Of doctors and meds
I just had my first post-release appointment with my regular doctor. It's a bit interesting how my understanding of what's happening is evolving.
The hospital doc said I'd be on Coumadin for life, mostly because of protein deficiencies. My regular doc says it'll be at least six months, and in about four he'll have a hematologist (blood specialist) evaluate to see if I really do need to be on Coumadin for life.
The hospital doc seemed most concerned with the massive quantity of blood clots in my calf. The regular doc seems to think they're a side-show, and is much more concerned about the three tiny clots in my lungs.
Vitamin K fights against Coumadin in the bloodstream. On the other hand, avoiding Vitamin K means avoiding a significant quantity of the foods that are usually described as "good for you": green leafy vegetables, canola and olive oils, etc. A quarter century ago, the medical advice was to avoid all of them; today, they tell us to try to eat the same amount every day, and the Coumadin dosage will be adjusted accordingly. This, it turns out, is easier said than done.
The hospital gave me a booklet that has a long list, dividing foods into "high," "medium," and "low" quantities of Vitamin K. Looking for more detail, laureth (who cooks ~98% of what I regularly eat) found a listing from the US Department of Agriculture online. Problem is, it disagrees with the booklet from the hospital. The doctor said he'd trust the hospital booklet over the USDA, saying that the USDA has been "less than helpful" in the nutrition information it releases. Given how widespread allegations of agribusiness overruling USDA's scientists for reason of profit are, I'll take this as another instance. Only, this time, it's not a self-appointed watchdog, but rather my doctor, making the allegation.
Of course, this leaves us back at the start: laureth wants reliable numbers, not just "low - medium - high" for Vitamin K. And the most detailed source of those numbers she's yet found has proven to be unreliable.
Another issue is alcohol. Before this, I had averaged a beer or two a day, with a "time out" for days that I took pain-killers. The hospital booklet said to avoid alcohol. I raised the issue with the doctor, who said that Coumadin puts a load on the liver, too. He said that a beer a week is reasonable, but a beer a day would be a bad idea.
A beer a week. Well. I'll not waste my weekly ration on something because it's cheap. My beer-snob tendencies have just gotten an excellent reason to kick the whole idea up a notch. If I brewed strictly for myself, that would be about a carboy a year. I think a greater portion of what I brew will be intended from the start as gifts, although with the notion of packing as much flavor as possible in the mix cranked up a bit.
The hospital doc said I'd be on Coumadin for life, mostly because of protein deficiencies. My regular doc says it'll be at least six months, and in about four he'll have a hematologist (blood specialist) evaluate to see if I really do need to be on Coumadin for life.
The hospital doc seemed most concerned with the massive quantity of blood clots in my calf. The regular doc seems to think they're a side-show, and is much more concerned about the three tiny clots in my lungs.
Vitamin K fights against Coumadin in the bloodstream. On the other hand, avoiding Vitamin K means avoiding a significant quantity of the foods that are usually described as "good for you": green leafy vegetables, canola and olive oils, etc. A quarter century ago, the medical advice was to avoid all of them; today, they tell us to try to eat the same amount every day, and the Coumadin dosage will be adjusted accordingly. This, it turns out, is easier said than done.
The hospital gave me a booklet that has a long list, dividing foods into "high," "medium," and "low" quantities of Vitamin K. Looking for more detail, laureth (who cooks ~98% of what I regularly eat) found a listing from the US Department of Agriculture online. Problem is, it disagrees with the booklet from the hospital. The doctor said he'd trust the hospital booklet over the USDA, saying that the USDA has been "less than helpful" in the nutrition information it releases. Given how widespread allegations of agribusiness overruling USDA's scientists for reason of profit are, I'll take this as another instance. Only, this time, it's not a self-appointed watchdog, but rather my doctor, making the allegation.
Of course, this leaves us back at the start: laureth wants reliable numbers, not just "low - medium - high" for Vitamin K. And the most detailed source of those numbers she's yet found has proven to be unreliable.
Another issue is alcohol. Before this, I had averaged a beer or two a day, with a "time out" for days that I took pain-killers. The hospital booklet said to avoid alcohol. I raised the issue with the doctor, who said that Coumadin puts a load on the liver, too. He said that a beer a week is reasonable, but a beer a day would be a bad idea.
A beer a week. Well. I'll not waste my weekly ration on something because it's cheap. My beer-snob tendencies have just gotten an excellent reason to kick the whole idea up a notch. If I brewed strictly for myself, that would be about a carboy a year. I think a greater portion of what I brew will be intended from the start as gifts, although with the notion of packing as much flavor as possible in the mix cranked up a bit.