In Corpore Sano

The Bad Drug Yasmin Nine Years On

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In September 2006 I suffered a Transient Ischemic Attack. I was 38, a non-smoker, otherwise in good health and of normal weight, so my only risk factor was the use of the oral contraceptive pill, Yasmin, which I had been on for four years at that point. Because that didn’t seem like ENOUGH of a risk factor to my doctors at the time, they conducted some tests and determined that in addition, I had a large Patent Foramen Ovale (hole in my heart) and a cystic ovary. This led to a year of medical procedures (including heart surgery) and general health discomfort which you can read about here and here and here.

The Bad Drug Yasminbad drug Yasmin

Re-reading my blog entries from that period it’s clear that at some point before May 2007 I had become convinced that the main villain of the piece was the bad drug Yasmin.  I was at the forefront of women attempting to publicize their experiences and insist that the side effects of Yasmin included higher risk of a stroke-type event. Not surprisingly I was eventually contacted by lawyers who wanted to include me in a class action lawsuit against Bayer, the pharmaceutical giant responsible for Yasmin and its sister drug, Yaz.

VTEs vs ATEs

Bayer has now settled (without admitting any liability) many of the cases involving VTE (Venous Thromboembolism) after the FDA concluded that for the bad drug Yasmin the “risk [of VTE] is reported to be up to 2 to 3 times greater than the risk of VTE associated with using levonorgestrel-containing pills.”

They are now supposedly willing to settle some money (again without admitting liability) on some women who suffered ATEs (Arterial Thromboembolism). (Hint: a TIA is usually the result of ATE, not VTE.) So it’s perhaps not surprising that after 9 years last week my lawyers got in touch wanting me to sign some papers and such.

Effect of My PFO

Here’s the thing though, (and I apologize if this is too much medical science) the presence of a PFO permits a VTE to become an ATE. In other words the hole in my heart may well have permitted a blood clot which would naturally have been in the venous system to pass across to the chamber of the heart that pumped it up in an artery to my brain, causing the TIA. Yes, the lawyers know this. I have given them all the paperwork.

I don’t really care about the money. I just want justice and publicity, so that women don’t continue to take the bad drug Yasmin, which, incredibly, is still on the market.

Five Things That Prove Aetna Really Doesn’t Care

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On Saturday night I was tidying the kitchen and happened to open a non-urgent looking letter from my insurance company, Aetna, that had been lying on my island table for a couple of weeks. The letter contained a notice of termination of the small business insurance health plan that my family has through the company I help my husband to run, Global Bridge LLC. Our coverage ends on March 1st. Aetna expressed their regret and blamed the Affordable Care Act for forcing their hand. While there is some truth in this, it is equally obvious that Aetna really doesn’t care about the people who buy its health insurance. Here’s why:

1. They Could Have Told Us Sooner

The letter was dated December 11th, so that’s when the decision was made. However, the envelope was postmarked January 2nd. By law, insurance companies are supposed to give 60 days notice of termination. We could quibble, and say that even if I had opened the letter when I got it, on say January 4th, that’s only 57 days. Be that as it may, why wouldn’t they tell us as soon as they knew? In order to defer postage costs until 2015, because they don’t care.

2. They Could Have Made It Clearer What They Were Telling Us

The letter came in an envelope marked “Important Renewal Documents Enclosed.” I know the renewal is March 1st, which is why I didn’t open it on receipt. If the letter had come in an envelope marked “Notice of Termination,” do you think I would have opened it sooner? You bet! Why wouldn’t they print up such envelopes for this important bulk mailing? Because it costs money, and they don’t care.

3. They Could Have Explained Why In More Detail

The letter says “because you are a sole proprietor husband and wife group and do not meet the federal definition of a group.” Say what? It was left to me to do the research: small businesses run by husband and wife teams no longer qualify for business group rate insurance plans under the ACA. (This is the part that is Obama’s fault. Husband & wife run businesses are not part of the 1%, but ordinary people trying to make a go of something in a difficult economy. The ACA makes health insurance less affordable for people like us.) Why wouldn’t Aetna explain this more fully? Because it would make the letter longer, and they don’t care.

4. They Could Have Given Us Options in the Letter

The letter says “we welcome you to explore our Individual product options at aetna.com” and “you have the option to buy coverage through your state’s Health Insurance Exchange.” Wouldn’t it have been great if, instead, it had said “We recommend you replace your Small Group Coverage with our plan XXX, which will cost you $Y per month and have a $Z deductible. Please see attached document for full details.” Why wouldn’t they do this? Because they would have to do some work, and they don’t care.

5. They Could Have Been Nice on the Phone

When we called to see if we could extend our coverage by one month in order to give us more time to explore our options, they basically said that they had fulfilled their legal obligations and we were on our own. Becky is going on her Senior Class Trip the first week of March and I have already provided the organizers with the insurance details, which are clearly wrong. I’m now under pressure to wade through the Health Insurance Exchange and find a plan that won’t cost the earth and allows us to keep our current providers by Feb 28. Why wouldn’t they extend us at least this courtesy? Because they really don’t care.

Anna’s Mouth Injury, the Scoop

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Photo06202142Here’s the thing: I have a 115 pound golden retriever called Sammy. He’s as affectionate as he is furry (I keep a lint roller in my car), dumb as rocks, and boy, does he love chasing small animals.

Now, I weigh a little more than 115 pounds, but not that much more. And I’m not in the first flush of youth (he’s three). When I walk him, I wear sneakers, I have a special harness that goes under his belly, and I concentrate. If he spots a bunny or a squirrel (or sometimes just a particularly interesting bird) I plant my feet, hold the leash with both hands, and the belly strap brings him down. Usually.

Saturday night I took him over our good friends’ and neighbors’ house. It’s less than five minutes away. I hung out, swam; they barbecued, and, of course (This won’t surprise anyone who knows me) we put away a fair few glasses of wine. Just after midnight I started off to walk Sam home.

I was wearing flip flops; I don’t remember if I attached the leash to the chest strap of the harness or just to his collar; there’s no way in the world I was concentrating. And he saw a…I don’t even know what it was…but he went after it. Caught unawares, I couldn’t get my fingers out of the handle of the retractable leash fast enough. Smack! I hit the kerb face first and he dragged me along several feet of road before I finally managed to let him loose. Blood everywhere.

I spat out half a tooth and called my husband to come and get me. Everyone arrived–our friends, the kids, my husband. Sammy returned and got roundly beaten (Not by me.) We all went to our house and tried to assess the damage. To ER or not to ER, that was the question. We decided not. None of my wounds were gaping–mostly they were road burns. And there was a certain amount of concern that if K took me to the ER in that condition the police might be called! Anyway, the tooth was the worst thing, and the lip above it. We alternated hydrogen peroxide and ice until I was pronounced fit for bed, and amazingly, I slept.

Next day we called our lovely dentist friend, Dr. Osler, and he (Bless the man! A staunch Democrat too. Love him!) mended my mouth as best he could. The funny thing is that the worst broken tooth (there was also a chip off a neighboring one) had been crooked forever. (We don’t do so much orthodontics in the UK. Yes, cultural stereotypes often have a basis in truth.) Now it’s half fake, but straight.

So, I have kerb marks on my left cheek, a scabby and swollen lip, grazes on my chest, neck, left shoulder and both knees. I can’t chew on the fake tooth for a few weeks (and right now I can’t chew anyway, cos it hurts. It’s a struggle to open my mouth wide enough to slide in the soup spoon.) Oh and I’m leaving for our annual trip to the UK on Wednesday.

I also have a confused but somewhat sheepish oversized golden retriever, still furry, still affectionate, probably still likes chasing small animals. Anyone want one?

Is Step Aerobics Really Dying?

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That’s what Diane, an instructor at my local LA Fitness (where I can be found typically 4 or 5 times a week) announced this morning, adding that today we were going to try Step with Kick Boxing, a combination that my neighbor chortlingly christened “Stoxing.”

Step Aerobics was developed around 1989, I learned from the Wikipedia article, although I don’t think it was widely adopted until Reebok started to market steps and videos for in home use. I took it up in around 1991, I think. I was living in Wimbledon at the time with my first husband, working as a Brand Manager for Birds Eye Walls, and I did classes at a boutique women only gym whose name I have forgotten. [Read more…]

How Do You Teach Those With No Capacity to Learn?

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That was the question I was struggling with as I confronted my new workshop group earlier this afternoon, examining faces which ranged from cherubic to haggard and which displayed expressions anywhere on the spectrum between blank and expectant.

Last week I was contacted by Arts Horizons, part of the consortium of NJ based arts organizations for which I am rostered by the NJ State Council for the Arts. They asked me if I would be willing to lead a Creative Writing workshop in an assisted living facility for seniors with memory loss, and not without trepidation, I agreed. I love my WWAC workshop group, and probably enjoy myself as much as my students in that class, but 8 hours of teaching a month at $45 per hour doesn’t pay that many bills. Arts One were offering $100 for a monthly 1 hour workshop, although I suspected the money would be much harder earned.

[Read more…]

Time to Get Serious–Calling Disillusioned Yasmin Users

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I’m here at Bread Loaf for a few more hours, and I just pitched my non-fiction memoir, Letters from the Body, to an Editor, who was very interested. Last night at dinner I also pitched it to a wonderful Agent, who invited me to send her the m/s to date (currently standing at about 30,000 words.)

So, I need some additional material. If you are a woman of child-bearing age who has had a bad experience with Yasmin (or indeed, any other hormonal contraceptive) I invite you to tell me your story. I am particularly interested in incidences of blood clot and of course, stroke, plus any withdrawal symptoms experienced from the drug. Please email me at evnsanna_at_comcast.net including your full name, age, location, a brief gynecological history, and the main facts of your experience.

Check back here for updates as the book progresses. More about Bread Loaf anon.

Tuning the Heart

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So, today I went to Jefferson for my one year post op check up.

Typically, the stress involved in getting me there was about enough to give me a heart attack. I had to drop Lorna at Hainesport Recreation as early as possible (8.53 a.m.) then drop Becky at Gymnastics ridiculously early, armed with iPod and DS (9.10 for an 11 a.m. practice,) then drive into Philly, attempting to beat my GPS predicted journey time by about 5 minutes to make my 10 a.m. appointment.

Of course, roadworks on I-95 meant I arrived around 15 minutes late. Nevertheless, I sat in the waiting room for almost twenty minutes (rating 14×14 sonnets–better pickings in the final two batches for this issue) before I was called back for my bubble ultrasound.

The echo tech was a German guy called Heinz, with whom I immediately struck up a “Europeans vs Yanks” type rapport. A bubble ultrasound is an almost embarrassingly intimate affair, requiring the subject (me) to be naked from the waist up while the tech presses the ultrasound scope to various points around the ribcage (read: above and below the breasts.) Like most of the staff in the Cardiac Institute, Heinz was not used to having to do this with a woman who potentially still made his sonar blip, but he dealt with the situation with admirable aplomb. As for my part, it helped that he was, like most of the Jefferson Staff, pretty damn cute. I also learned a new word: I am, apparently, “echogenic.”

The good news is that the hole is completely closed. No bubbles are crossing the former PFO site whatsoever. Dr. Savage was very pleased, and wants me to try weaning myself off the beta-blockers, and phasing down to a Baby Aspirin (81 mg vs 325 mg–hopefully this will reduce the ridiculous bruising I have suffered over the last 18 months!)

Also in good news while I’m at it, Rattle took “Crash,” the poem about the motorbike which hit the back of the van in March. Yesterday, the careless driving trial against the motorcyclist, at which I am a witness for the prosecution, was postponed for the umpty-fifth time.

And I wrote a sonnet today! First poem since the day after my fortieth birthday, when I wrote “Midriff Crisis”, a triolet about the potential navel piercing a good girlfriend gave me as a gift. I got the piercing a week ago, and the poem was accepted for publication today.

Sometimes, life has a pleasing symmetry…

Heart, One Small Hole (Repaired, should not affect function…)

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At 6.30 on Thursday morning I turned up at Jefferson Hospital to sign myself over to their Cardiology Department for the closure of my PFO.

Note: this early start time could have been a major problem. They were supposed to call me the day before with my reporting time. When I hadn’t received a call by 9 p.m. I called them. Turns out they had left a message on the wrong answerphone. I then had to arrange something for the kids at extremely short notice. My friend M. stepped into the breach, and as I know she is hardly a morning person, I appreciate this more than she knows.

In a surprisingly short time I was sitting on a bed in one of those dreadful hospital gowns with a print that looks like rorschach ink blots and the lovely ties that leave it flapping open at the back. I signed consent forms, chewed a 325mg Aspirin (turned out I should have already taken it that morning after all), had a drip put in, and pretty soon after that I was being wheeled down to theater. Oh I also learned some good nursing jargon. I believe I have mentioned the problems medical personnel have finding a good vein of mine from which to draw blood. Well, apparently I am a bad stick!

This, my second OR this year, looked much like the first one. Another sense of deja vu arose when a) I realized I was going to have to repeat the TEE as part of the procedure, and b) that the same cute young doctor was officiating over that part. He had a different assistant however, whose bedside manner left something to be desired: “There is a two in fifteen thousand chance of DEATH from this procedure…” (Capitals reflect the emphasis of delivery!)

But that’s pretty much all she wrote as far as the procedure was concerned. I sucked on the dead sea creature lollipop and by that time they were already pumping very strong medication into my IV.

I woke up in the recovery room, my long-suffering husband by my side. The next unpleasant part was when they had to remove the tube they had inserted into my groin down which the closure device had been wiggled. A heavyset male nurse called Tim told me that he was the ‘pressure’ nurse. When the tube was removed it was his job to apply pressure to the vein in order to staunch the bleeding. Bloody hell that hurt! Poor Tim, if that was really his job–doesn’t sound much fun doing that all day!

I then had to keep that leg as still as possible for six hours. Ick. I’m going to gloss over the next few hours but it involved cramps and bedpans. Meanwhile the staunched vein was bruising up nicely, and my throat felt like I’d swallowed the dead sea creature, and that it had been a rather scaly one at that. (Of course I’d really only swallowed the ultrasound probe.)

The interesting thing is that my heart didn’t hurt at all. I had thought I would be able to tell that there was now a foreign body sealing the flaw in the living tissue, but no.

They moved me to the ward and here I struck up an acquaintance with my roommate, C, who had also had a PFO closure on Thursday after a series of strokes and TIAs. C is 10 years older than I am and was not on the BCP at the time of her incidents, but in a way that was a good thing to know. Perhaps, if I hadn’t been taking the BCP I would have been her in 10 years time when an age-related clot made its first appearance. She had also suffered some minor but bothersome long term effects from her attacks. (Her PFO was 7mm to my 5.)

K disappeared and returned later with the kids. In his absence I was treated to a glorious ‘heart-healthy’ hospital dinner: roast beef and pearl onions in watery gravy with chipped potatoes and tinned carrots. I was starving though so I ate every mouthful. Fortunately K came back with chocolate.

Then I was left to a Law & Order fest on TNT. Oh it was a joy at around 9.30 pm to move my leg at last, even if it was only to shuffle to the bathroom with my drip!

I slept as well as you can in a hospital, with the nurses waking you every three hours to check your vital signs. When they did this the third time at 7 am, I gave up on sleep and read my book until it was time to go and have my chest x-rayed.

Everything checked out, so by lunchtime I was ready to leave, although I am not allowed to drive until Monday, lift anything more than 10lb until next Thursday, or take any exercise for 2 weeks. I’m still going to Liam’s memorial, though. I can walk okay for short periods and not fast, but I think I’m going to take the wheelchair to be safe.

So, thanks again to M for stepping in there, Twinings and the QNDs for the gift basket and flowers respectively, and to all my friends who have left me messages of support and encouragement. Hopefully this episode of House is now over. I’ll let you know when I’m done writing the book.

Health Update

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Tomorrow I am going into Jefferson for my PFO closure. I haven’t blogged about this because I don’t really know what to say. I’m confident it’s the right decision to minimize my risk of future stroke-type incidents. (The risk of serious side-effects is <2%.) I got some good news today to help keep my outlook positive. Nancy Scott of US1 Worksheets called me to let me know that they are accepting “The Proof Reader.” She’s also going to see about getting me a featured reading for the group.

In a peculiar knock on effect this means I can let Gina Larkin of the Edison Literary Review have “Archetype,” which she heard me read last Wednesday and requested.

That means I have now had 16 of my thesis poems accepted for print publication. Rattle & the Harvard Review are perhaps the most prestigious credits; other print credits include Raintown Review, Mad Poets Review & Iambs & Trochees, while e-zines include Literary Mama, Mezzo Cammin, Umbrella and Lucid Rhythms.

They are keeping me in overnight tomorrow, but I will try to check in here on Friday afternoon and let my readers know how everything went.