Monday, January 5, 2009

Ummm...change of plans

So we had a little unexpected turn of events today. The end result...we are home, but it was a long day to say the least.
Here's a little background to the story of the day. Olivia is on coumadin because of her artificial mitral valve. This is a blood thinner. We monitor her "INR" regularly to make sure it falls into the range of 2.5-3.5. The INR dictates what dose of coumadin she gets on a daily basis. We originally went to the hospital here in Macomb, but they test differently and her INR was always coming back high. So, that's when we switched to Peoria for all labs. We had received a home machine to test her INR way back when, but it never worked with her blood for some reason. So Saturday we got a new machine. In anticipation of her going to Peoria for her INR check, I wanted to make sure I knew how to work it before trying to calibrate it with the lab.
Fast forward to last night. I check her INR and get a reading of "greater than 7.5" At first I'm ecstatic that it actually popped back a number. That was a first for us! However, that's obviously too high.
Is it accurate?
I decide to test my own INR and get .9 which is great for a person not on a blood thinner.
What to do, what to do?
I call our pediatrician. We brainstorm. Is has to be off. We decide to watch for any signs of bleeding and definitely get the INR drawn this morning.
I then wake up feeling icky and Olivia had been sick in the middle of the night, so I'm not going to drag her to Peoria. We'll give Macomb another try with the expectation of it being a little off kilter.
Her INR is reading at 16.something. Whoa!
"Head to Peoria. We'll have to admit her"
So, Zac forbids me to go, since I'm feeling icky. I tell him he's crazy and we head to Peoria. The cardiologist doesn't want to jump the gun on this, so we have Peoria re-draw the lab. As blessed as we are to have a big hospital with exceptional care close by, it sure does take a ridiculous amount of time to get through the process of having someone draw a lab.
Anywho...Dr. S. pops in and says if her INR is less than 10, we'll just watch her closely. If it over 10, she need some fresh plasma.
Luckily, Dr. S. is awesome and let us come home this evening and skip the plasma. We are watching her very closely for any bleeding from anywhere. The concern is, if she were to start bleeding, she wouldn't stop. We've stopped the coumadin until further notice and will head back to Peoria tomorrow morning for another INR test. We're praying for a lower one!
Oh, could you please pray for some more pee, too. She's only gone twice today and that's not meeting her quota. Just something else to add to the list.
Okay. I guess this turned into a really long post or a lecture on coumadin therapy, for that matter. Have a good night!


Lynn Lotz said...

We will pray that you don't get sick, Olivia doesn't bleed, and Olivia does pee!

Anonymous said...

Oh, Julie!!!!!!!!!!! We will be PRAYING!
Jen Weber

Judy said...

That girl of yours! I tell you, it's never a dull moment with her! I hope you're feeling better and that you can get a good night sleep! Praying for Olivia!

Crystal Montgomery said...

I'm suprised they didn't give Olivia some fluids too. It would make sense that her medicine's concentration is higher if she is dehydrated. Simple dehydration can make everything go out of whack with a medically fragile child :( I will certainly pray for healing for both of you.