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Wednesday, November 3, 2010

There But For The Grace Of G-d...

I'll call him Murray, although that's not his real name. He's about my age and he attends the same shul as my brother-in-law, Dave. He got sick about the same time as I did. The similarities were uncanny: he had pneumonia, I had pneumonia (different strains). He went to Cornell, I went to Columbia. He was on a vent, I was on a vent. We were discharged from our respective hospitals around the same time. He went to Rusk for physical therapy, I went to Silver Lake. Once again, we were discharged almost on the same day. We'd both been making slow progress since we got home. I don't know what other meds Murray was on, but I know that we were both taking Coumadin. I'm not sure why he was taking it. I was taking it because of my A-Fib episode. The way I understand it is that once you've had A-Fib, you have a higher propensity to develop a blood clot which in turn can then travel to your brain and then you're in big trouble. I was happy that Murray's recovery seemed to be going smoothly; I don't really know him very well but he seems like a nice enough fellow. Then suddenly about a month or two ago, Murray suffered a massive stroke. Bam! Just like that. Dave didn't even want to tell me. I can understand why; the news shook me to the core. When it happened, I was just beginning to believe that I might actually recover. It took me a long time to get there. I saw in Murray's progress positive signs for myself, as in "hey, if he's gonna be okay, maybe so will I". Then he goes and ruins it all by getting sick all over again. I happened to have an appointment with Dr. Katzenelenbogen that week, so I asked him if he knew Murray. Dr. K. is a special guy. He's not supposed to discuss other patients with anyone, HIPAA laws and all that. He knew, however, that this was important to me. Without commenting directly on their relationship, he assured me that he had heard about what had happened and was very upset about it. I asked, "isn't Coumadin supposed to prevent stuff like this?" His answer, I believe, was intended to help me face a sobering reality: "There's no such thing as 'prevent'" he said, "all you can do is cut down on risk and hope for the best." The answer was quite jarring, to be sure. Am I going to have to live in the shadow of a stroke for the rest of my life? I went to see Dr. Plawes today. As my cardiologist, he has the final word on how long I stay on the Coumadin. He told me that all things considered (I've only had one A-Fib episode, my cardiogram was normal and my lungs were clear), my risk of stroke was minimal. He and Dr. K. conferred by phone. Dr. Plawes wanted me on aspirin. Dr. K. vetoed that because of my history of gastrointestinal bleeding (boy, am I a mess!). So they compromised on Plavix. I haven't started taking it yet but it's waaaaay less toxic than Coumadin. No more mystery hematomas. No more worrying about cutting myself and bleeding to death. Plavix is one of the most prescribed medications in the world. Good riddance, rat poison!

PS As of this writing, Murray is in rehab and is making progress walking, but is still having trouble with his speech and cognition. Refuah Shelaimoh*, Murray; we're all pulling (and praying) for you!

*Refuah Shelaimoh = very freely translated: get well soon!

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