questions

[kimfusca]

Hi Everyone,
I am still doing well. My open wound is not quite closed yet, but getting there. I still have a PICC line (so I can give myself IV antibotics). I have been doing a lot considering I am still recovering and somedays I pay for that.

Unfortunately my husband soes not seem to understand that I am still recovering from not just my original OHS surgery, but also form my second emergency OHS, my staph infection and am trying to stay healthy while regrowing tissue so that my wound can close and heal up! Anyone else suffer from spousal denial?

Anyway, I am still getting used to being on coumidin. For the most part, it's not too bad, but I am "worried" about some of the coumidin issues. For example, my knee was hurting the other day, tylnol did nothing for it. I wanted Advil, but I know that anti-inflamatories (sp?) are a no-no. How do people on coumidin deal with issues like arthritis?

I think I am feeling like I might become one of those young people who have soo many health issues (although I don't feel that way about myself) that I will have the health issues an 80yr old but be a 40 yr. old. I think this summer, I got a glimpse of what quality of life issues were.

I've already beaten cancer. Now I've conquered OHS, staph & open wounds. I think that's enough for now. I feel that my health history is complicated enough without having to add more to it - like coumidin.

They weren't pretty. Maybe I should mention b'day is on Wed. I think I am perhaps too worried about getting older. Maybe the worst is behind me?

 

[RandyL]

Alieve is okay to take with coumadin, maybe that will help you. Boy, somehow I missed your posts with all your surgery difficulties. Hope things are going better for you. Why do you still have an open wound?

 

[tobagotwo]

Aleve is naproxen sodium, and it has the same warnings the other NSAIDs carry about bleeding. Not only can it cause intestinal bleeding, but it also has an anticoagulant effect similar to aspirin's, which won't show on your INR. Don't take any of them without consulting with your doctor first.

From http://www.rxlist.com/cgi/generic/naproxsod_ad.htm about naproxen sodium drug interactions...

Warfarin
The effects of warfarin and NSAIDs on GI bleeding are synergistic, such that users of both drugs together have a risk of serious GI bleeding higher than users of either drug alone.

Drug/Laboratory Test Interactions
Naproxen may decrease platelet aggregation and prolong bleeding time. This effect should be kept in mind when bleeding times are determined.

Check Al Lodwick's site or search the anticoagulation posts. I'm afraid you're not apt to be too happy with the pain relief options.

If you work with your doctor, you may be able to determine if some NSAIDs are relatively safe for you. Some Coumadin users can take them successfully.

The earliest you shuld be returning to work (or chores) is six to eight weeks after your last infection cleared up. Tell hubby to check with his work's short-term disability carrier if he thinks you're malingering.

Best wishes,

 

[RandyL]

Gees Bob, I thought Aleve was okay to take. Somebody on here said it was thats why I took it. If anybody would know it would be Bob, so listen to him and forget what I said. Sorry about that.

 

[tobagotwo]

I don't mean to come off too strong, Randy, but I know Aleve has come up in this light before, and Al Lodwick had some cautioning things to say about it at that time.

As I said, some people do seem to be able to take some NSAIDs. I don't know how you determine if you're one of them or which ones. By all means, you should touch base with your doctor first, if you plan to try to use them. Be wary for signs of GI bleeding, such as black, tarry stools, stomach pain, or unexplained fatigue, syncope, or weakness.

Best wishes,

 

[RandyL]

no problem Bob. I think this is where I read about Aleve and actually it was from Al .

http://www.valvereplacement.com/forums/showthread.php?t=12890&highlight=coumadin+aleve

But like you said the best thing to do is check with your Doctor. Sorry about the pain your having Kim.

 

[Susan BAV]

Wow, Kim, you've really been through it, haven't you?! Where did you have your surgery? I ended up going up to Los Angeles for my OHS. I still go up there for my yearly cardio exams -- HATE that drive up there though.

Hopefully the worst is behind you. And, regarding spousal denial, there is a thread in "Small Talk" right now, begun by a woman in Vegas who had a similar question. Some of the Valvers comments in reply to her questions were very good and might help her and you too.

 

[tobagotwo]

Heck, that wasn't the way I remembered it. I also found another one from him with similar thoughts. My apologies to Al and you. Plainly, he doesn't feel it is as much of a problem as the other NSAIDs.

This would seem to agree in part, from http://www.rxcarecanada.com/anaprox.asp?prodid=106:

Blood loss and gastroscopy studies with normal volunteers showed that daily administration of 1 100 mg of naproxen sodium caused significantly less gastric bleeding and erosion than 3 250 mg of ASA.

I assume that ASA is acetylsalycilic Acid (aspirin). I should note, however, that this short positive blurb about Aleve is directly followed by a long listing of the gastrointestinal bleeding concerns listed in the previous post. Certainly, it should not be taken if you have ulcers, Crohn's Disease, or similar GI issues

Again, I would check with my doctor first. GI bleeding tends to be one of the biggest bleeding concerns for warfarin users.

Best wishes,

 

[Karlynn]

I will take Ibuprofen occasionally. I have not found it to be an issue. Unfortunately Kim, at this early stage of the Coumadin game for you, the cautious approach is much better.

If knee or joint issues tend to be a problem, I would look into starting glucosamine. I take it without any issue for my Coumadin and my cardio is fine with it.

 

[Janea]

I am so sorry to hear about your difficult recovery. I can't believe you have been through cancer and now this! So, the radiation from yoru cancer treatment caused your valve to go bad? I have never heard of that before. Hang in there. Some days it feels like you will never be the same again....but you will. It's especially hard having a little daughter. I have young kids too and it was tricky trying to transition back into motherhood after surgery. I am rooting for you and bump-free road ahead! --Janea

 

[temp69]

tylenol with codeine. in canada it's 2 plus 2's. I think this stuff is okay. Also, darvocet, vicodin. both narcotics...

 

[bvdr]

I had a neurosurgical appointment this am for neck issues and was questioned about any NSAIDs, ASA, or anticoagulants I take and was going to be given a Rx for Tramadol (though he forgot to write it and I overlooked that it wasn't in my paperwork). I'm going to have a nerve sleeve epidural and according to them Tramadol is fine to use without worrying about any bleeding side-effects. I'm waiting on a call about my coumadin and bridging/IV heparin before and after the procedure. So today my vote goes for Tramadol....also a prescription drug but one that is non-narcotic.

 

[sue943]

Before I take any medication not prescribed by my doctor, or before using any ointments, suppositories, anything at all, I always ask the pharmacist even if not making a purchase. In most cases I am told not to use or take them but the parmacist always checks in his book if in doubt.

 

[PJmomrunner]

I would look into starting glucosamine. I take it without any issue for my Coumadin and my cardio is fine with it.

Taking Glucosamine may be sort of like taking vitamin K or other things that do interact with Coumadin in that if you take a steady dose all is well, but it does interact, so you may want to check with your doc before getting started even on Glucosamine.

http://www.drugdigest.org/DD/Intera...D=705&dN="Glucosamine"+"Warfarin"+&CheckFDA=1

 

[Karlynn]

Taking Glucosamine may be sort of like taking vitamin K or other things that do interact with Coumadin in that if you take a steady dose all is well, but it does interact, so you may want to check with your doc before getting started even on Glucosamine.

http://www.drugdigest.org/DD/Intera...D=705&dN="Glucosamine"+"Warfarin"+&CheckFDA=1

This is the first I've read of Glucosamine interacting. Al does not have it listed on his site and my cardiologist said there were no problems. I had no change in my INR, or change in any bruising or bleeding when I started. I've taken it for 3 years now and did research on it before beginning and found nothing at that time. What I have read is that Chondroitin can react with it. I do not take the Glucosamine/Chondroitin mix because I was told by a pharmacist that they don't think Chondroitin really does much.

Whatever you take as far as suppliments you need to discuss it with your doctor. And then be a little more frequent on your first few INR test when starting, such as a few weekly test.

 

[RandyL]

I had a neurosurgical appointment this am for neck issues and was questioned about any NSAIDs, ASA, or anticoagulants I take and was going to be given a Rx for Tramadol (though he forgot to write it and I overlooked that it wasn't in my paperwork). I'm going to have a nerve sleeve epidural and according to them Tramadol is fine to use without worrying about any bleeding side-effects. I'm waiting on a call about my coumadin and bridging/IV heparin before and after the procedure. So today my vote goes for Tramadol....also a prescription drug but one that is non-narcotic.

Just curious, are you taking the Tramadol for pain relief? Do you have nerve pain or joint pain? I am curious since I am presently seeing a neurologist to help my nerve pain since my back surgery did not work. I am presently on Lyrica which seems to be helping my thigh and feet pain. BTW I think if you look up Tramadol you will find it is a narcotic and it can be habit forming.
Thanks

http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a695011.html

sorry if I derailed your thread Kim.

 

[aussigal]

I have been on Tramadol for over 1 year for my bad back. However I have found that it didnt cover the pain from Arthritis as well as a NSAID does. If its inflammation that is causing your pain I dont think Tramadol will do a thing for you. Tramadol is like a narcotic but not quite. While I didnt find it habit-forming (I took extended-release Tramadol) it has nasty withdrawal effects if you dont taper off your dose.

I seem to remember being told that you can take a NSAID once in a while, but if you need them more often you would need careful monitoring. Of course check with your Doc before you do this.

I wish you well in your quest to heal ... being 40 isnt that bad so maybe this is the start of the healthier Kim