Big Oops

[Gnusgal]

I made a big boo boo last night that I discovered this morning. I forgot to take my night time meds! (coumadin, lasix, vasotec) I discovered it this morning because my morning meds weren't set up (I always take my night meds and set out the next morning's for some reason, I guess this is it). I took my coumadin and vasotec as soon as I noticed it, but it is still 8-9 hours late. I know this is going to completely screw up my INR. I'm having it checked today, which I know it won't show up on, but should I have it checked Monday? Also, do I take my meds at my regular time tonight??? I'm going to call my card's office (need to ask some other questions too), but I thought I'd ask the "experts" since she's not as knowledgable about coumadin as our wonderful Al.

Also, I am being EXTREEMLY forgetful. Yesterday and today I have had a very hard time remembering things. For example, I am on a loop recorder, and I know I pushed the button three times. I remember the first and third with no problems. But for some reason I'm a bit hazy on the second one. I THINK I was climbing the ladder to our light booth, but for the life of me I can't think of when or why (I usually have students do it so I don't have to climb the ladder). Then, of course, there's the medicine thing which I haven't done in a REALLY LONG time. My mind is always a little gone, but it seems to have taken a long distance vacation or something!

The thing is, the third time I pressed the loop recorder's button, it was because my right arm (which is left to all you "normal" people--my insides are backwards) went numb. Down part of my forearm and into my pinkie. Completely numb. I couldn't feel anything except some pressure in my pinkie. It's back to normal now, but this isn't the first time it has happened either. I'm hoping it's something like a pinched nerve, and not a sign of a TIA, but I will mention it to the card today.

Thanks for letting me vent a bit. I appreciate you all!

 

[hensylee]

Glad I checked in here - I forgot my meds this morning! Friday is the day I fill the little box for the week and I just slam forgot. Thanks for the reminder. Sorry you forgot, too.

 

[Guest]

The instructions usually say not to play catch up. But, I think this applies to forgetting for longer than 8 or 9 hours. I think that you did the right thing. I would take my meds at the regular time tonight. You may have an INR that is a little high for a few hours but that is far better than having one that is low.

 

[McCln]

Gnusgal

Gnusgal

Perhaps you should purchase a smal pill box that has am on one side and pm on the other. It is what I use everyday. It helps. Or you could bet one of those pill boxes that tells you the time it is to take your meds. Anything to help I had a hard time with my morning meds when I first started taking them. When I got what I use now, it works like a charm. All I have to worry about is making sure I get up early on the weekends on time to take the meds. You take care and you will work out something.

Caroline
09-13-01
Aortic valve replacement
St. Jude's valve

 

[Gnusgal]

Caroline, thanks for the suggestion. I really don't usually have a problem remembering my meds. I don't know WHAT happened Thursday night. I always take out my contacts, take my meds and set out the next mornings (in my pill splitter), brush my teeth, then get dressed for bed. It's my routine. Unfortunately, I skipped a step for some unknown reason. I've been taking meds ALL my life (well, at least since I was 7) and occasionally I have a problem with remembering but it had been a VERY LONG time since that had happened, and certainly not since starting on coumadin. Guess I was just too tired.

I actually ended up in the ER last night. The reason being that I was having speech problems. I would know what words I wanted to say, but not be able to get them out of my mouth. The more frustrated I got, the worse it was. When I called my cardiologist about the coumadin I was a little bit rattled. She could tell from my voice that there was something else going on besides skipping the coumadin. So I gave in and told her. She told me she wanted to talk to my electrophysiologist and would call me right back. I was called back and told to leave for the ER right away. So I had to go to my principal and explain the situation so they could cover my classes for the rest of the day. My principal refused to let me drive to my house where my husband could take me the rest of the way. Instead he had someone drive me home, leaving my car at school. At the ER they did an echo, CT scan, x-ray, EKG, blood work, and I saw a neurologist. All to discover that there was nothing wrong. I hate that. Why is it that I end up in the ER so frequently and it is always nothing. I honestly can't remember one time that I've visited an ER and it's been something. It is so frustrating!!! And now I've wased a half-day sick leave, AND my students didn't get to finish the work they were doing so I could grade them this weekend as progress report grades are due Monday. I HATE HATE HATE this!!!

Sorry. Had to vent. Sometimes I think I may be too well informed. I start noticing symptoms that "might" be something I've heard about, but really it was just stress or my imagination. It's no wonder my insurance hates me.

 

[JimL]

Niki, not being able to talk right sounds serious enough to go to the ER.
I went a few weeks ago. Last summer we bought some Cutco knives from a friend; they are rather sharp. I managed to stick one into my arm, and patched it up with a bandaid.
Later on, it started bleeding again, and wouldn't stop, so I ended up driving to the ER. A woman was there who had cut her hand butchering a deer, and she got five stitches. For my cut, I got super glue. I spent three hours for what I could have done myself.

 

[Guest]

Niki, You may have had a TIA. The body dissolved the clot before they were able to make a diagnosis. Had you not gone to the ER and the body not dissolved the clot, you might not be able to type today. You are much better off with a negative diagnosis. You did not waste your time.

 

[Blanche]

You did the right thing

You did the right thing

Niki - Husband had similar symptoms and would not let me drive him to the emergency room, so I called an ambulance and dusted off the medical power-of-attorney. He was having a TIA. His neurologist said that he must be taken to the emergency room at the first sign of trouble, no matter how small, because he takes coumadin. It must have been very hard to leave your class. But, please know you did the right thing. I will pray that things go more smoothly for you. Do you know of a patron saint for teachers?
Blanche

 

[Nancy]

Niki-

Things like this have to be taken very seriously. No one wants to have to go to the ER because it's truly a super PIA, but valve and heart people just have too many issues to ignore. I agree that you were probably having a TIA. Joe has had about 16 of them, one of them with unintelligible speech. Maybe I've mentioned some of the others to you before, I can't remember, but I'll tell you about them because they might help you recognize what is happening.

This is what he's had, several involving blindness or diminished vision in one or both eyes, stabbing head pain, confusion when trying to accomplish a minor task, falling out of bed, unintelligible speech, dizziness or vertigo, syncope, trouble understanding conversation, general confusion. He has not had any more of these since his mitral valve was repaired.

These are also symptoms of stroke, so you must go to the ER, and you must have someone else drive you there. You will have to be checked out to rule out a stroke, and also to rule out any damage from the TIAs.

I'm very sorry you are having these, they are scary and unpredictable. Make sure your doctor is kept informed of the number and nature of each event, so he/she can address these issues and take the appropriate action.

It's not something caused by stress, in my own opinion.

Please take good care of yourself. Your life is precious.

 

[Gnusgal]

Thanks for all the replies. I'm curious. Do TIAs not show up on CT scans? Because if they don't, I suppose it is still possible I had a TIA, but nothing was abnormal about my CT scan.

However, I got a phone call today from my electrophysiologist. Apparently my echo WAS abnormal. They saw something "floating" around in my ventrical (?) that the tech first thought was a pacing wire, but my pacemaker wires are attatched on the outside of my heart, so that's not what it was. They are unsure about what it is, though. Their guess is either a piece of a valve flapping around uselessly (though I don't know what "piece" that would be?), or a blood clot. I am now taking asprin as well as my coumadin. I will be having a TEE in one week (Oct. 28). This is the date we are shooting for because I don't have to be at work until noon because it is parent conference day (and I certainly don't mind missing all day if I must). The doctor thinks it will be okay to wait until then because I am already on blood thinners and we have added the asprin. But she said that if I had ANY abnormal symptoms to immediately head to her office or the ER.

Why can't life be more simple???

 

[Nancy]

Niki-

The TIAs in Joe's case showed up in none of the tests done. They pass on through the vessel system and then dissolve, I've been told. It's while passing through that they can cause temporary problems.

One of the neurologists that Joe went to was very helpful and explained every one of them, even the part of the brain that they had gone through based on the symptoms.

Joe was on Plavix (in addition to the Coumadin he takes anyway) for a while. He's no longer on that.

Here's a link to the American Heart Association:

http://www.americanheart.org/presen...pper.qt=+&_DARGS=/heartheader.jhtml&x=30&y=14

 

[Vicki448]

Niki,
I am so glad that you did go to the ER and find out what, if anything, was wrong. It's certainly better to be safe than sorry.
I know from the reading of so many posts that I've had such a simple problem as compared to many - mitral valve repair. I'm only taking 81 mg. of aspirin and my only symptom seems to be stress/nervousness/anxiety when I'm out and about. We headed to the fair on Saturday - Dixie Chicks tickets...and on the way I had a panic attack (self-diagnosis from me). I was sitting in the backseat of the truck imagining all kinds of things happening to me while walking at the fair....my head started spinning, I couldn't breathe, I was gasping for breath.....I totally freaked out my husband and daughter.
Once we decided to go home and forget about the money we spent for tickets, I immediately started feeling better. My neck and shoulder muscles ached from holding "my chest up" so my scar doesn't bother me as much. My head barely turns at times and I walk like the Hunchback....and it's all from stress...I know it is...I'm so afraid that something will happen to me since I've had "heart surgery", but I never had heart problems before....just a murmur.......that's now fine, as far as my doctors tell me.
I've gone way off track here, but I just wanted you to know, that as a teacher myself, I know how you feel about leaving school, getting a sub, worried that your kids aren't learning, etc. I chose to ignore going to the heart dr. for all of last school year because I just knew that if something was wrong and I needed to be out, then my kids wouldn't be ready for the TAAS, they wouldn't learn what they needed to know to be successful in 5th grade = in other words, no one could do my job as well as me. That is all well and good, but I know that I put my job before my health....that when I did get around to having myself "checked out" that I wish I'd done it sooner (while I had benefits to cover being at home)....and I now realize that NO JOB is worth putting in front of you and your health. The kids will survive with a sub, the kids will learn in spite of you not being there a day or two....take care of yourself first.......you are Number 1 here on earth.....

 

[John & Joann]

TIA's--valve surgery,etc.

TIA's--valve surgery,etc.

Joann had 1 full blown stroke that did show up on the various tests. She had at least 20 TIA'S (Some observed by doctors at Cleveland Clinic) and they never did show up on any tests.

Joann has no residual effects of the TIA'S. They think that they were caused by the scar tissue that they had to remove to install the new valves. Second and third surgeries are much more difficult and have a higher risk!

30 years, 10 months and still ticking!!
Joann has climbed a High mountain.

God Bless!

John for Joann

 

[Guest]

John & Joann
Good words, as usual.
I still can't shake the cough. "Viral, nothing we can do."
Hope you are well.

 

[Gnusgal]

Well, I now have a TEE scheduled for first thing Monday morning (Oct. 28). Hopefully that will not be too late. Ever since I was told there was something abnormal about my echo I've been completely paranoid. I keep thinking "Is that a symptom, or my overactive anxiety." I have, in the past, had chest pains from anxiety, so it is difficult to tell. And since these started right when I was told by the doctor about the abnormal echo it leads me to believe that it is anxiety. The chest pain isn't intense, just a dull ache really. Feels just like the last time I had anxiety over something "abnormal" found in an echo (that is the echo that led to my VR in June). Please pray that I can last until Monday without going completely crazy.

 

[weekycat]

Niki,

I'm so glad you got yourself to the ER even if it had turned out to be "nothing". I'm not sure that I would have gone with those sypmtoms a year ago, before I knew about any of my health problems...But not being able to think of the right word or not being able to form the right words were symptoms that my sister had. She went to the ER too and had all kinds of tests done and it turned out she had a BRAIN TUMOR! Thankfully she went when she did, and the tumor was removed successfullly. (Unfortunately she's still battling breast cancer though.)

Now don't get me wrong, I'm not suggesting that you have a brain tumor or anything, I'm just trying to point out that sometimes we need to go get checked out even when we think it might be "nothing".

As far as remembering to take meds, when I was on about 6 different ones, after heart surgery, I had a pill box labeled: Breakfast, Lunch, Dinner and Bedtime that I found very helpful. I would refill it every night after taking my coumadin which was in the "bedtime" compartment.
My 5yr old daughter loved to help me with this task and soon knew exactly how many of each pill went where. She also was very good at reminding me, "Mom, did you take your iron pill?' at meal times, or "Don't forget your Coumadin". BTW, she wants to be a heart surgeon when she grow up!

 

[TSH]

Niki,

I have a St. Jude mechanical aortic valve and had a similar episode this past June. The left side of my face and my left arm went numb. At the same time, I experienced double vision. These symptoms lasted for hours.

I too went to the ER and ended up spending a couple of days in the hospital. The usual tests (CT scan, MRI, echo, etc.) were performed, and as in your case, all results were negative. Consequently, all of my docs said that the symptoms were not as a result of a TIA. Later, I even went to see a neurologist at Vanderbilt Medical Center and he agreed that this was likely not a TIA.

My docs seem to think that my symptoms were the result of some sort of bad migraine headache. I do have history of migraines, and they have been worse in the last couple of years. Therefore, that seems to make sense to me.

I don't know if this post is helpful, but I add it so that you know that someone else has experienced the same thing and that other doctors diagnosed it as something other than a TIA. Who knows, maybe mine was a TIA too. But, from what I understand, I don't see how it could be a TIA when all the tests are negative.

 

[Guest]

Gnusgal, When was the last time your INR was below 2.5? How long was it below the desired range? These will help determine your chances that it is a clot adhering to the wall of your heart.

 

[Gnusgal]

Al

Al

It was 2.2 on 10/4 and 2.0 on 10/11 got it back up to 2.7 on 10/13. So it had been low one week before the episode. That is another reason I paid attention when I had my symptoms. At first I'd just chalked it up to a simple "brain fart." I still wonder if that is all it was.

Also, if anyone can shed some light on this new "symptom" I'm having, I'd appreciate it. I don't THINK it is related to my heart or what happened last week, but it is starting to worry me a little. I already called my EP and they don't seem worried about it. What's happening is this: my middle finger on my right hand has been twitching off an on since yesterday morning. I cannot figure out why or what to do to stop it. I'm thinking it is most likely a pinched nerve somewhere in my arm, but it's really getting to bug me. Any suggestions would be nice.

Thanks,

 

[Guest]

I have no idea about the finger.

It does not seem very likely that a clot would have formed from your INR being only 2.2 and for a short period of time. Possible but not likely.