75. Paper or plastic; Percocet or Dilaudid

In Her wisdom, Mother Nature boosts a pregnant woman's self-clotting mechanisms.  After all, when the placenta separates (or perhaps better said, tears off) from the uterine lining, a lot of big blood vessels suddenly open up and bleed.  So stronger clotting means less risk of postpartum hemorrhage (in the developing world the most common cause of maternal mortality).

But the clotting mechanism is a delicate balance.  Too much causes larger clots to form in veins, some breaking off and traveling to the heart, lungs and/or brain, where they can wreck havoc.  Beth is about 10 days postpartum (a cesarean--surgery and anesthetic agents also increase clotting) with a pulmonary embolus (PE)--several of those clots are plugging parts of both lungs.  So she gets heparin and other blood thinners to dissolve those clots, or at least keep new ones from forming.

PE hurts, but Beth tells us that Percocet helps that pain, though does not help the pain associated with her abdominal pain, unlike Dilaudid, which helps the incisional pain but not the chest pain.  Both are equally strong narcotics.  Go figure.