Yesterday, Carlos had a minor episode of bleeding from a place you wouldn't expect to see blood from. We did mention it when at the clinic and it was no surprise that his INR was a bit high at 3.3 or thereabouts. But his hemoglobin was good at 9.6. So they decided to watch it.
Unbeknownst to me it happened again this morning, slightly worse. Then he started experiencing dizziness about lunch time. This happened a couple times, where I was worried he might hit the floor. We called the VAD clinic and spoke to one of the coordinators, who suggested we come on in.
When we arrived, he had some blood drawn. Then he needed to use the restroom. He was gone quite awhile. But he eventually made it back to me and the wheelchair. He said 'Tiff, it's getting worse'. Sounded like horror movie scary....I knew then, he was destined for a ticket straight to the fourth floor. We got back to the room and met with the ladies from yesterday, Eva RN, and Jennifer PA. He was barely able to stay awake at this point. They looked at his labs...his hemoglobin had dropped to 7.3. This indicated a blood loss of 2 liters in the past 24 hours. I almost fell on the floor. His INR was way high at 4.5. A therapeutic level is between 2 and 3! Shortly after the arrival of Dr Scott, he promptly committed a couple times without warning. No blood in that thank god. Dr Scott left very quickly after that, after confirming that the PA was getting him a bed.
Lots of excitement as we arrived back on the 4th floor in Pod A. It's kinda sad when you know a lot of the staff by name. The GI team came and visited as did the cardio surgeons. The plan was formulated to transfuse packed RBCs and plasma. The plasma would hopefully 'thicken' his blood up a bit so the bleeding would slow or stop enough to possibly do a colonoscopy to determine the source of bleeding. At this point a couple of possible sources were tossed out on the table such as diverticulosis and hemorrhoids but find the source seems to be on the back burner. It seems they want to replenish and slow things first. Will post more tomorrow as things develop. Carlos is very down right now.....partially from the low hemoglobin but also being back in the hospital.