May 17, 2003
Had my first visit to the Coumadin Clinic at two yesterday. Had several disturbing realizations: For the two week period of my outpatient shots, they drew blood almost daily in vials (“wine decanters” is the term I used when describing this to Kathy) and then it took an hour to get my PT results. At the clinic yesterday they pin-pricked my finger, fed the miniscule drop of blood into a portable mouse looking deal and the results came up in three seconds. All that wasted time and blood!

The coumadin nurse also asked me if I was taking Aspirin. “No,” I told him. “The nurses at 3C told me to avoid Aspirin because it counter-acts the coumadin.” The coumadin nurse shook his head as if to say, “I don’t know where you got that Stone Age advice.” He told me they love Aspirin at the Coumadin Clinic and believe it affects different blood platelettes than the coumadin and they recommend taking three Aspirin a day. Ay-yi-yi! I don’t expect everyone to be on the same page, but being on the same chapter might be helpful.

Other oddities I didn’t enjoy hearing: My chronic 1.19 scores were a “probable” sign that the coumadin was just passing through my body (a person who is not on coumadin will score from 0 to 1.20). When the nurse asked me about my diet I told him I was eating more vegetables and that elicited his by now familiar “Tsk, tsk,” and he went on to say that was “probably” why my coumadin scores stayed so low. To which I said, “Well let me see if I’ve got this straight. My regular doctor says I’ve got to eat more vegetables or I’ll die of a blood clot, but you say if I eat more vegetables I’ll counteract the coumadin and die of a blood clot.” The nurse pretended not to hear this and continued his “silly boy” looks.

Other delightful news: when I told the nurse that my regular doctor increased my dosage of coumadin up to 12.5 mg. a day, the nurse said, “I have never heard of a dosage that high in my entire career.” Which prompted me to ask, “Are you saying that is a dangerous dosage?” He mulled this question for a long time (no doubt picturing himself on the witness stand trying to defend his answer) and finally said, “That is a very large dosage.”

That did it. I just snapped and jumped off the examining table and rammed my open hand against his throat, pinning him against the far wall. Vials of drugs and syringes were falling everywhere. The receptionist ran in crying, “For God’s sake don’t kill him! He’s just trying to protect the doctor who’s out golfing!” But it was too late and I broke his neck and left him in a broken heap on the cold, sterile floor. Then I went out to the waiting room and grabbed up the True West I had planted on the coffee table. I shook it at the quivering office staff hiding behind the receptionist's glass window, saying as I went out the door, “Don’t expect anymore free issues!”

Actually I smiled and thanked him for being so “forthcoming.”

"It is impossible to defeat an ignorant man in argument."
—William G. McAdoo