Time to Take Control

The end of 2009 is nearing, marking my third full year of being on blood thinners. I can gleefully admit that my life hasn't been negatively impacted by being on Coumadin. It has become my way of life and is a permanent fixture, ingrained into my lifestyle. On the complete opposite end of the spectrum, I have been very passive. I can give a multitude of reasons for my passivity -- college, wedding planning, marriage, work, etc. -- and never really put my health first in any of those situations. I try to be mindful of my body and respond to the quirks and hurts, but I still let the rest of my environment dictate how proactive I am about my health.

I have recently been speaking up about my thoughts and concerns about my lack of enthusiasm to get going on finding answers, deeper answers. Thank you to my dear friends, I am gaining momentum and courage to take a stand and move forward on empowering myself about myself. Even if this empowerment means finding out what I already know, again, from someone else.

Today I went into my primary clinic and met with my new Internal Medicine doctor for a managed care visit. I have been doctor-less for six months now and didn't try to get a new doctor at any point. I thought I might switch clinics during annual benefit enrollment in the late fall at work. I again used an excuse to not do anything about my concerns. The doctor I had from day 8 to 6 months ago was assigned to me the day I was released from the hospital. I never once tried to get a different doctor. She was nice, courteous and seemed to suit my needs. HA! Needs, I am still figuring out what those are!

The new doctor reviewed my health history today. He could not find on my medical records why I was on Coumadin. The information on Factor II and Lupus Anti-coagulant was buried very deep and nowhere in there did he see a concrete diagnosis that I was to take blood thinners permanently. He did see a letter from the hematologist I saw back in January of 2007 stating that I will be a chronic user of blood thinners. "Chronic" is an implied term. I want explicit instructions, dammit! After almost three years, I want someone to point blank tell me "yes" or "no." The new doctor told me I had every right to want a 2nd opinion and he said "being on Coumadin in your 20s is no good, it sucks, I understand." Yes! Validation! Just what I wanted to hear.

Month in and month out, I go in and get poked at the clinic and I am always the youngest by about 40 years in the clinic. I felt very out of place at the clinic the first year but then I just turned into a chameleon and mentally made myself one of them. One of the old people with serious health issues taking Coumadin.

Moving forward, I requested that I be given a referral to a Fairview University Hematology clinic. Mr. Doctor didn't even bat an eye. He wrote up the referral and told me that I would be getting a call in two days to get the ball rolling to schedule an appointment. I am SO excited to go to a clinic that knows their stuff, that has doctors that live and breath issues like I have been living. To top that fat cat off, I can finally get a referral for a doctor that specializes in women's health and blood clotting disorders. Or at least, I can hope that will happen.

In other, related news -- my INR was 4.5 today. Yowza. That is the highest it has ever been. I have to go back to the clinic tomorrow for a re-test. I am pseudo-nervous about my INR being so high because I have no idea why it would be. I ate asparagus for lunch and well, that is about it. Unless Pepsi-Co has been pumping Vitamin K into Diet Mt. Dew, I can't think of any other reason why it is so high. I decided to sit home and not go for a run tonight. I didn't want to risk falling and bleeding to death mid-stride. A bit of an exaggeration, but not completely unlikely. Instead I came home to my fun-loving 5 year old neighbor telling me how much he likes Kindegarten and how good he is being to the Joe Mauer-on-a-stick I gave him. "Joe is the greatest" he said. Really, what else could a girl ask for to brighten her day?

Update: I went back in the next morning and my INR was down to 2.6. The nurses didn't bat an eye and dropped my dosage on one day a week from 10 mg to 7.5 mg of Warfarin. That is the first time my dosage has been changed in at least two years. I go back in for monitoring in two weeks to see how the adjustments fare.