DAYS 220-239 RECOVERY

My last visit to the orthopedic surgeon showed no bone growth in my broken ankle so we've done some research and concluded that the blood thinner warfarin/Coumadin I have to take increases the risk of bone fracture. I avoided taking this medicine for two years, but after developing clots in my lungs after the open heart surgery, the surgeon and hematologist said I had no choice.  This puts me in a dilemma and I feel I'm playing Russian roulette.

A study done six years ago at Washington University School of Medicine, a very respected research institution ranked #3 in the nation, found that elderly (that word makes me cringe) patients taking warfarin have an increased risk for bone fractures.  Another study showed that taking warfarin for longer than one year led to a 25% increase in bone fracture. It's not clear if this affects women as well as men. 

Warfarin was initially introduced in 1948 as a poison for rats and mice and is still used for this purpose today.  In the early 1950s it was found to be effective and relatively safe for preventing abnormal formation and migration of blood clots.  It was approved for use as a medication in 1954 and is the most widely prescribed oral anticoagulant drug in North America.

This drug interferes with vitamin K's role in blood clotting.  Vitamin K interacts with a protein vital for bone formation and affects bone strength as well.  Fractures occur when the bones become so weakened that minor trauma causes breakage.

I had bone density tests done last year and five years prior.  The first showed I had great bones which I attribute to all the milk I drank as a teen.  I hated milk, but when others were drinking Cokes I stuck to my milk because I thought it would help me get boobs.  Well, it didn't do much in the boob department, but certainly my bones benefited.  The results of the test done a year ago showed I was still in the normal range, but closer to the low end of normal.

I'm required to take warfarin, not only as an anticoagulant to prevent blood clots and strokes, but mainly because I have two genetic blood disorders that cause my blood to hyper coagulate. This can cause clots which can lead to strokes.  So far I've met with the psychiatrist, the hematologist and next week will see the orthopedic surgeon and the cardiologist in an effort to come up with some alternatives. Some newer drugs are available, but since they aren't approved specifically for my condition no one wants to prescribe them as "off label" because of the fear of lawsuits. No doctor is going to give me "permission" to stop taking warfarin, once again because of the lawsuit thing.  So I took myself off this drug two weeks ago, thus I feel I'm playing Russian roulette.  Right now I'm going the natural route with vitamins, supplements and diet. 

There is no definitive answer because with the blood thinner my heart will be protected, but at the risk of broken bones and without the blood thinner I'll have strong bones, but at risk of blood clots that can cause strokes. 

Meds:   Amiodarone, Cardizem,  Vayacog, L-Carnitine, Vitamin D, I-Caps, Flax seed oil, Multivitamin, B-12, L-Arginine, DHEA, Glucosoamine, Calcium, Garlic, Aspirin, Omega-3 Fish Oil, Vitamin C

       

Days 204 - 219 Recovery

I almost feel human after getting two full nights sleep in a row.  The throbbing pain from my broken ankle went up into my leg.  Because it's been more pronounced at night, getting beyond three hours sleep has been hard to come by the past four weeks.  Two rounds of antibiotics finally wiped out the skin infection and most of the swelling is gone, so I feel I've gotten over the hump. The only pain I feel now is centered in the ankle area caused by the break and the surrounding torn ligaments. 

I received discouraging news yesterday, though, when the orthopedic doc said x-rays showed that so far the bone shows no evidence of fusing.  Age is a factor in bone growth.  Fifteen year olds can have bone fusion in just a couple of weeks. Since I'm a very long way from fifteen, I'll need lots more time and patience.   He wants me to return after another four weeks for more x-rays.  In the meantime I need to keep my ankle iced several times during the day until the swelling is completely gone.  I also need to do some ankle flexing exercises a couple times a day to help restore full range of motion.  Looks like there won't be any tutus and tights in my future.  This will probably kill my dream of becoming a ballerina. 

I won't be kicking my big black superhero boot anytime soon.  The doc wants me to continue wearing it all the time except in bed.  I'm becoming more proficient in walking in it and only use crutches when going up and down stairs.  Right now slopes are out of the question as they scare me too much. Since most of our property is slopped, I can't get up to the barn or down to the duck's pen.  I'm confined to the flat area where the cabin, the flower beds, and the greenhouse are located.  This will have to do for now.  

Meds:   Coumadin, Amiodarone, Cardizem,  Vayacog, L-Carnitine, Vitamin D, I-Caps, Flax seed oil, Multivitamin, B-12, L-Arginine, DHEA, Calcium, Glucosamine