A new enemy emerges, a new fight ensues

As Gilda Radner might say, "It's always somethin' " -- and so it is in Neuro Science ICU Unit A. I've fallen silent, as is apparent, since Friday -- first for "technical difficulties" (yes I am a techno-idiot and yes, Taz fixed my dark screen by pecking keys til the screen lit up, monkey-at-typewriter-style).
But about the time I was back in business Saturday, trouble was brewing. Severe swelling in John B's legs was causing concern. Swelling elsewhere had begun to clear up, but the legs -- they were taut and full-looking. The team of docs, nurses, pharmacists and other experts that visit patients every morning huddled over the issue. I asked my usual battery of nosey questions and "played doctor" with wild speculation that turned out to be right.
John B., unfortunately, has developed serious clots that basically fill the central veins in each leg, pretty much from lower abdomen to toes.
As many of you may recall, John had a serious clot "issue" after surgery on his knee in 1990. Then, the clots went to his lungs and he was saved through the valiant efforts of his docs and nurses at the time.
This time around, the emergence of Enemy No. 2 was subtler but a very dangerous thing nonetheless. And, the options are limited. (We thought of giving this new enemy its own name but decided that we wanted the eviction to proceed post haste, leaving no reason to name a character we planned to be rid of soon. Pray our plan holds.)
So, the options and the plan: John has been put on a blood thinner that aims to prevent further clotting and to allow some blood to sneak through and around the blockages to keep circulation in his legs. The issue is that you have to get it just right: too much blood thinner could cause a bleed in his newly sliced and diced head. What's good for the legs is potentially very bad for the head. That means more CT scans to monitor his surgical wounds etc., and very precise use of the anticoagulant.
John was put on a different anticoagulent a day after surgery, but the team (called "intensivists") suspected John had a sort of allergic reaction to that agent (called HIT for Heparin Induced Thrombositopenia, or something like that). The anticoagulant Heparin actually causes, in this case, the very thing it is supposed to prevent. Later tests show he probably didn't have HIT, but taking no chances, a different drug is being used for now. A hematologist has been brought into the club, and he is researching John's twisted history, and plans to come back with further thoughts about what to do.
Likely, it will be some version of what we're already doing: the blood thinner balancing act, and the wait. Because of the surgery, none of the more aggressive clot-busting techniques can be employed. So, you just have to wait and hope John's body gets busy producing the enzymes that normally dissolve clots. They will have lot of work to do.
This is a quieter battle, but feels just as challenging. It has been a tough time, but John B is being his usual steady, gracious self, bending to the task with patience and determination. I didn't think I could admire John more than I already do, but apparently I was wrong.
Perhaps it is no accident that the hospital bed he's jockeying is a Stryker brand. But unlike the Lewis-McChord brigade, John's is pretty much a one-man assault force.
I've enlisted, of course, and John's sister, Mary Jo, arrives from Cincinnati tomorrow to report for duty. And yes I will now, as Carol Ostrom would say, kick that metaphor and make that point!
Thanks to you, dear friends and family, who came yesterday to prop me up and get me through a very bad day. Taz, Robin and Fred, Fred and Charlene, Trish and John, Anne, Ryan, Deb, Steve and Viki, Joe and Cyndi, Megan and Jake, I made it, thanks to you.
Looking ahead, we know we have to take it "one day at a time" (funny how that phrase comes in handy for many things). Nobody's got a timeline for this, and being deadline types, we really, really hate that. It's all part of the frustrating feeling of being unable to do more, control more. I think of the 26 beds occupied tonight in this one small unit of an immense hospital full of people facing challenges of all sorts, and reach a more nuanced understanding of our place on the planet and what it means to try to do the right thing. If there is any blessing in this present misery, it is a finer sense of all this, and my own commitment to be a little kinder, adjust the balance in life if only a little.
Finally, congrats to Steve's Crew at the MS Walk today. Molly Johnston, you rock (and we'll send some money since our bodies couldn't make it). Thanks, too, to Tom and Jodi Kelly for bringing John that awesome Steve's Crew T-shirt! Stevie, we've been thinking of you a lot lately, what you went through for so many months and years and still managed to tell jokes. We won't forget.
I'll continue to report, but realize I may not have much to say for awhile. Too many unknowns. Jeez, I hate that!!!
Your semi-faithful correspondent,
Kathy