the verdict

well, the wife got her angiogram read by the pulmonologist.
everything is fully resolved!

however, she will remain on Coumadin for another 2 weeks (to make the treatment a full 6 months), just to be safe, then she'll have ultrasounds performed on her legs (to ensure that no clots are hanging out there, either) and if everything is clean we have a decision to make:
the doctor said she can either remain on Coumadin for life (which brings with it a 1% chance of bleeding to death) or she stop taking it (which brings about a 5% of a second clotting event). those percentages are pretty much even, so we really don't know what to do. the doctor, even, couldn't tell us. he said her case is unique in that she had no risk factors, and she was so young, so they'll have to play it by ear.

i think we're going to experiment with taking her off of Coumadin for a few weeks, get some genetic testing done to rule out those rare but serious disorders, then see how it goes.
i suppose the really good news about all of this is that the treatment worked and those massive clots in her lungs (she saw both angiograms -- the first one from 6 months ago and the one from yesterday -- and she said it was shocking how large the clots in her lungs were) are gone.

an update on the wife, and a little poetics

well, we've been having a bitch of time getting the wife the xray for her chest (actually, an CT angiogram, to be precise). Monday, we went in and it turns out we were supposed to have an appointment, yet were never told to set one up. so, we drove all the way to the hospital for nothing. fine, whatever. the doctor's appointment (to have the angiogram read) was also that day, so that had to be rescheduled. we set up a an appointment for the angiogram for yesterday (Friday) and the doctor's appointment for the reading for next Monday. yesterday, we go in and the nurses (3 different ones) were unable to tap a vein in Julee's arm. she has 5 pricks on each elbow pit and one on the underside of her right forearm. and, since she's on bloodthinners, they are bruised like she's some kind of heroin addict. she had to stop because it was hurting her so much. so, no dice on the angiogram once again.
she set up another appointment for Monday morning, then that afternoon (assuming all goes well) she will have the damn things read and we'll know where we stand. her veins are deep and she's always had a hard time when she tried to give blood, but this was ridiculous. anyway, we're hoping Monday will be different.

i just found out from Eric Dejaeger that he has uploaded my poem six pack and his translation of it here. i still haven't received my copies of the book Eric released. i'm afraid they have been lost in the mail.

for what are we paying?

my wife is required to get her blood thinning levels (known as an International Normalize Ratio; or an INR) checked every so often. She has been on Coumadin for six weeks now (with four and a half months to go, at least) and in the beginning her levels will fluctuate as the doctors try to pinpoint the correct dosage for her body chemistry and eating habits (certain foods can counteract the effectivity of Coumadin).

a therapeutic INR level is between 2.0 and 3.0 (where a 1.0 is "normal"). she has gone to the clinic weekly to get it checked out, and it's fluctuated rather wildly. it rose up to 3.7 three weeks ago, whereupon her dose was adjusted. it dropped the subsequent week to 2.4 (just about where she needs to be) and was told to come back in two weeks. being the vigilant and intelligent girl she is, she went back the next week (just last week) surmising that without an adjustment it is likely her INR had continued to plummet.
it had dropped to 2.0.
then, the doctor told her to come back in a month without adjusting her dosage! A MONTH! he obviously didn't review her chart, or the trend of her levels, or anything like that. anything BELOW a 2.0 and she is at risk to have another clot. jesus h. christ!

well, my vigilant and intelligent wife KNEW a month wasn't right as her levels had been steadily dropping, and who was to say it plateaued at 2.0? she went back this week to get it tested and lo and behold! it was at 1.6! well below the therapeutic level. if my wife wasn't vigilant and intelligent, she would've been walking around with an increased chance of having another thrombic episode, and we would've been through the same hell we just went through six weeks ago.

so, my question is this: what the hell are we paying this guy for, exactly?
insight? no.
concern? no.
expertise? no.
incomptence? apparently.
apathy? definitely!

i can tell you this, we will no longer be paying him a dime. we're looking for another clinic that can handle the workload; with doctors who care, understand trends, and with the time (or ethics) to do their job right.

and all of this now reminds me of a little joke:
Q. what do call a person who graduates last in his class in medical school?
A. doctor.

it appears we found ourselves such a guy.