May 27, 2006
A fierce south wind blew today carrying the heat of high summer with it. Several mosquitoes came forth for the evening walk, and we said, “That it. . . spring is finished.” I am having a struggle between mind and body. My mind says, “Remission, you should feel wonderful” and my body says, “Eeeuuuwww, chemo, chemo and Coumadin too”. Or at least I think that is what it is saying because I have waves of nausea, tiredness and aching. Today I concluded that I have to sit down and listen to the body because it is too frustrating otherwise.
I am still in the process of getting the correct amount of Coumadin (Wayfarin – blood thinner) into my system. The term “blood thinner” is misleading; one assumes that one takes the medicine and the blood gets thinner, sort of like paint thinner, or adding more water to tomato juice, so that you can imagine the color of the blood getting paler every passing day. “Not so” said the doctor, “the blood does not change, just the manner of making clots.” Some clotting is needed to protect you should your skin be breached, and to keep the blood from seeping right through the walls of the stomach and such, but too much and you get clots in the arteries or vein with nasty repercussions. (i.e., the third of the kidney that got blocked off and died). The blood is tested every few days, in a PT test (Prothrombin time – the time it takes to make a clot). 
Since the results of this test may vary from lab to lab, a ratio called the INR (International normalized ratio) is used. This ratio was developed by the World Health Organization, and means that there is now a standardized measure of Coumadin levels throughout the world. We have a friend in Banda Aceh, Indonesia who gets his Coumadin levels checked at a hospital near there. I have gone from four to five to seven and back to six mgs. There has never been a reason found for the arterial blood clot that occurred a little over a month ago, and this medication apparently will be a part of my life from now on.