INR

The needles go on, and on, and…

Advanced Prostate Cancer, blood thinners, David Emerson, INR, Lovenox, Wafarin -

My Oncologist’s Physician’s Assistant called yesterday afternoon with the results of Monday’s blood test.
When it was her, I knew it wasn’t good, as the nurse usually calls.
After increasing the blood thinner dosage to 12.5mg three days a week and 10mg the other four, she had the results. My INR was DOWN from 1.8 to 1.5! WHAT?!!!
She had spoken with Dr. V and he was concerned that perhaps the study drug (Atrasentan) was interfering with the INR number. The short story is this, I could increase the Wafarin yet again, or just suck it up and use the Lovenox exclusively (Lovenox is the thinner I have been self injecting since the clot was discovered in early August).
The choice was easy. I was already getting a little concerned about the large amounts of Wafarin I was taking and going to 12.5mg a day, everyday was not a guarantee that my INR number would ever get to 2.0.
So, just like every morning for the past seven weeks, I got up this morning and stabbed myself in the belly. I’m already bruised from side to side. I can’t imagine how my stomach will look after four more months of this daily ritual!
OK, so the whining about this is over…it’s just another bump in the road!

Some good, some not so good

Advanced Prostate Cancer, chemotherapy, David Emerson, INR, white blood cell count -

What a whirlwind day yesterday was.

First, I barely slept Monday night. I would guess I got about 4-5 hours of sleep. Most of it was tossing and turning. Must have been the Dex!
My treatment appointment was at 1:00pm. We usually do mornings but with the holiday we had little choice. Morning avoid delay and backlog…..afternoon appointment tend to get you want we got. I checked in at 1:00pm and just before 2:00p, I was called back to have my blood drawn for lab work (PSA, CBC panel, INR all the good stuff!).
The phlebotomist says “I can’t believe you checked in at one and they just gave me your paperwork. We’ve just been back here catching up on paper work and refilling supply cabinets”. I don’t believe you could describe the look on my face as a smile.
So, needless to say that was followed with a meeting with Dr. V’s Physician Assistant. All went well there. She did review the radiology report from Friday’s bone scan. “No new areas, all existing areas (i.e. tumors) are stable and show no uptake”. She did not have my INR or PSA but my CBC showed my WBC had fully recovered and was actually a little high. She said it can indicate that I am fighting an infection but after further discussion and a re-cap of my activities over the last two weekends she was confident I am not. I shared with her the lovely bruising across my stomach (from the Lovenox shots) and expressed my desire to get off them ASAP. No such luck as I’ll share later.
After this we went up to treatment. This takes about two hours with all the preparation, pre-treatment medications and then one hour of Taxotere. Mary was catching up on work, I watched most of the movie “Sideways” on my iPod [great movie!]. As the time was approaching 5:00pm Mary went back down stairs to get my lab results.
PSA – 41.36
INR – 1.6
The PSA was ‘stable’ using her words. The increase was just 1.38. As others have described this is ‘statistically insignificant’. Whatever! We had pinned our hopes on another decrease, but oh well, we looked forward to the next test on the 22nd.
As for the INR (test for blood thinner to deal with blood clot in leg). They want this number to be over two. After almost four weeks we obviously are not there yet. They upped the dosage of Coumadin but I have to continue the shots. I am getting REALLY tired of poking myself with a needle each morning. I mean REALLY tired! I think I do a pretty good job of not complaining or whining here, give me a little slack for once….this just plain sucks! So it’s back to Walgreen’s to get a new stock of needles!
The good news at the end of the day is last night, after all the Dex that I took and that they pumped into me I actually got some sleep! It was not complete or without interruptions, but it wasn’t the standard night after treatment when I am awake from 1-5am! The silver lining, well perhaps bronze but I’m not complaining!
And so the saga continues…..