Well that was fun.

Monday Joe had a scheduled ultrasound for his left leg that had the blood clot (DVT) in May. He was told to use the outpatient services in the building where he has his doctor and weekly blood work done. A clot was seen in his thigh and his doctor’s office was given the information. His doctor was out because he broke his ankle and so the CNP was taking care of things. When Joe first developed the clot in May it was seen by staff and equipment at the Cleveland Clinic. Local doctors never saw it just from reports and from Joe how extensive it was (from the groin to the calf). What was seen on Monday it was not communicated (or believed when communicated) that what was seen was most likely the old clot still there taking some time to dissolve because of the size of it to begin with. Joe was told to report to the ER for IV Heparin then transport to the Cleveland Clinic. He waited until he heard for sure from Laura (the super hero oncology nurse) because he wanted to see what the CC staff thought. He was thinking that even if there was still a clot it may be better than it had been and he had no issues. He had run a 5K 9/10 and has been running with E&J at cross country practice, and up and down the steps at Lucas Oil Stadium at the Browns game Sunday. Laura agreed (maybe not knowing what was seen or that the local doctors did not know the history of the clot). He was told to not stop at home to pack a bag. He did stop to get something to eat and enjoy since he knew it would be a while before having good food again.
So I’m making plans at work to have the kids taken care up and get my self to Cleveland. When I get out of work at 12:30 I run home to pack him a bag and make to St. Luke’s to see him before he leaves. I make it as the transfer ambulance staff wait for me. It was stressed to Joe they could not wait long for me but they were in no hurry evidently because they opted to make Rt 2 all the way. Joe said it took forever as he was checking the map on his phone. Once he did get to CC the staff there said he had been waiting for him and wondered what took so long. He got to his room but he was disappointed in how long it took to get the Heparin restarted.
Not wanting to freak out E&J by having them be picked up by someone else, I picked them up from school, picked up Mark and went home to have something normal while waiting for my Dad to get there after work (Mom was going to relive Dad and stay the night to get the kids to destations Tuesday morning). After dinner a dear friend took me back to St. Luke’s so I could get Joe’s car and drive to Cleveland. With the rain and Joe’s little car (and the news that a long time friend and teacher of Joe’s was killed that morning in a car accident) I used caution and stayed in the right lane. I did not get to the CC until 9:15. Joe said nothing has happened since he got there not even an ultrasound to see for sure. I stayed an hour just missing the first hour of free parking by 4 minutes. I went to stay with Joe’s aunt and uncle who have been so kind in letting me stay over night so many times. I never did get to see them because they were asleep when I got there and had already left early when I left there at 7 to get back to the hospital.
Back to the hospital (and the traffic on I-77 oh what fun). We waited for hospital transport for more than an hour. Joe could have walked himself (3 times for all the time waiting) there no issues but they needed him to be with transport. Their ultrasound showed that there was no longer a clot below his knee. The thigh area was “inconclusive” because the first ultrasound in May did not get a good image of that area because of the swelling in his leg. So not having a good image to look at they were not able to tell if what he had was new or old. I’m no doctor but I’m really frustrated that given how extensive the clot was in May and what it looks like now my guess is it is still just part of the old one. He has been on blood thinners since the clot in May was discovered so the chances of developing something new was slim.
So they stop his Heparin and let it wear off for a few hours before getting him started on shots of Lovenox. It is a blood thinner he has to injected himself with twice a day. In order to get a better handle the interaction of the trail meds and Coumadin they opted to stop the Coumadin (great we just had a prescription refilled) and start with the Lovenox. The blood coagulation rate, INR, was never right where they wanted it because the interaction with the trail med made the Coumadin not as effective. When he was taken off the trial meds (twice now) his INR gets too high and he has a greater chance of bleeding. The trail meds and Lovenox don’t cause problems together but the Lovenox does tax his kidney some. We can never win.

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Well it has taken me almost a week to get this written. The latest is that Joe is just tired from the trial meds. He did coach at the Cross Country meet on Saturday and walk/run the Northwest Ohio Race for the Cure on Sunday. If the children/dog would let him get a good night of sleep then he would not be so tired.
We go back to Cleveland for a regular check up Oct 6.