The Invisible Black Woman

Whew! It’s late, but I made it, and the streak continues! Next episode below, hot off the press.

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If you guessed that we wound up in a room with another patient, you’d be right. Hubby was smart to taper his expectations. Honestly, it wasn’t even that having a roommate was bad in and of itself. It was the type of roommate he wound up with. It was going to be a long haul for the time we were there.

Anyone who’s ever stayed in a hospital room that isn’t private knows the only thing the flimsy curtain is good for is giving you physical privacy. Besides that, you can hear everything: conversations, the TV that was louder than it needed to be competing against the videos being watched on what I could only guess was a mobile phone, even the sound of a monitor beeping obnoxiously because his roomate had taken the sensor off. But that wasn’t even the worst part. It was the constant, non-stop bickering between the patient and his partner. They argued about everything under the sun: who didn’t bring what, how long they’d been stuck in this hospital, and the latest—the patient’s lack of interest in sticking to the health regimen that would keep this from being a long-term stay, or a near-immediate return when he did get out.

I couldn’t believe it. Here we were, having gone through this whirlwind of a day, making sure we were doing everything possible to ensure hubby was on track, and this man was actively choosing not to take the treatment that could save his life. My husband and I exchanged a look and shook our heads, silently thanking the universe that, despite everything, we were on the same page.

A few minutes after that, there was a flurry of activity by the door. A woman in a white coat walked in, followed by a group of what I assume were residents who looked like they were barely out of college. The white coat had “Doctor” written all over it.

“Hi, I’m Dr. Petrovic,” she said, her accent thick, sounding almost like Petra from my assessment days. “I’m here with my team to check on you. How are you feeling, today?”

“I’m feeling okay, just tired. “

“That’s understandable after yesterday. Are you experiencing any chest pain?”

“No, no chest pain,” he replied.

“So, you’ve had two more procedures done, right?”

“I was supposed to have them later in September, but I stopped taking the medicine before the first one, early this month. That’s when I got a lot worse.”

“Mm-hmm. When they were evaluating you before and after the procedures, they must’ve done an ultrasound, right?”

“Yeah, they did one the day after and checked.”

“Got it. And there were no clots at that time?”

“There were none.”

“Understood. So, how are you feeling after the ablation?”

That’s the procedure he had done that kicked everything off. If you concluded that there is no way in hell he was going to have the other two done, you’d be right. Juice wasn’t worth the squeeze on that one, AT ALL.

“It’s better, yeah.”

I threw in my two cents on that one: “The swelling was definitely better. Before that, his leg was almost twice the size of the other one.”

“That’s good. But you mentioned he started having symptoms similar to the first time he had the PE?”

PE was a lot simpler to say than pulmonary embolism. Plus it definitely sounded a bit more fun, like gym.

“Yeah, exactly.”

“Given your history, now this being the second time, you’re essentially in for lifelong anticoagulation, as long as you can tolerate it. Hopefully, you will—many people do. It’s much easier now with newer medications. You’ve already been on them before, right?”

“Mm-hmm.”

“It still makes sense to get checked by a hematologist to rule out any genetic factors. There are some we can identify, but there are others we just don’t test for yet. Usually, we don’t test for genetic causes in the acute setting, but it might be worth checking later. Even if we find something genetic, from a practical standpoint, you’ll still need to be on blood thinners. The risk is just too high otherwise.”

“Right.”

“There are some lifestyle considerations—you shouldn’t do high-impact sports like hockey, but otherwise, it shouldn’t affect your day-to-day life too much.”

It made me chuckle that she thought my husband was into hockey, but her point was well made.

Hubby smiled too, so at least it lightened up the mood a tad.

“They retrieved a lot of clots, right?”

“Yeah, that’s why I’m feeling much better now.”

“Exactly. Most people are just treated with blood thinners, which prevent new clots but don’t remove the ones already there. We wait for the body to break them down on its own, which can take time. In your case, they retrieved as many as they could, but it’s impossible to get them all. Some clots are still there, and they’ll dissolve over time.”

“Right.”

“The issue is usually either forming too many clots or not breaking them down fast enough. Our bodies naturally produce and break down clots all the time. That’s how we stop bleeding from minor injuries, but when that balance is off, it becomes a problem.”

“So how is he doing now?” I asked.

“He’s doing well, all things considered. He shouldn’t need oxygen anymore, and while it’ll take some time to feel completely normal again, he’s on the right track. I’d recommend following up with a specialist who deals with these types of issues—pulmonary hypertension and blood clots. We have Dr. Singh here at the hospital, or you can go to your usual hospital network if that’s easier for you.”

“Okay.”

“He’s a specialist in pulmonary hypertension and blood clots. If you want, we can set up an appointment with him. Otherwise, your hospital has great specialists too. They’re a big center, so you’ll be in good hands there as well.”

“I think we’ll stick with Dr. Singh for now.”                                     

“Sounds good.”

“You’ll be on apixaban, right? Right now, you’re on 10 milligrams.”

My one pet peeve of care providers is they should do better with using either brand names or stating what the drug is for. Hubby looked a bit puzzled because we’d always known the drug as Eliquis or “the blood thinner.”

“Yeah, I think so?”

“She’s talking about the blood thinners, Babe, the Eliquis—right?”

“Correct, yes, the Eliquis,” she confirmed. When you first develop a clot, we usually give you ten milligrams for the first week, then reduce it to five milligrams, which is the maintenance dose.”

“Got it,” I said.

“Since you had an intervention yesterday, you might still be on injections for now.”

I love how sticking a tube up a person’s femoral artery to suck out clots from the lungs could be boiled down to an “intervention.”

“Yeah, he was getting Lovenox shots,” I added.

“Right, those are temporary until we transition you back to apixaban. It’ll be 10 milligrams for a bit, then down to 5.”

“Okay.”

“We’ll get you set up with Dr. Singh. If you decide to switch to later, you can cancel the appointment, but Dr. Singh can be hard to get into, so we’ll go ahead and schedule it now. Sound good?”

“Yeah, that works. Thanks.”

“No problem. Take care.”

The residents followed her out like a mother hen with her chicks. Out of the corner of my eye, I saw his shoulders slump completely. My heart sank, too. I knew what he was thinking about: “lifelong anticoagulation.” A life sentence of blood thinners. Definitely not what we expected to hear. I guess we were both naïve to think that he’d have to be on blood thinners for a few weeks or months after discharge, tops. Her “foreseeable future” statement all but ruled that out.

He leaned back, looking up at the ceiling as he sank back into the hospital bed, shaking his head as if he was waiting for an answer to the obvious “WHY!?” that was written all over his face.

Still mindful we were in mixed company, he leaned towards me with a lowered voice and said, “my whole life? I’m gonna have to be on these my entire life?”

And just like that, he went from an infrequent visitor to the town I’d lived in all of my adult life to a long-term resident: Chronicville.