ones that offered free shipping. His drugs were running $800+ and even with coupons, goodrx and I could see the Poor House ahead if we didn't find a way around this. Canadian pharmacy's ended up saving us as much as $300 per month. And if you haven't please look up on Wiki all the foods you cannot eat. It's certainly an eye opener. Star fruit would kill my hubby due to one of the medicine he took. Rest, relax and you'll get your strength back.

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  14. Rest and recuperate... If you need me to run for stuff, let me know.

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  15. On shaving while on thinners, blades are out of the question, a conventional electric may work for your skin and beard or may be too aggressive. I ended up with a Phillips One-Touch that gets the beard short enough to look decent and almost never nicks me.

    Blades aren't cheap but if you use them until dull, not changing them every couple weeks as recommended the cost per shave is much more reasonable.

    Take it with you for haircuts too, your barber should be happy to use it instead of his tools if they are likely to nick you.

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  16. The normal post-stent blood thinner was Plavix (Clopidogrel) which has a generic. Last I looked it was about $75 per month. Is it up in price or did your doctor decide the new name brand only drug was what's needed now?

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  17. Yeah, I have AFIB, Doc put me on Eliquis. The first Rx was $300 for a months supply, yikes. Now I get a 3 months supply for $90, not cheap, but I can live with it. Insurance is Medicare Part D through CVS, pharmacy is Walmart. YMMV. I use a Fisher and Pykel 431 (or 432) full face mask on my CPAP. It fits around the nose and under the chin. I have sinus issues, and when (not if) the sinuses clog up at night, I need to be able to breathe through my mouth. Also a suggestion, if you do get a full face mask, get a humidifier for your CPAP. You'll likely still have dry mouth in the morning, but not as bad as without. I am not a doctor, nor do I play one on television. Just my personal observations.

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  18. Mr. Grant,

    Regarding snoring: As a general rule, noisy breathing is obstructed breathing. In the presence of OSA it is often indicative of the soft palate obstructing airflow.

    The mouth-opening symptom points toward the need for a full face mask. If you go to a full face mask you might also need to adjust the pressure on your CPAP/APAP machine. Many patients feel less anxiety (with initial use of full face masks) with increased flow rates.

    The Resmed Airfit F20 is a very comfortable mask: https://www.resmed.com/us/en/consumer/products/masks/airfit-20-series/airfit-f20.html

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  19. I was on coumadin (rat poison) for years because of my afib until my old cardiologist retired and the new one switched me to asprin. With that you have mothly or more often blood clotting tests. It is affected by what hou eat. I wonder if you should ask yuor doctor right now if you should be tested and the dosage of the newfangled drug needs adjusting! You might keep some Israeli battle dressings in your kits. They are pressure dressings and might avoid the need for a tourniquet. Since I live 40 miles from the nearest medical facility and frequently run a chainsaw and other instraments of destruction I chose 3% greater chance of stroke over the risks of more agressive anticlotting drugs.

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  20. What Nuke said above. Full face mask is the way to go. Especially if you have allergies or any nose restrictions. Yes, it's annoying, but it is what it is.

    Use an electric shaver to de-fuzz where the mask sits, in order to get a good fit.

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  21. If 'tis but a scratch, why not fix it up instantly with super glue? Bonds instantly to skin.

    Yes, obviously I am not a doctor.

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  22. I had a triple bypass in 07 and two stents in 16. The heart doc had me on Plavix for a year after the stents. When that was up, he ok'd me to stop the Plavix and stay on baby aspirin daily. As you have noted, the most minor scratch, bump or bruise causes prolonged bleeding.

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  23. My wife has a genetic blood disorder discovered in her early 30's that requires anticoagulant meds. Be advised, your food/drink intake affects this (greens and alcohol the most I think). Also, 2 things: you can get a home testing kit (not cheap, think a grand or so) to test your levels and skip the doctors visits (most of them) for adjusting your dosage, so in the long run it will save you money, and the other is don't use quikclot - it is dangerous when on the meds - use Celox (look it up, I hope I don't have that backwards). I upgraded my med kits to Celox as it is recommended for anyone on anticoagulants. (Dang I use run-on sentences...).

    My 2 cents.

    Be well my friend! We're all rooting for you!

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  24. Three groups of anti-clotting agents: anticoagulants block the actions of normal levels of clotting factors; vitamin k antagonists decrease the levels of clotting factors; and antiplatelet agents that disable the clotting effects of platelets. In fast-flowing high pressure zones, the arteries, a clot would take time to form and would be swept away unless the flow is completely stopped. Platelets stick to any foreign (non blood vessel lining) surface like snowdrifts in the wind, and become activated, producing factors that cause adjacent clotting.

    To keep a short stubble one way is a beard clipper with a ¹/₃₂ inch comb.

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  25. Relax and concentrate on getting better. Your writing can wait. Don't stress yourself by thinking you need to work; you don't. You can work later when you've recovered. Relax and let your wife pamper you.

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