Saturday, April 18, 2009

The Need to Bleed

Every Tuesday or Wednesday my wife drives me to a blood-lab over behind Tri-City Hospital where one of several phlebotomists accepts my donation, usually about two ounces but periodically the amount will be twice as much. Sometimes it is significantly more.

One of the drugs I'm taking reduces the blood's clotting time, a precaution against the formation of blood clots. Unfortunately, the drug also prevents the needle's tiny puncture wound from healing as quickly as it should, so that some blood escapes through the hole into the space between the vein and my skin.

The size of the needle determines how quickly the sample can be taken. Most of the time they use a tiny needle, something so small you can barely feel it. But a tiny needle means a tiny amount of flow and when several samples are needed they generally use a larger needle.

It's all relative, of course. All of the needles are tiny. Indeed, it is remarkable that they are hollow. Or that blood, that thick, dark juice, flows through them at all. But sometimes the hole does not close itself up and blood seeps out of the vein into the space under my skin, leaving a purple rose that may persist for as long as two weeks.

After each blood test the lab sends me a copy of the results which I enter into a suit of software obtained from the International Multiple Myeloma Foundation. The physician requesting the test also receives a copy but in a different format. The software I'm using gives me a series of charts that makes any change graphically evident. The nurses and nurse-practitioners also have access to the results. They are common topics of conversation.

I'm presently taking fifteen drugs or mediations. Some inter-act with one-another and those interactions upset the 'scores' from the blood tests. A common chore is to try and achieve a chemically perfect 'score' without causing any harmful side-effects. When that happens it is considered Good News and the phones start to ring, as thy did this past Friday.

This particular 'score' has been difficult to nail down. Each time we got close it triggered an undesireable interaction. When that happened we would have to go back to the drugs; to tinker with their frequency and amount, then work our way back to a mix of drugs that gave stable results. The results from last week's blood test were 'clean' -- the desired score was achieved without any undesireable interaction.

Next week we'll go for the 'big' test, looking for the unwanted interactions among factors we've already nailed-down; among factors we test only once a month rather than once a week. In the meantime we won't talk about it. It has taken ten months to reach this point. Patience is part of our medicine, along with the drugs and the x-rays, MRI scans and all the rest. Patience... and not getting our hopes up.

-R.S.Hoover
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