Back to the Mayo

So Carlos has been doing well at home aside from minor issues.  They managed to get his INR therapeutic two lab draws in a row!  That was just in time to stop the coumadin in preparation for this admission.  He's had some fluid status issues, as well, so they have been playing around with his lasix dose also.

So this is the hospital admission to re- begins this evening.  check his colonoscopy.  They need to follow up on the area that was ischemic (poorly oxygenated area) and check out a possible polyp that was mentioned in the previous pathology report.  If everything is good, then he will be reactivated on the waiting list for transplant.

It sucks that they can't do this outpatient.  Such is the life of an LVAD patient - nothing is ever simple any more.  He has to have a heparin bridge, which is where he stops the coumadin a couple days prior, gets an IV (which they have attempted to start three times thus far without success - waiting now for the PICC nurse to come have a stab...haha), and gets heparin to keep him anticoagulated until the procedure is done.  Heparin is very short acting so this enables him to keep his blood thinned until the last possible moment.  If you recall, the risk of developing blood clots in his pump is high if not adequately anticoagulated.  Then those clots can break off and pinball around his body, potentially leaving him a drooling idiot.  While part of that equation is in effect already, I cannot handle drooling....haha, jk.

Carlos enjoyed a lovely gourmet liquid lunch.  His enthusiam was very overwhelming.  Not.  The Golytely prep begins this evening. You can imagine how excited he is for that. My chat with him about maintaining a positive attitude during this hospitalization quickly was forgotten by the second IV attempt. The PICC nurse just showed up to give it a try. Will update tomorrow.