December 7, 2016
Den has an appointment with Marrietta at the Electrophysiology office today to check his pacemaker. We are planning to wait until closer to the appointment time to go for his weekly blood draw, since the outpatient clinic and the doctor’s office are in the same complex. This week Den’s blood work includes some extra labs for Dr. Hennecke. She gave us an order for a cholesterol panel and an A1C, to check for any signs of diabetes. It is always an odyssey when we need to add extra labs to Den’s standing order. It seems to give the registrar a panic attack, since they are not quite sure what to do. We finally got done with the blood draw and headed over to see Marrietta.
Den’s weight is up to 269…not good, but not too worrisome yet. He is in solid AFib, but that no longer is a concern since he got the LVAD. He did have a short rum of Tachycardia in early November, but we never new and his pacemaker did not need to shock him (good news). Marrietta suggested that we ask the LVAD team if putting Den back on Bi-V pacing would be beneficial to him. She also let us know that the battery in the pacemaker was getting low. We would need to start planning to have it replaced in the near future. This would have to be done at the U of C, since the hospital the doctor’s office uses will not take Den as a patient.
After we got home, the LVAD team called me. Den’s INR came back at 1.7 (too thick). They wanted me to give Den Lovenox injections and they had already sent a prescription to the pharmacy. I needed to start these tonight. The Lovenox would keep Den from developing blood clots while we worked with his blood thinner levels to get him back into the therapeutic range.
I have to tell you that Den does not have problems with needles. He is not shy about getting any kind of shot, IV or blood draw. I have always been a little gun shy about giving injections. I hate thinking that I might hurt him or do it wrong and really cause a problem. I have come to really not like Lovenox injections. The pre-filled syringe with the retracting needle is great, but the medication causes severe bruising. Den said that the bruising does not hurt, but it looks really painful to me.
This would not be our last run in with Lovenox, unfortunately.