Driving Can Be Dangerous to Your Health by Phil Stephens

Part V—A Few Days Later

After they returned from the hospital, Dave and Jen took the children to dinner and a movie in order to give the grandparents some peace and quiet. As they came into the house, John was coming down stairs carrying the cat.

“I found Muffy in our room,” said John.

“How’s Mom?” asked Jen taking the cat from her father-in-law.

“She’s asleep right now.”

“I called work and they’ve given me the rest of the week off,” Dave said to his father. “We’ve booked Mom and me on a flight to Orlando on Saturday.”

“That’s perfect, son, I’ll pick you up at the airport.”

“So, what did the doctors say?” asked Jen.

“Well, as you know, she had a pulmonary embolism,” replied her father-in-law. “That’s a blood clot in her lung. They found clots in the veins in her thighs, and think that one of them broke loose and traveled to her lung and blocked the blood circulation there.”

“So only part of her lung was functioning,” interrupted Jen. “I guess that, together with her asthma, gave her the breathing problems.”

“That’s what they said,” confirmed John. “They repeated the tests and found that the initial intravenous heparin treatment dissolved the embolism in the lung and the blood clots in the veins in her thighs. So there shouldn’t be any more embolism problems in the near future. The Warfarin tablets have stabilized her blood clotting. She needs to take the tablets as prescribed. She doesn’t need any more medication today. Oh, and she’s not supposed to take any aspirin or ibuprofen because they can affect blood clotting.”

Jen and Dave nodded.

“I called our doctor in Florida and Mom has an appointment on Monday,” said John. “In the meantime, all you need to do is look for signs of bleeding like bruises, purple toes and fingers, or if she tells you that she has blood in her urine, is feeling dizzy, weak, or has a headache. We must try to keep her moving around; apparently clots are more likely to form if she is sedentary. The doctor says that Mom will be on this anticoagulant medicine for months, and she should get periodic blood work to check that the Warfarin is keeping her blood clotting times within normal limits.”

Jen looked down at Muffy, who was squirming in her lap, and saw blood on her pants.

“That cut must have opened up again,” said Jen as she held a tissue to the cat’s nose. “You’d better get some sleep, Dad, if you are going to start driving to Florida tomorrow.”

Jen looked at Muffy’s nose, but the bleeding would not stop. After about ten minutes, she gave the cat to Dave and went quietly upstairs to the spare bathroom. Two minutes later she came downstairs.

“I’m afraid that Muffy got into Mom’s medicine. I can see we’ll need more Warfarin, and I’d better call the vet.”

Questions

You should consult the Internet for this last group of questions.

1. What would a V/Q scan tell the doctor about air flow through the affected part of the lung?
2. What would a V/Q scan tell the doctor about pulmonary blood flow to the affected part of the lung?
3. Why should Barbara not take aspirin or ibuprofen?
4. How does Warfarin control the clotting time of blood?
5. If Muffy the cat ate Warfarin, which is used as rat poison, what would be the vet’s treatment?

 

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