Question regarding life on anti-coagulants

I love to cook, and every once in awhile I cut my finger. Is this something to worry about while taking anti-coagulants? Or is it only bigger injuries that are an issue? This was the first thing I thought of when leaving the doctor and thinking I had made up my mind about getting a mechanical valve. We had a discussion about my nose bleeds, and how I would be fine to go mechanical even though I get them a few times a year. I believe they bleed more than the usual small cuts I get in the kitchen.

Thank you, just hoping you guys can ease my mind on this tiny issue.

I'm on warfarin and my INR is usually around 2.5-3.0. When I nick myself shaving or accidentally cut myself doing something else, the wound bleeds a minute or two longer than it may have in the past. That's it. Small injuries will not be an issue

I cut up a lot of vegetables every week and cuts do happen. It's really not a big deal, just takes a little longer to stop the bleeding than before warfarin.

Clean wound, apply pressure then bandage, just as you would if you were not on warfarin.

I will say that since being on warfarin I tend to be more careful and mindful as I cut. I probably would get a cut every 4 months prior to warfarin and now it is more like once per year.

SatoriFround said:

Thank you, just hoping you guys can ease my mind on this tiny issue.

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Excessive bleeding from small cuts is not a problem. Normally it will just take a few more seconds to stop the bleeding and simple first aid with a bandaid will stop any bleeding. Like Chuck C posted "we learn to be a little more careful" when handling sharp objects.

dick0236 said:

Like Chuck C posted "we learn to be a little more careful" when handling sharp objects.

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And I have, since being on warfarin, completely given up machete juggling.

Chuck C said:

And I have, since being on warfarin, completely given up machete juggling.

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Darn, but it sounds like so much fun!

Morning

this has got to be the most discussed topic here (after bio or mech) and my experience is that most people have everything totally wrong.

SatoriFround said:

I love to cook, and every once in awhile I cut my finger. Is this something to worry about while taking anti-coagulants? Or is it only bigger injuries that are an issue?

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The idea that a shaving nick leads to this is patently absurd



as you'd expect for life threatening injuries (leg ripped off in a car accident) the miniscule difference provided between warfarin and no warfarin is nil. So if you have a gunshot wound to the groin you're in as much trouble as anyone.

This was the first thing I thought of when leaving the doctor and thinking I had made up my mind about getting a mechanical valve. We had a discussion about my nose bleeds, and how I would be fine to go mechanical even though I get them a few times a year. I believe they bleed more than the usual small cuts I get in the kitchen.

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To be honest I can't see any difference between my bleeding response now and then; it is about what it was before I was on warfarin. My dentist even remarks that when doing cleans "if I didn't know you were on warfarin I wouldn't know.

The key to this in my view is proper INR management. Proper means be actually successful of being inside the designated range ... you know 2 ~ 3.
This just does not happen (statistically speaking) for people in clinics (where 70% time in range is cause for celebration). Myself I'm in range greater than 90% so much that I call 93% a bad year and 97% a good year.

I recommend you read this blog post of mine from 2014
https://cjeastwd.blogspot.com/2014/09/managing-my-inr.html

PS: I meant to add, that my Dad used to regularly nick his arm or back of his hand and it bled a lot. He was never on warfarin or any blood thinners. I know that working with him (with steel or aluminium, drills and grinders building truck bodies or working in boats) that he did bleed more from nicks and scratches at his age than I do now at that age (also working with steel and stuff)
https://cjeastwd.blogspot.com/2018/01/raising-roof.html

I commenced warfarin in late 2011, so lets call it 2012.


Best Wishes

Just keep a box of plasters in the kitchen

LondonAndy said:

Just keep a box of plasters in the kitchen

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and some superglue in the fridge ...

SatoriFround said:

I love to cook, and every once in awhile I cut my finger. Is this something to worry about while taking anti-coagulants? Or is it only bigger injuries that are an issue? This was the first thing I thought of when leaving the doctor and thinking I had made up my mind about getting a mechanical valve. We had a discussion about my nose bleeds, and how I would be fine to go mechanical even though I get them a few times a year. I believe they bleed more than the usual small cuts I get in the kitchen.

Thank you, just hoping you guys can ease my mind on this tiny issue.

Click to expand...

You just do what you normal do for a cut, if the bleeding is excessive, you need to apply pressure to try to get it to stop. If it does not stop after applying pressure, time for the trip to a doctor. Good luck.

I was talking to my sister (a pediatrician, but still an MD right) about this because I have noticed a lot LESS bruising on Eliquis than when I was on 325 mg aspirin for the last 20 years. She said that the effects of anti-platelet medication (like aspirin) can be more noticeable to patients in terms of daily injuries than the effects of a DOAC or warfarin. Something about more impact from anti-platelet medications on the capillaries / smaller blood vessels which are what you're hitting with nicking your finger with a paring knife in the kitchen, or accidentally banging your hip into a table. Not sure I am getting her explanation perfect but it tracks with my experience.

Hi

dornole said:

...I have noticed a lot LESS bruising on Eliquis than when I was on 325 mg aspirin for the last 20 years.

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its interesting, I have this view that we need both platelets and also thorombin, however while we have a way to regulate the effect of our anti-thrombin medications (INR) we don't have a way to regulate the effect of our antiplatelet medications. Aspirin (as I'm sure you know) works as an antiplatelet by damaging the ability of the platelet to aggregate (link and link), which it would seem is binary rather than a continuum.

So, my approach to my own anticoagulation therapy supplement of anti-platelet is done knowing also that

• aspirins effect is quite short (because half life is quite short) but duration extends due to platelet lifespan
• platelets turn over and are produced constantly

which is why I take a lower dose but take it every second day (my administration is 150mg).

This process has resulted in good outcomes for me (less bruising while still avoiding any small occasional issues which I believe are TIA's)

(references reproduced also below)

https://www.thrombosisresearch.com/...d that aspirin and,, swelling, pain and fever

https://www.sciencedirect.com/scien...Acetylsalicylic acid (aspirin) is an,A2(TXA2)

https://www.sciencedirect.com/topic...t=Aspirin decays rapidly, with a,(7 ± 2 days)

pellicle said:

Morning

this has got to be the most discussed topic here (after bio or mech) and my experience is that most people have everything totally wrong.


The idea that a shaving nick leads to this is patently absurd

View attachment 890575

as you'd expect for life threatening injuries (leg ripped off in a car accident) the miniscule difference provided between warfarin and no warfarin is nil. So if you have a gunshot wound to the groin you're in as much trouble as anyone.



To be honest I can't see any difference between my bleeding response now and then; it is about what it was before I was on warfarin. My dentist even remarks that when doing cleans "if I didn't know you were on warfarin I wouldn't know.

The key to this in my view is proper INR management. Proper means be actually successful of being inside the designated range ... you know 2 ~ 3.
This just does not happen (statistically speaking) for people in clinics (where 70% time in range is cause for celebration). Myself I'm in range greater than 90% so much that I call 93% a bad year and 97% a good year.

I recommend you read this blog post of mine from 2014
https://cjeastwd.blogspot.com/2014/09/managing-my-inr.html

PS: I meant to add, that my Dad used to regularly nick his arm or back of his hand and it bled a lot. He was never on warfarin or any blood thinners. I know that working with him (with steel or aluminium, drills and grinders building truck bodies or working in boats) that he did bleed more from nicks and scratches at his age than I do now at that age (also working with steel and stuff)
https://cjeastwd.blogspot.com/2018/01/raising-roof.html

I commenced warfarin in late 2011, so lets call it 2012.


Best Wishes

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I'm not sure, but it sounded like the actual worry was highly physical activities in which you could get hit hard and risk of internal bleeding. As far as my nose bleeds he did ask how often they were and how often I have to get help to have them stop bleeding, which is a few times a year, and ONCE I had to go to the ER to have them stop it from bleeding.

Anyway, after reading the responses I'm not worried. I know how to put on a band aid. And should something major happen to me there are plenty of hospitals around me. LOL

Is a medical ID bracelet recommended when on anti-coagulants?

LondonAndy said:

Just keep a box of plasters in the kitchen

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Actually, our Band Aids are in a lunch box on top of the refrigerator. HAHAHA I am assuming a "plaster" is a band aid.

pellicle said:

and some superglue in the fridge ...

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That would be in the junk drawer, which is also in the kitchen.

SatoriFround said:

That would be in the junk drawer, which is also in the kitchen.

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needs to be the fridge for reasons of longevity (once opened). I also always use a small zip loc bag ... keep it propped "top end up".

SatoriFround said:

I'm not sure, but it sounded like the actual worry was highly physical activities in which you could get hit hard and risk of internal bleeding

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no, in my mind I was addressing the people who worry about every little nick and scratch (of which I got quite a few). Nothing in the above example involved things which would fall on me an give me a concussion or even remotely internal injuries.

I've seen far too many "I do gardening" reasons to explain why they'd bleed to death if they got a scratch from a thorn.

Amusing anecdote from that "roof raising" episode. I was so buggered and it was 7pm (getting quite dark) by the time I wound up and cleaned up (mostly). So I went to the pub for dinner and a beer or two. I was asked twice if I was ok by the barmaid. I said yes twice and put it down to being dirty, sweaty and smelly (not unlike most of the other men in the public bar). When I got home I discovered a large amount of blood staining on my (was white, now dirty and soiled ...) t-shirt. I wondered how that got there and remembered that the drill was slipping off the roof before me at one stage (as I was screwing in a metal thread) and I had chosen to block that from falling (one less trip up and down that bloody ladder) with my chest. Apparently it had cut me (it did sting a bit) and bled for some time (sweat perhaps helped spread it).

I laughed and went "ahh, that's why".

Lifes for living; I try not to hurt myself but minor events don't bother me. Few seem to get that who come from the city.

Best Wishes

Just felt that I should add that it is important to be sure that you aren't "a bleeder" before you make the choice.

If you are prone to bleeds (and I don't mean cuts) then you should weigh that factor as highly significant. Very few are bleeders, but if you are it can go very bad for you.

pellicle said:

Just felt that I should add that it is important to be sure that you aren't "a bleeder" before you make the choice.

If you are prone to bleeds (and I don't mean cuts) then you should weigh that factor as highly significant. Very few are bleeders, but if you are it can go very bad for you.

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That's why I brought up the nose bleeds to the surgeon. Some people get them, some don't. I have always gotten them, my wife said she's had ONE her entire life. On another note, I have my other consult scheduled. Monday afternoon. Then I will have to choose one and schedule my surgery.

SatoriFround said:

That's why I brought up the nose bleeds to the surgeon.

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also you totally do not want to have this complaint
https://www.ncbi.nlm.nih.gov/books/... tortuous,to diagnose in pathologic specimens

pellicle said:

Just felt that I should add that it is important to be sure that you aren't "a bleeder" before you make the choice.

If you are prone to bleeds (and I don't mean cuts) then you should weigh that factor as highly significant. Very few are bleeders, but if you are it can go very bad for you.

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We often do not have a choice when it is an Emergency Situation for OHS.