Hello again!
Good news to report.
I told the nursing home that I wanted my cardiologist to "bless" the transfusion before sending me down there, but then I could not reach her. After leaving several messages for Dr. Kansal, and with nursing home staff knocking on my door every 5 minutes (or so it seemed!), I called my internist (pre-surgery, "regular" doc), and explained the situation. My hemoglobin count was 8.8 on 6-20 and 8.1 on 6-22. She said that 8.0 is the key number, as that's the point where something should be done. She said it was not at all uncommon to expect something like this after such major surgery and that taking this approach was important, because if the hemoglobin is too low, it makes the new valve and the already traumatized heart work harder than they should. That made sense to me, and so I told the nursing home to go ahead with it.
I still insisted on having it done at Northwestern Memorial, though, as that's where the surgery was and a little part of me hoped that somehow, Dr. Kansal would decide to stop it...
As this was a medical procedure, the nursing home was able to arrange for ambulance transport, and I confirmed with my insurance that the round trip was covered. At least I didn't have to hit up my sister or brother for a ride. The ambulance rides were fine; I always did have a thing for cute young paramedic guys with tight pants! lol
(Not dead yet, that's my motto!!)
So at NMH they took blood. Again. I was examined by 1 doc and later 2 others, all asking specifically about any blood loss or signs of internal bleeding and how I was feeling and such. All three of them said that they'd confer with Dr. Kansal, and I said "Good luck!" as neither I nor the nursing home had any luck reaching her. And there I sat, in the emergency room for a few hours, just twiddling my thumbs and doing sudoku puzzles.
A little before 4pm, one of the docs came in to say, "You don't need a transfusion after all!" My hemoglobin was up to 9.1, so it was no longer warranted. Also, these docs had been able to reach Dr. Kansal, who told them to inform the nursing home and the attending doc there that all such requests should be cleared through her in the future so that other such trips can be avoided... Sounded good to me, except for the fact that she'd been unavailable...
Whatever. I'm just glad I didn't have to do it. And there was a part of me that was exceptionally pleased that my position had been validated by Dr. Kansal, i.e., that she should be the one to make such a decision. Had I gone ahead with another nearby hospital, I'm not sure if they'd have simply followed the doc's orders and done the transfusion rather than confirming with their own labs... Who knows?
So with the round trip ambulance and the emergency room waiting, door to door, it was about an 8-hour adventure. I missed two Norcos, and decided now might be as good as any to start slowing down on them. Two days now with 4 per day instead of 6 per day, and so far I'm not too much worse for the wear. Yay to progress! Friday morning, I refused yet another blood draw. (Thanks, Steve for giving me the idea to just say NO!)
And most importantly, I am OUT! I was released from the nursing home on Friday afternoon, and am staying with my brother and sister a few days. A visiting nurse will be by shortly to check my incisions and such, and I'll have OT and PT here, too. I will probably go home one day next week. Things are moving along.
