February 3, 2011 - 9 PM

Sarah had follow-up visits today including an echocardiogram and visit with her cardiologist.  The echocardiogram showed no signs of new or continued infection (vegetation) and the atrial patch seems to be secure.  There were also no indications of pericardial effusion (fluid collecting around the outside of the heart) or pericardiotomy syndrome (a reaction to have the pericardial sac around the heart disrupted by surgery).  All good.

Her physical exam with her cardiologist revealed nothing new or worrisome.  Blood pressures in both of her legs were the same - indicating good blood flow in her right leg where surgery removed a large infected clot.

Lab results from Monday included negative blood cultures - no new signs of infection in her blood.  Her white blood count was normal indicating that her body is not trying to fight an infection at the moment.  She remains anemic, but has improved a little since her hospital discharge.  Some tests that provide a kind of barometer of inflammation in her body (Sedimentation Rate and CRP) are still quite elevated, but these tests may take awhile to improve - actually the CRP has improved since the beginning of this.

The INR test of her blood clotting from yesterday was 3.0.  We are aiming from 2.5 to 3.5 for this test using the Coumadin medication.  So 3.0 is exactly where it should be.  Her cardiologist recommended continuing with 7 mg of Coumadin nightly pending the next check.  Many, many things affect the impact of Coumadin on thinning the blood - illnesses like colds and the flu, other medications, diet (foods rich in vitamin K will counteract the effect of Coumadin - e.g. dark green vegetables, salad greens, etc. Brussel sprouts are on this list, but there is no great risk that Sarah will suddenly have cravings for this vegetable!)

By the way, and no surprise to those who know Sarah, she looked smashing today in black pants and a sea blue sweater.  But, it was the added flourish of the blue Pashmina scarf - a recent gift from Amy Flores, Lucy's mom - thrown around her neck and covering the upper half of her surgical scar that seemed to draw all of the compliments from the staff at DHMC.  Thank you, Amy!

A cancellation at the cardiac rehab program at Concord Hospital provided an opening for Sarah tomorrow at 9:30.  It will be great to have a reason to get out of the house and a program of safe strength-building under way.

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