2 questions

[Missy]

I take premarin and was wondering if coumadin can overcome the clotting associated with it? I don't know if it is something that effects the INR or does it just happen all of a sudden and coumadin has no effect. Can anyone help me ??? Al , maybe???

Also, does how does biotin effect the coumadin level or does it? My nails are really splitting since I am limited on the foods that supply nutrients, also hair is suffering and wondered if I should ask dr. next visit. I know I could take more coumadin so that I could eat more but have trouble with coumadin and if I failed to eat something I get sick. Also I am a thin person and don't eat a whole bunch. Usually, I am prone to just eat when I am hungry and that varies , so have had to train myself to eat at certain times and it is hard for me. There are lots of vitamins that I don't get and dr. will only let me take B vitamins but the one I take has minimal biotin.
Has anyone else had troube with nails ???

 

[Guest]

I don't know that there has been any information published about women taking warfarin and Premarin - certainly no studies. I think that the way to go would be with an estrogen patch. I know that the FDA has a warning about clots on the patch, too but I think that it is one of their almost meaningless "class warnings". The reports of clotting with patches are minimal. I think that the reasoning goes like this. When you swallow a pill and it is absorbed for the stomach, the blood flows directly to the liver. When the liver detects a high estrogen level it programmed to respond - "Pregnancy - need to produce lots of clotting factor so she doesn't bleed to death when the baby is born". So you have a high risk of clotting. But with the patch, the blood is absorbed through the skin and is diluted throughout your body and by the time it gets to the liver the level of estrogen is not high enough to produce the "pregnancy reaction". Thus fewer clots. Again, no scientific evidence that thsi is true but I have discussed it with a lot of docs and they all seem to agree that it makes sense and none have responded that they have had a woman on the estrogen patch get a clot.

I don't know anything about biotin being harmful with warfarin.

Hair loss is a fairly common reaction with warfarin.

 

[ALCapshaw2]

WHY are you "limited on the foods that provide nutrients"?

Did someone tell you NOT to consume ANY vitamin K because of Coumadin?

If so, you received BAD ADVICE. As Ross says, "Dose the Diet, don't Diet the Dose" which means you can consume foods containing vitamin K as long as you are consistent. It is MUCH easier to eat some greens EVERY DAY and adjust your Coumadin dose accordingly than to try to avoid vitamin K entirely.

'AL Capshaw'

 

[Missy]

I am limited because I am a slow metabolizer and I have all the side effects of coumadin. It makes me sick in just a few minutes of taking it. And I have to eat something. But my body cannot tolerate much coumadin and I am not a big eater. I am consistant on the vitamin k that I eat. I just have kind of found my niche so to speak after all kinds of bad experiences. And my doctor doesn't want me to take a multiple vitamin. I guess he is afraid I will get in trouble with it.
There are just some people whose bodies cannot tolerate coumadin but yet have to put up with it because of medical reasons. So unless I can come up with something better I just try to eat what I can with my same old diet. It does get tiresome and I know I am not eating properly. Just I don't know what to do about it.
The dr. is not making me do it. I just cannot tolerate coumdin. He has done everything he can.
Thanks for the help.

 

[Guest]

What are "all the side effects of Coumadin"? The most common side effect is hair loss and that is pretty rare. When a medication causes upset stomach a few minutes after taking it, this almost always subsides after two weeks of taking the drug. Taking warfarin with even a small glass of milk should beffer all of the irritant effects. I can't think of one person in the thousands that I have seen who had side effects persist beyond two weeks who was not so afraid of the warfarin that they worked themselves into a panic every time they had to take it. My guess is that you have had some bad advice from people (maybe even professionals that you trusted and others who just want to "jack you up") and that they have made you so afraid of the drug that you are convinced that something bad is going to happen.

Here are the results from my clinic.

A minor bleed usually a nosebleed occurs about every 1.5 patient years.

A major bleed occurs once in every 33 patient years.

The odds are highly in your favor that if you took warfarin every day for the rest of your life, you would never experience a bleed bad eniough to need a transfusion.

Read as many of the posts on this site as you can. You will find that there are marathon runners, competitive cyclists, a guy who has been taking warfarin for 45 years, several others who are approaching 40 years and all have lived good lives. You need to start believing some good reports instead of scaring the life out of yourself by listening to people who either don't know good advice or people who are deliberately giving you scare stories.

Can you go see a good warfarin doc like Alex Spyropolous at Lovelace in ABQ? If so let me know and I'll give you his phone number. (His patients call him Dr. Spy)

 

[Missy]

I appreciate what you are trying to tell me and I do understand about all of that. It is the same thing that I have heard from my doctors. I have been in the hospital and they have seen how I react to medicine. I am highly sensitive to medicines. Lots of other things also.

I would also not be against going to see another dr. but am really satisfied with my own. Unless he can work out some of this problem I experience.

I don't think the way a person feels or the side effects they experience should be discounted just because 100 other people have not experience it. Or that some dr. somewhere hasn't seen it.

I feel there might be one person in several milllion who has certain things happen to them and that they should be treated as an individual.

My daughter in law died of cancer 2 yr. ago because it took the dr. too long to decide that she had a rare type of cancer only documented 4 other times and no way to treat it. They just had to guess at it. And we are talking about M D Anderson Hospital. They did the very best they could after they figured it out. I also have another friend who has some sort of lung and heart problem associated with Primary Pulmonary problems that the dr. tell him only happens once in several million. It took him awhile to get his dr. to get him to the right dr. also. He did have severe symptoms that they could see. It is a good thing or they might not have believed him either.

When I take coumdadin I get sick to my stomach and if I don't eat something I throw it up. And I get all rashy after a few hr. if I don't get my vitamin k right away. I get woozy and start getting prickly and burning on my skin but am freezing. The bottoms of my feet go numb. I get headaches and have little episodes of prickly sensations in my head ( inside) I am also still having hair loss. The only way the dr. have figured out how to keep my INR in range and for me not to be sick (and some of this was my own experimentation) is to take my pills without meals but eat about an hr. after. It doesn't take long for the symptoms to go away after I eat. I also have other side effects but have had to be hospitalized at one point to determine what was caused from the coumadine and what was caused from lanoxin.

I take my lanoxin in a spit dose because a whole dose almost paryalyzes me. Brain and all. My heart really slows down and I just take a small dose.

I went into the local hospital once because of all this. Husband rushed me in and had a local cardiologists laugh it off and say it was impossible. He wasn't laughing several days later after having all the monitors on me. Just a few minutes after taking medicine my heart acts up and almost quits. He put me back on my spit dose and told me to continue as he had never seen anything like it.

Sorry to be such a pardox. Maybe I shouldn't tell this stuff on here and get others confused and afraid. I won't do it again. At least not real often. LOL. I just cannot help but complain every now and then. I am normally a stoic person. I think one has to be to put up with some of these things.
I am not afraid of the coumdin too badly other than the feeling bad. But like I said it is not the only medicine I take.

 

[Guest]

Making a diagnosis is a lot about statistics. If you fit in the bell shaped curve it gets made fairly easily. If you fall way outside the curve sometimes the diagnosis is made with an autopsy. If a cancer workup was done for everyone who had vomiting the health care system would be so full that your mother would have to make an appointment for all of the ailments you might develop right when you were born. So when you are way outside the curve, nobody is going to have the slightest idea what to do for you. You have to do what Missy did and either tough it out or figure it out on your own - both diagnosis and treatment.