Of blood thinners, gross hematuria, and broken ribs

 I've been taking Xarelto since early September, when my regular 12 week scans revealed extensive pulmonary embolisms. My December scans showed that the PEs had abated, but my doctor said I should continue with the blood thinners because this was my second episode of PE's. In the past 12 weeks, I've kept seeing gross hematuria (visible blood in my urine), including a Sunday morning in January where the majority of my urinary output was bring red. I followed up with a urologic oncologist, who ordered a scan of my kidneys and ureters. That February 17 scan showed nothing out of the ordinary, so everyone shrugged their shoulders and told me to stay the course.

Yesterday I had another round of CT scans -- No. 52, if I'm counting correctly. The results were posted today. No new metastases. No evidence of disease. Yay. The scans did show chronic inflammation in my ureters and neobladder, which is the likely result of the blood thinner and source of the bleeding. It also showed that I had two cracked ribs: "New nondisplaced fracture of the anterolateral left sixth and seventh ribs with callus formation."

I'm pretty sure that happened when I was skiing with my brother in January. We had stopped to discuss whether we were done for the day, or to take another run. I didn't notice that my left ski had slid slightly downhill to cover the basket of my ski pole. We decided to take one more run and I shifted my weight to get going; however, my ski pole was stuck under my downhill ski. My momentum caused me to topple over and I fell hard on the left side. The carbon fiber pole snapped right above the basket and I fell like a tree on the left side of my chest , unable to extend my arm to soften the fall. I landed squarely on the handle of my pole which slammed into my chest just below the heart. My breath was knocked out of me and as I sucked in new air, my chest lit up in pain. I muttered that I thought I might have broken a rib, and that this was my last run. The impact area of my chest hurt for several weeks, and even now it's a little tender. Now I know why. But it hasn't hurt enough to keep me off the mountain, even though this has been a sub-par year for snow. Suck it up, buttercup. 

Jennifer has not been doing too well. At the end of December, Layton Park Memory Care abruptly announced that it was closing. The owners had received an offer they couldn't refuse for the building. We screened several new memory care locations and eventually selected Apple Village in Layton. But Jennifer's transition was rough: new location, new staff, delays in transferring medications, and a Covid-19 outbreak within days of her arrival. Fortunately she didn't get sick, but the quarantining ratcheted up her anxiety. It's been a rough couple of months, but I think that she's doing better now. Her frontotemporal dementia continues to gradually degrade her capacities. and sometimes it feels like we're bailing the Titanic with a teaspoon. As David Robert Jones said, it ain't easy. With the help of the good Lord, we can all pull on through.