Nicholas' Hospitalization - 2

Nicholas continues to improve and is able to walk a little further today without getting too winded. He was disappointed this morning when his doctor told him that his target INR range is 2 – 3 but his INR was only 1.16 this morning. Yesterday they increased his Warfarin (generic Coumadin) dose from 5 mg/day to 10 mg/day and his INR went up from 1.05 to 1.16, so it is a very slow process. The other change they made was to switch him from the generic Warfarin to Coumadin. Hopefully this will speed things along.

He had an ultrasound on his legs this afternoon and they found that the clots he has have now attached themselves to the walls of his veins so the risk of those clots moving to his lungs is gone. The doctor also found several old clots (maybe a year old) in his legs so he has been very fortunate to remain healthy despite these clots but it is yet another reason for us to get to the root of the problem and for him to remain on Coumadin. One piece of good news we got is that the doctor mistakenly told Nick on Tuesday that the clot in his right calf was 3 inches in diameter when it was actually 3 centimeters in diameter. That’s about half the size we thought it was! I don’t know if it was simply an error the doctor made or if was a language barrier issue but we’re glad to know that the clot isn’t nearly as large as we had thought!

It looks like Nick will be in the hospital until at least next Monday, which is quite frustrating for him, but it will likely take at least that long for his INR to move into the goal range. The plan once he is released from the hospital is for him to go back to Antigua where he is living in the home of a host family that he has lived with off and on for the past 3 years. They are like a second family to him and he loves being there, so it will be a great place for him to recover. His friend from Los Angeles, Will is arriving tonight and will be with Nick for the next week in Guatemala, which will be really nice for Nick! He is planning to return to LA on Sunday, July 29^th and will continue to receive care from his doctor there. He will need to find a Pulmonologist and perhaps a Hematologist to follow up on all that has happened and to keep an eye on him.

Thank you again for all your prayers, emails, notes, phone calls and concern. It is so nice to know how many wonderful and caring friends we have in our life and we are so grateful for all of you!

Love, Laura