Yippee, Anti-Coagulants

This was going to be a quick post about the brain MRI results that I keep forgetting about.  Instead, while I was hanging out with Mom on Wednesday I received a call from the Pain and Symptom Clinic to reschedule my appointment I have next week to the other doctor (may he be a good one).  The nurse also told me she thinks that the referral to the Anti-Coagulation Clinic has finally gone through so I should get a call from them in the next couple of days.  Within minutes of hanging up the phone it rang again.  This time it was the Anti-Coagulation Clinic.

The clerk asked if I could come in that afternoon – it was 15:45 at the time – I declined.  The clerk then offered Thursday but I already had plans to see the Lego Batman Movie so we settled on Friday.

First, the Lego Batman Movie.  It wasn’t as funny as the first one but it was still funny and a lovely way to spend some time with my aunt.  And really, it is a movie based on Lego, how is that not fabulous?  I did miss the Everything is Awesome song though.  And there was one scene involving Robin’s pants that gave me flashbacks to a Willows beach experience.  Keets, do remember that time while we were still in Uni and we had gone down to Willows beach?  We were minding our own business watching the water when we were blinded by the 70+, maybe 80+ year old guy with the perma-tan leathery skin and wait for it………the fluorescent green thong bikini.  Nope, not just a Speedo, but a thong.  And we were so lucky he had to strut by 3 times I think it was.  Horrifying is all I can say.

So the movie, aside from the flashback, was very entertaining.

On Friday it was off to the Anti-Coagulation Clinic.  It also gave me a few flashbacks as the clinic is located in the Royal Block of the Royal Jubilee Hospital.  This is where the main entrance of the hospital was back when I was a student lab tech and the new buildings had not opened yet.  The inside had changed and been updated from what I remember but the outside was still pretty much the same.  It was a real trip down memory lane.

From reception I was sent down the hall to sit on a stretcher for about 10 minutes.  A nurse popped in then to asked if someone had seen me already and he seemed a little surprised when I said no.  I didn’t think people just randomly hung out in clinics sitting on stretchers but maybe they do. 😝

The nurse left and then came back about a minute later with the pharmacist.  I believe he is a doctor of pharmacy as opposed to a doctor of medicine.  And woowzers, a totally different bedside manner from the guy at the Pain and Symptom Clinic.  This guy actually listened to me and my opinions.  He gave me a short lesson on anti-coagulants and how they have evolved over the years.  I knew some of what he said but I knew there have been changes in the 4+ years since I was a practicing lab tech.

He asked me if I had heard of Low Molecular Weight Heparins, and I responded with “yes, I am a lab tech.”  His next question was, “did you work here at the Jub?”  I said I did part of my training here and worked here until just after the new building opened…….although now, the new building from my time is now the old new building since the new new building opened.  The joy of healthcare, so clear yet so convoluted. πŸ˜‚

When I told him I had moved to Vancouver and worked at St. Paul’s he said he had just been at St. Paul’s lab the day before to participate in haematology rounds.  It also turns out his wife is a lab tech in Victoria so there were a few people we knew in common.  The lab is such a small world.

Back to the actual, current medical stuff, we discussed how I did not currently have a clot, but vein narrowing.  He did say it was possible I could have a micro clot that would not show up on the ultrasound that could interfere with the circulation in my arm but there wasn’t any way to know for sure.  If a micro clot is present though, the anti-coagulant would help with that.  It is possible the treatment could actually help the swelling but I am assuming it won’t.  The priority is just ensuring that I don’t get a more serious blood clot.

I told him that I had been on Fragmin last year for a few months and while it wasn’t horrible I wasn’t excited to have to go back to daily injections – it sure adds to my respect for diabetics that have to do multiple injections a day forever.  There are pill anti-coagulants but the pharmacist thought that the LMWH would be better for now.  With all of my treatments drug interactions can be an issue and the pills apparently tend to have more drug interactions.  Plus, because their efficacy can not be easily tracked with blood tests interactions can be a real problem.  So…….back onto the injectable LMWH I go.

I am now on tinzaparin (trade name Innohep).  Yet again, thank goodness for extended health, as it turns out that last November BC Pharmacare decided they were over budget and have decided to not cover the cost of these drugs for most patients.  Hmmmmm……… we are just about to have the BC budget come down.  It is an election year and apparently the treasury has at least a spare billion dollars from the property transfer tax.  What are the odds we get either a tax break or a cheque in the mail but anticoagulants will continue to not be covered?  I guess this is another sign that we could use a national drug plan in Canada.

Before I left the clinic I was booked in for the following week to make sure I was surviving on the injections.  I also have to get my platelets checked to make sure I don’t get Heparin induced thrombocytopenia (low platelets from antibodies that form due to the heparin.  The antibodies cause the platelets to activate and clump…….basically the exact opposite of what we want to have happen.)

Then it was off to the outpatient pharmacy to pick up my anticoagulants.  Ten syringes per box so 3 boxes.  I could have picked up 3 months worth but I know extended health plans often are resistant to covering more than a month at a time.  Kinda makes sense when the drug is $300 a month.  My arm could miraculously recover so after 2 months I don’t need the drug any more.  That would be $300 wasted on the 3rd month I don’t use.

And lucky me they just gave me a sharps container.  Plus, I already have alcohol swabs and little bandaids left from last year so I was good to go.  The pharmacy tech that was helping me asked if I needed any instructions on how to do the injections I said no, I had done it a lot last year between Neupogen and Fragmin.  She laughed and said she thought I looked familiar from when I was on Neupogen.

I did my first injection a couple hours after I got home.  It didn’t sting at all like the Fragmin used to.  Although I found where I injected could play into whether or not there was any pain.  Day 2 was also pain free so I’m optimistic I will survive 😝  The next trick will be trying to not bruise too much.  Fortunately my balance is better than it was last summer so I haven’t been randomly falling down.  I still stumble regularly but I am able to catch myself.  And when I stand up I still veer randomly like I just got off a year long ocean voyage but overall my balance is good enough.

Just long this post is now long enough.  I’ll be back later…..

 

 

 

6 thoughts on “Yippee, Anti-Coagulants

  1. The fluorescent thong is permanently etched! You must be repressing the fluorescent pink thong on parade the next time we went back πŸ˜€ 😘

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  2. I hear your pain and marvel at your strength. The fluorescent thong is a scary image. Glad I didn’t see it 😲
    Thinking of you 🌹🍁🌷Barb

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  3. Sounds like you were talking to Dr Reg Smith. He is a fixture around RJH ( a well regarded fixture that is). The fluorescent green thong is a terrible but funny visual!

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