325) Big Bad Bloody Nose

February 5, 2009

Bad morning so far. Woke up at 6 am with a bloody nose that didn't stop until about 9:15.
At times it was pouring like a faucet, at times dripping either down my throat or out my nose, depending upon which way my head was tilting. Right now it is not bleeding but still dripping clearish liquid from all the Neo-synephrine I've shot up there... and I have an appt with Dr. Leary my Nose Guy at 1:45. He will sit me down in his chair, look up in there and say, "Ah yes. I see a small point that we should zap." and then will laser it and I'll be done in about 10 minutes and it'll cost $30 on my insurance. I appreciate Dr. Leary and his nurse for always being able to get me in the same day I have one of these BN's that I consider "bad". All this is due to my "not so bad" case of HHT which causes my regular but not-so-serious nosebleeds. Every so often I get a 'bad one' and whenever the 'bad ones' become frequent I call my Nose Guy for a zap... today is the day.

My mom also had HHT and I recall her nosebleeds taking her completely out of the scene at times when I was still living with my parents. Mine didn't really develop until I was in my forties, but they have progressed since then. My daughter Shayna seems to have the same HHT, which can be signaled by spontaneous nosebleeds for no apparent reason.

Before 9:30 it has started again... more squirts, lay back, try all the tricks I know to stop it... and nothing is doing much today. I call the office and tell them I won't be in til I see Leary, and maybe not then...

I get to Leary's office right at 1:45 and again it has pretty much stopped. I read on my MI book, borrowing a highlighter from the secretary. Pay my co-pay and wait. Since Betty his Nurse has slipped me in between folks who have appointments, it takes about 20 minutes or so before I get in. He comes in and I describe the morning and how I have already arranged for a Blood Count when I get to El Milagro, and that they have been saying my count is 'somewhat low' but I don't know the numbers. He has Betty call over there and fax my numbers so he can check them out. Then he looks up both my nostrils (non bloody one first) and says, "There's some sign of recent scabbing up here." and moves over to the other one and checks it out, saying something like, "Evidence of bleeding in the general area of past problems". He says he wants to get the info from the dialysis center, and then he squirts me with some deadener and lets me sit for awhile while he starts with another patient.

I sit, feeling quite spent... in fact, I think to myself, "If I could get this chair to lay back, I'd take a nap." He returns with a fax showing that my blood count was in the 12s in November, the 10s in December and is now down to the 9s at the end of January. His take is that it looks like my end stage kidney problem is lowering my count over time and it makes sense they are giving me more Epogen, but he also warned that I should tell the nurse to cut back on my Heparin if possible, since Heparin thins the blood and my nose bleed today doesn't need to be restarted at dialysis. He lasered my nose, packed my nose with some disolvable stuff, and let me go. By the time I was driving south to El Milagro, my nose was dripping some diluted blood.

El Milagro: I arrived almost on time and Joseph the Tech stuck me and took a tube of blood, which I gave him a card with Leary's fax number to pass on to the lab. I called Jo the Nurse over and while she did my nursing eval I caught her up on the doctor's visit and his recommendation to cut the Heparin if possible. She nodded in agreement and put a sticker on my machine warning all other staff to not give Heparin. Rosie the Tech was curious later when she came by, so I explained to her too.

By the time I was all set up I had inadvertently sucked some of the packing back thru my nose and from that time on until I left, my nose dribbled back down my throat, although frequent testing of the discharge into kleenex made me feel okay, since it was very light, watery blood, rather than the 100% variety I had in the morning. I wonder, as I am sitting there exactly how much blood I lost today.... enough to move thru my stomach and intestines.... enough to make me feel shaky and have tingly fingers in the morning... and enough to put me to sleep for a long snooze right now.

I wake up and watch an AMC movie about a woman who gets pregnant by a GI in WWII... quite a risky subject in the 40's with Betty Hutton and it's a Comedy, to boot. By the time it is over I have had my first few laughs of the day... and am ready to go home and turn in. What a day.

Notes: In at 78.3 and out at 76.0

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