Tilt A Whirl Kind Of Day

The answer as to why my INR was low yesterday….. the beginning of a flare. Today I was hit with spells of dizziness that landed me back at Dr. C’s office. Dizziness was one of the things on the list he told me I should return before Friday if I started experiencing. So when I started having dizzy spells this morning around 11 I called and got his last available appointment at 4.

I spent the day between the before the appointment taking it easy. Doug and I watched How To Train Your Dragon, ate lunch and assembled my Medical Bracelet that finally arrived. Stay Tuned for a separate post dedicated to it! I continued to have dizzy spells throughout the afternoon, even after eating, and making sure I had adequate fluids. We thought it might be my blood pressure dipping too low so we checked it at one point and it was 123/77.  Yesterday at my appointment it was 130/86.

Doug and I got to Dr. C’s office and went in after Mellow called as he got off work. I signed in and we sat down to wait for the check in process. A little later I was called up and one of the ladies signed me in. It never fails when this lady checks me in she argues with me over if I have a copay at their office or not. Even though she can clearly see on their copy of my card I have no copay for my PCP. The convo this afternoon went like this

Receptionist: “Do you have a copay today?”

Me: “No.”

Receptionist: “Are you sure?”

Me: “Lady I’m here at least every other week, I’m pretty sure I know what my copays are.”

Receptionist: “Are you here for a physical?”

Me: “No”

Receptionist: “Are you sure?”

Me: “You can see the reason for my visit on your screen.”

Receptionist: “Are you sure you don’t have a copay?”

Me: Blank stare on my face

I’m usually a lot nicer and chattier with the front desk ladies. Dizziness does not make for a friendly version of me though. The lady that usually checks me in was quietly smirking behind this lady at our exchange. At one point she mouthed, ‘I am so sorry.’ Finally she finished her line of questioning and printed off my paperwork for the nurse and let me go sit back down. Which was great, because I was starting to get really dizzy standing there, and I told her that a couple of times. It would not have been good if I had of fallen out in the floor.

A different nurse processed me for this appointment, a nurse I had never worked with. I’m so use to Cindy, Dr. C’s main nurse that it always catches me off guard when a different nurse calls my name. She came to the waiting room says “Nicole” I just sat there assuming she was asking for someone else. After several seconds in a more urgent tone she goes “Nicole Davis!” Oh that’s ME! Doug and I stood up and followed her to the scales. Weight was down a lb from yesterday. Then off to the room we went. No fever, good sign. Pulse was okay, O2 was good. BP was 116/77, even lower than it was earlier in the day. I mentioned to the nurse that Dr. C probably wanted my INR checked and she said she would go ask Cindy. She left said that he was running a little behind and told me to be patient and hang tight. We are good at entertaining ourselves while waiting in the rooms at appointments so it was all good.

We were busy chatting when Doug pointed out that my butterfly rash had returned. My face had felt warm for a little while, I took a look and sure enough there it was across both cheeks and bridge of my nose. A few minutes later we heard Dr. C ask Cindy if they had gotten an INR on me, they told him no and in he came. “What happened?” ……Wait is this a repeat of yesterday? “I missed you so I came back.” I blurted out. Yea I’m an awkward individual. Then I told him about the dizziness and he pointed out the butterfly rash, asked about the level of joint pain which were hurting a good bit. Then he asked if I had increased the amount of time I was spending in the sun over the last few days, activity level, and questions about other known triggers of Lupus flares. He then said Cindy would be in to get an INR and that if it was any lower than it was yesterday we would be doing a Lovenox Bridge while we rebounded to my target range. I was so happy he brought this up because if he hadn’t, I was going to suggest it myself. He said other than that we were looking at doing another round of steroids because it was becoming evident we were dealing with another Lupus flare. Why on earth my INR drops like this when I flare, I have no idea but it’s a definite pattern that we have documented.

He went out to take care of another patient or something while Cindy came in to check my INR. To our surprise it was 2.7. It was up a whole 0.4 points from yesterday! When Dr. C got back to the room he said luckily we didn’t have to do the Lovenox bridge, but we would keep that in mind for future dips like this. He did tell me to go ahead and do the extra day of 17.5mg tonight as planned. Then I go back to my regular doses the rest of the week. It was the end of the day so he sat and talked to me a bit. He gave my medical bracelet his stamp of approval. He also is sending a referral to another Dermatologist that accepts my insurance. Apparently the one my Rheumatologist wants me to see doesn’t take my insurance, even though my insurance says he does, that makes no sense to me. The appointment at least calmed the worry that my INR had fallen even lower than it was yesterday, confirmed that I was flaring again, and allowed us to discuss a few things at a leisurely pace since I was the last patient there for the day. It’s up to me if I want to take Prednisone or if I want to ride this flare out since it’s not as severe as my last one. We will see how I feel tomorrow and I’ll make a decision about the steroids for tomorrow in the morning. They come with their own risks and issues so we try not to use them unless I absolutely need them.

He told me I could either keep my INR check on Friday, move it to monday and he’d be fine with that or I could move it to Tuesday, but he wouldn’t be all that happy with that but it was up to me. I am leaving it on Friday and we will go from there. I left out a bunch of things. I’m tired and my brain isn’t processing properly. I guess after being on a tilt a whirl all day that is to be expected.

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19 thoughts on “Tilt A Whirl Kind Of Day

    1. Thanks! It will pass in a few days. I tend to recover quickly and I’ve got permission to start a round of steroids if I feel the need. I have plenty left from the last flare. 🙂 *hugs*

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    1. Thanks. Seeing my INR on the upswing was a huge relief. We weren’t sure yesterday if that was it at the bottom of it’s fall or if it was still on it’s way down. At least now we know the answer to this part of the puzzle! Hope you are doing well!

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    1. Thanks Hugh! Big hugs! I’m hopeful it will pass soon as well. I’m back at Dr C’s Friday for another INR check and to let him know how I’m feeling flare wise. He keeps a close watch on me at times like this. He’s a pretty amazing doctor.

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      1. It’s great to have such a caring Doctor who you can trust and talk to. He sounds an amazing guy (not like that receptionist!). Take good care and my fingers are crossed for some good news after you see him on Friday. More hugs on the way to you from over the pond 🙂

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      2. She’s a sweet lady, but sometimes I wonder about her brain function. Especially with the line of questioning. LOL He is a pretty awesome doctor. I lucked out by finding him back in January when I had to switch doctors. Out of all my doctors he is the one I know I can always turn to. Part of that is because I do see him the most frequent so I’ve had a chance to build a deeper trust with him. He does have a more pleasant personality than the others though so that helps too. haha. *HUGS back* How is your week going?

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      3. It’s going well, thanks Nicole. I am back writing again after taking a weeks break and have posted some information on our recent trip to Dorset on Covey View, plus I am just finishing off the third instalment of my ‘Murder at the Vicarage’ Miss Marple story. I’ve also put together my second post for my ‘Digging Deep’ feature. Joining WordPress and doing the recent 101 course is the highlight of my year so far.

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      4. I will have to catch up on reading your blog! I started the 101 course but fell behind over the last few assignments so have to play catch up at some point.

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      5. Oh, I’ve only done some of the assignments from the 101 writing course due to not finding enough time, so I’m way behind on that as well. I’ll be thinking about you today Nicole, when you visit the doctor again. My fingers (and everything else) are crossed that its better news for you today.

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      6. Thanks Hugh. Unfortunately the news was not good. I’m on increased doses of warfarin Til Monday and I had to start a round of Prednisone to try to knock this flare out. It was a long stressful morning. Afternoon has been less so. Blog to follow with details about my day. Hope your weekend is off to a good start.

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      7. Oh no, no more sun, we think that’s the culprit. 😛 *warm hugs!* The good news is I’m ‘safe’ and eventually everything else will work out. It always does. 🙂

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    1. Meredith,
      That is true there were some positives. Thank you, I am hopeful it will be back in range Friday. There was some speculation that it was related to Chickpeas at first, but that got thrown out when I started showing symptoms of a flare. So hopefully as the week progresses it will return to the range we try and keep it in. I hope your week is going well!

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