Status Update on Vanessa

Family and friends:

We are almost 48 hours into this situation and I am just now taking the time to provide an update on Vanessa’s condition. There has been a lot of interest from family and friends so it seemed that posting something might be a good way to provide a status update.

For those in a hurry, here’s the deal:

--Vanessa developed blood clots which traveled to her lungs
--We are hopeful that she will make a complete recovery
--We are hopeful she will be released sometime on Sunday
--Our family has been blessed in many ways thanks to God’s love and mercy, and thanks to the faith and prayers of loved ones like you.

For those interested in more detail, here it goes.

Vanessa began experiencing acute pain on Monday of this week in her chest and back. By Wednesday, we were feeling she should see a physician. In discussing symptoms with physicians at work, we were advised to bring her directly to an emergency department. That was really good advice, though I am not sure I could have kept Vanessa away from the ER as her pain escalated. Once admitted, she received an EKG to assess heart function and a CT scan with contrast (meaning she was given an IV that allowed for better imaging). The scan was of her chest. It revealed a bilateral pulmonary embolism, a cluster of blood clots in each lung in the lower part of the lungs. I guess all that chain smoking is finally catching up with the old girl.

The acute pain she was experiencing is explained by the reaction of her lungs to the absence of blood flow. The doctors called this a pulmonary infarction. Similar to the way a heart attack is a myocardial infarction, a pulmonary infarction is a “lung” attack.

Her blood was also drawn in the first hours. Blood work can reveal some causes of clotting, and there is a scary list of conditions that can cause it such as cancer, heart malfunctions, diabetes, too much Neil Diamond, extended periods of stasis (immobilization due to travel, etc), and genetic irregularities. Thankfully, all the tests for which we have received results were normal. The genetic tests were sent away and results should be back early next week.

Apparently, most clots begin in the legs or abdomen because blood flow can sometimes be slower there. From there, the clot can travel through the veins to the heart and on to the lungs where it becomes oxygenated. Many patients with clotting have swelling or pain in the legs or ankles where clots originate. Vanessa never had those symptoms, and an ultrasound of her legs suggested no clots there now. The attending physician believes that there are not any additional clots somewhere in her body on the way to her lungs. I don’t know how he could be very certain of this. He also believes that there is a very, very low likelihood that one of the clots in her lungs could travel to the brain.

Regardless of whether all the clots have been found, I believe the treatment plan is the same. Vanessa began receiving Lovenox injections (blood thinner) twice per day on Wednesday. On Thursday, they began a once per day pill called Coumadin (also a blood thinner). Once the Coumadin begins taking effect, the injections will stop. The blood thinners require careful management, as too much can cause internal bleeding and too little will not stabilize the clots.

We learned that the medicine does not dissolve the clots, our amazing bodies can break down and dissolve the clots. The medicine, when dosed correctly, prevents additional platelets from flocking to the clot and expanding it. The body’s dissolving process can take place over a few week period when the medicine is dosed correctly. Then, based upon the original reason for the clotting, the medication will continue for 3-6 months or longer, possibly for life. The genetic blood test may shed light here. Though the idea of lifetime medication is sobering, this particular medication does not appear to have undesirable side effects (nausea, weight gain, elongation of the ear lobes). Interestingly, vitamin k acts contrary to the blood thinners so Vanessa will have to be avoid green leafy vegetables, especially dark green veggies like broccoli, spinach for a time.

The doctors feel that it is possible and even likely that Vanessa could make a complete recovery from this. The focus right now is to get the pain under control and to get the blood thinner up and working. We are being told that Sunday is a possibility for coming home if both these goals can be achieved.

Vanessa is comical and even cute on the painkiller medication, though our conversations are not what they used to be. Last night she fell asleep in the middle of putting her hair back behind her ear. There she was, asleep with her hand elevated resting by her ear. At times, she mixes dreams with reality. She asked me recently if the port authority got a new scripture case, and on another occasion, if the purpose of the hospital was to stabilize the carrots. Tough questions, I have to admit. She is coherent a lot of the time, but given the situation, visits from friends are probably going to go better once she is home rather than while she is in the hospital. In the meantime, I want to say how humbled and grateful we both are for the many prayers on Vanessa’s behalf that we feel. We have great peace with the situation and the prospect of recovery. Though God’s ways are not always the ways of man, there is great love and purpose in life’s experiences, including our trials.