Thursday, 14 November 2013

Just A Little Blood Spot

It's one of those days here in Calgary, those days where the warm air rolls up over the Rockies, settling in on the wintery countryside. The snow is mostly melted, my tree is relieved of its ice covering and the sounds of dry roadway rise up from the traffic below. It will be warm today, perhaps warmer than most of the rest of the country. It is called a Chinook when this warm air comes a-calling. The locals have turned it into a verb; they say it's "chinooking out". It's the kind of weather where people get nosebleeds, at least some people.

I am getting my blood taken again today for my regular blood clotting tests. This is a result of the warfarin I am taking. The warfarin is a result of the blood clot in my left femoral vein, where my leg joins the trunk of my body. The blood clot is a result of sitting all day in my wheelchair. Sitting in my wheelchair is a result of having lost all muscle control in my legs, or almost all of it. The muscle loss is a result of ALS. There is a very well connected causative chain here, not that knowing it does me any good at all.

This whole ALS and wheelchair thing has lots of other little impacts, some extremely personal and almost embarrassing in their result. It's not that I am ashamed of my failing body, but to disclose it will make me seem even worse off and weaker than I feel. These days I have enough going against me; I don't need to publish those things that make it seem worse. Yet here I go.

There are a few things I will share, things that are kind of personal but you wouldn't ever see them unless I told you. For example, bleeding. When you take warfarin they warn you to watch out for any bleeding, especially nasal, urinary, or rectal bleeding. A nose bleed is obvious but those suckers can really pump out a lot of blood. The initial warning they gave me was that if I bled more than a bowl full, I should get to the hospital right away. So far, no nose bleeds. Chinooks don't seem to do it to me.

Bleeding from the other end of ones body is more serious. Actually there is a serious kind and a not so serious kind. They tell you to watch for blood in your urine or stool. So every trip to the toilet is an inspectionary adventure. I have to check. The reason the doctors worry so much about this kind of blood showing up is that it most likely represents some sort of internal bleeding, such as an ulcer, something that the body might cover up and something that would be exacerbated by the warfarin. So far, no blood in either alblutionary element.

On the other hand there is the less serious kind of bleeding. Almost all of us have some sort of rectal fissures, polyps or hemorrhoids. These little lesions like to bleed every once in a while. In most of us, we won't even see it as our body closes these pinhole leaks very quickly. Warfarin makes them close not so quick, so you end up with visible blood spots in your underwear. It's not enough to call the doctor, but you see it and you worry. Women must be used to this kind of thing; it's a new experience for me.

The other blood spot is a male only issue; it's extremely small blood blisters on your testicle and penis. This happens to most men but these blisters are so small we don't even notice them. They typically occur because of "overly enthusiastic sexual activity", sports activity that impacts the groin, or just plain tight pants. These pinhead blisters rise up and are reabsorbed back into the body, unseen and unnoticed in most cases. Except when you are on warfarin they can get larger and will sometimes break open. I haven't had to worry about any of the causative events so much lately, so I haven't had to deal with this outcome, at least not so far. But a fellow can always hope, can't he?

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