Bloody Battles

Fiorella is not happy with her coumadin nurse.

Because she has an artificial aortic valve, Fio takes a daily dose of coumadin/warfarin to thin her blood and thus keep her from forming a blood clot. The goal is to maintain her INR (a blood analysis figure) between 2 and 3.  But whenever she has surgery, Fio has to stop taking coumadin--usually five days beforehand because coumadin has a three-day bounce--to enable the wound to heal properly.

Starting the coumadin again afterwards is tricky.  After her facelift, Fio was started too soon with dosages that were too high and ended up with an INR of 3.9 and coagulated blood in her cheeks.   

Once burned, twice shy, Fiorella informed everyone involved in her hip replacement of the coumadin bounce problem before the hip surgery.  The surgeon emphasized he wanted her in the low 2s after the surgery.  But before Fio knew it, by following the dosages prescribed by the coumadin nurse, she was up to 3.4--and a second hematoma was forming.

She called the coumadin nurse, who was too busy to take her call.  She called the surgeon's office and was told to call her cardiologist.  She called the cardiologist's office and was told to call the coumadin nurse.  Finally she got hold of someone else in the coumadin nurse's office and was told what dosages to take. Four days later, she still high, at 3.1.  The remedy?--she was told to take high dosages five days a week and lower dosages twice a week, which is sure to send her up to 4 in no time.

Despite the temptation to go all passive aggressive and bleed out in an emergency room just to prove how wrong the nurse was, Fio's not going along with it the nurse's prescription.  She's putting herself on a reasonable dosage, then requesting copies of her records for the past two years so she can figure out her dosages for herself.