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Agian
Well-known member
Arizona is a degenerate place with mediaeval anti-Warfarin laws. The vigilantes will test your INR and if it's over 3.5 they'll kick the **** out of you and leave you for dead. Get a blood nose in a place like that and you're on your own.
pellicle
Professional Dingbat, Guru and Merkintologist
Agian;n875228 said:
Arizona is Open Carry (https://en.wikipedia.org/wiki/Gun_laws_in_Arizona#Open_carry)...
so do like the locals and blend in
[IMG2=JSON]{"data-align":"none","data-size":"full","src":"http:\/\/secretlaboratory.org\/wp-content\/uploads\/2013\/07\/open+carry1313499177.jpg"}[/IMG2]
don't let some thug give you a blood nose
God created (hu)Man(ity) but Colt made us equal ;-) (non sexist verion)
Agian
Well-known member
The Elmer Fudd convention.
Now that's something you don't see in Adelaide LOL
Now that's something you don't see in Adelaide LOL
Homeskillet
Well-known member
Wowsie - simply Wowsie! Seriously almost didn't make it through this one. Pain was over the top (even accord. to the surgeon, staff, etc.). Developed a herniation that slipped between the ribs. Also developed Pneumonia 2 days after surgery & had to go back on ventilator for 2 days w. 100% oxygen. Surgeon told wife "This is serious" at that point & that he could not "predict the future." Slowly began to work out of it though.
The surgeon removed a piece of "something" that was a "stroke waiting to happen" he said. Sent it off to be tested. Said the clump of "whatever" just easily came loose when he removed it.
Received an On-X valve w. an INR range of 2.5-3.5 for now. It's currently stalled at 2.1 (almost 2 weeks post-op. now). Hence, I am bridging w. Lovenox & they have upped my Coumadin intake to 11.25 mg. for next 3 nights in an attempt to get me off the Lovenox. However, the surgeon stated that w.in a few months we hope to shoot for lowering the range due to the On-X valve.
Of course, the disconcerting thing is that no one knows what caused this & thus cannot predict whether it will pop up again or not. Honestly do not think I would make it through another one if this one is any indicator. And, the surgeon said that he would not want to be the person performing the 3rd one since this one was so extremely difficult according to him.
Spent a while at the Coumadin Clinic today talking to a lady about the dangers & regulation of warfarin. Though I could be mistaken, a few of her comments were a bit concerning.
(1) She stated that once we get me into the current range of 2.5-3.5 that she thinks that a once/month check is fine if the INR level is remaining consistent. I told her that that does not sound right since that's quite a long ways in between tests. Of course, she disagreed (the very reason I despise dealing w. stubborn doctors). Until I can get into self-checking I am left w. no other option I guess.
(2) She stated that if I were to receive a blow to the head or a bruise that looked ugly & was growing that I should go to the ER immediately. This made me wonder about bruises that pop up when someone accidentally jams an elbow on a door frame, stubs a toe really bad, hits a shin, etc. - all causing pretty serious bruising (w.out even being on an anti-coagulant). To illustrate, about 6 months ago I was walking through the house barefoot when I accidentally slammed my toe into a door jam, clearly breaking it. It was horrid pain. Well, would a broken toe of finger merit a trip to the ER now that I am on Coumadin?
Or, what about when we are bending over & then raise our heads quickly & slam it into a desktop or hit your head on an overhead beam, etc.? Am I to run off to the ER every time something like this happens? Not being funny when I ask if I should purchase a pair of steel-toed work boots, cow-hide gloves, etc.?
I realize that y'all were being humorous when you answered my question about nose bleeds in an arid climate like Arizona, but, seriously, there's not a time that I don't go there that my nose doesn't start gunking-up w. blood almost as soon as I get there - and that's w.out Coumadin! How do I offset this? I would have the same question about high elevations, etc.
Finally, the surgeon has placed me on Carvedilol 3.125mg. tab, 2x's per day - & stated that he would likely leave me on this beta-blocker (I already have 11 refills). Is this really beneficial? Or is it just another unnecessary drug I have to be on? Will this beta-blocker impair my quality of life even more than the Coumadin? Just honest questions drifting through my mind.
Really concerned about the insistence by the Coumadin Clinic to only have INR checked once/month - which I fully anticipated.
Again, I want to thank every-single person who has taken the time to educate me on these topics (no doubt I will have more questions as time rolls)!
The surgeon removed a piece of "something" that was a "stroke waiting to happen" he said. Sent it off to be tested. Said the clump of "whatever" just easily came loose when he removed it.
Received an On-X valve w. an INR range of 2.5-3.5 for now. It's currently stalled at 2.1 (almost 2 weeks post-op. now). Hence, I am bridging w. Lovenox & they have upped my Coumadin intake to 11.25 mg. for next 3 nights in an attempt to get me off the Lovenox. However, the surgeon stated that w.in a few months we hope to shoot for lowering the range due to the On-X valve.
Of course, the disconcerting thing is that no one knows what caused this & thus cannot predict whether it will pop up again or not. Honestly do not think I would make it through another one if this one is any indicator. And, the surgeon said that he would not want to be the person performing the 3rd one since this one was so extremely difficult according to him.
Spent a while at the Coumadin Clinic today talking to a lady about the dangers & regulation of warfarin. Though I could be mistaken, a few of her comments were a bit concerning.
(1) She stated that once we get me into the current range of 2.5-3.5 that she thinks that a once/month check is fine if the INR level is remaining consistent. I told her that that does not sound right since that's quite a long ways in between tests. Of course, she disagreed (the very reason I despise dealing w. stubborn doctors). Until I can get into self-checking I am left w. no other option I guess.
(2) She stated that if I were to receive a blow to the head or a bruise that looked ugly & was growing that I should go to the ER immediately. This made me wonder about bruises that pop up when someone accidentally jams an elbow on a door frame, stubs a toe really bad, hits a shin, etc. - all causing pretty serious bruising (w.out even being on an anti-coagulant). To illustrate, about 6 months ago I was walking through the house barefoot when I accidentally slammed my toe into a door jam, clearly breaking it. It was horrid pain. Well, would a broken toe of finger merit a trip to the ER now that I am on Coumadin?
Or, what about when we are bending over & then raise our heads quickly & slam it into a desktop or hit your head on an overhead beam, etc.? Am I to run off to the ER every time something like this happens? Not being funny when I ask if I should purchase a pair of steel-toed work boots, cow-hide gloves, etc.?
I realize that y'all were being humorous when you answered my question about nose bleeds in an arid climate like Arizona, but, seriously, there's not a time that I don't go there that my nose doesn't start gunking-up w. blood almost as soon as I get there - and that's w.out Coumadin! How do I offset this? I would have the same question about high elevations, etc.
Finally, the surgeon has placed me on Carvedilol 3.125mg. tab, 2x's per day - & stated that he would likely leave me on this beta-blocker (I already have 11 refills). Is this really beneficial? Or is it just another unnecessary drug I have to be on? Will this beta-blocker impair my quality of life even more than the Coumadin? Just honest questions drifting through my mind.
Really concerned about the insistence by the Coumadin Clinic to only have INR checked once/month - which I fully anticipated.
Again, I want to thank every-single person who has taken the time to educate me on these topics (no doubt I will have more questions as time rolls)!
pellicle
Professional Dingbat, Guru and Merkintologist
Sorry to read about your rough ride.
I can only concur with your observations in stubborn medical professionals. It seems the lower in rank and qualifications the more blinkered and officious they are. There are many anecdotes over in the AC forum.
I'm not sure why they aren't just doing the obvious and raising your dose of the INR is not approaching target. Some places seem to regard that numbers of mg are somehow significant when INR is the actual significant goal.
A blow to the head of severity is increasingly dangerous as you age. So it's sound advice. I lick the chair and table leg from time to time and get bruises from working doing carpentry around the house and don't go in for an MRI every time I get a mark
There is a lot of manic advice stuff is caused by public over reaction. Recently at a supermarket there was a stand doing taste testing of peanut paste (called butter in the USA, which I find weird cos it's lumpy and crunchy and not like even the right colour for butter). The woman at the stand has a sign in large print "WARNING may contain traces of peanut". I looked at her as I had a sample in my hand and was reading the sign and said "you mean this peanut paste may contain peanuts?"
Oh yes, are you allergic to peanuts. On my head I'm like WTF its PEANUT PASTE I expect it to have more than traces.
Don't worry about the monitoring or that sort of issue right now. You have bigger fish to fry it will work itself out in the coming months and years.
Best Wishes
I can only concur with your observations in stubborn medical professionals. It seems the lower in rank and qualifications the more blinkered and officious they are. There are many anecdotes over in the AC forum.
I'm not sure why they aren't just doing the obvious and raising your dose of the INR is not approaching target. Some places seem to regard that numbers of mg are somehow significant when INR is the actual significant goal.
A blow to the head of severity is increasingly dangerous as you age. So it's sound advice. I lick the chair and table leg from time to time and get bruises from working doing carpentry around the house and don't go in for an MRI every time I get a mark
There is a lot of manic advice stuff is caused by public over reaction. Recently at a supermarket there was a stand doing taste testing of peanut paste (called butter in the USA, which I find weird cos it's lumpy and crunchy and not like even the right colour for butter). The woman at the stand has a sign in large print "WARNING may contain traces of peanut". I looked at her as I had a sample in my hand and was reading the sign and said "you mean this peanut paste may contain peanuts?"
Oh yes, are you allergic to peanuts. On my head I'm like WTF its PEANUT PASTE I expect it to have more than traces.
Don't worry about the monitoring or that sort of issue right now. You have bigger fish to fry it will work itself out in the coming months and years.
Best Wishes
Agian
Well-known member
Bruises tend to grow and be ugly. In fact, I have yet to meet an attractive one. Bump a llmb and you will likely bruise. If you go to emergency with a bruise, they're likely to say 'so what'? You can't freak out every time you hit yourself. As for the blood noses... they're blood noses. Pinch your nostrils and ask for a blood transfusion if you lose consciousness.
The surgeon probably removed a piece of calcium (that's what they do) and hammed it up for dramatic effect (the wanker). Then you got pneumonia, like I did. Also, not uncommon.
Once you get your own kit, you'll be able to check your inr whenever you want to.
Relax. You'll be fine.
The surgeon probably removed a piece of calcium (that's what they do) and hammed it up for dramatic effect (the wanker). Then you got pneumonia, like I did. Also, not uncommon.
Once you get your own kit, you'll be able to check your inr whenever you want to.
Relax. You'll be fine.
I have an ON-X. Surgery was November 1 last year at Mayo. I had the same problems as you getting INR in line. Did the shots in belly of Lovonox also. It came in line shortly thereafter.
I now go to coumadin clinic once a month and surgeon said I could eventually go a few times a year. He DID say I could get a tester for at home but still thinks once a month is enough. He said the reading could be 1.7 and still be ok.
Do what makes you comfortable and let your doctor know of concerns. Make the decision with him/her and then ........go forth and live!
I now go to coumadin clinic once a month and surgeon said I could eventually go a few times a year. He DID say I could get a tester for at home but still thinks once a month is enough. He said the reading could be 1.7 and still be ok.
Do what makes you comfortable and let your doctor know of concerns. Make the decision with him/her and then ........go forth and live!
Superman
Well-known member
Once a month is pretty standard with lab draws. They will step it up if you are out of range. But home testing should be your goal where weekly testing is the norm. With me, the Coumadin clinic is still involved. I test. I call the testing company with my result. The testing company calls the Coumadin clinic with my result. The Coumadin clinic calls me to tell me the result I already knew. Then, if I need a change, the Coumadin clinic tells me what I should do. Then I tell them what I already did. Then they put me on hold, talk to somebody, pick the phone back up and tell me that will work and they'll note it in my file. It's all about gaining efficiency.
Regarding bruises, cuts, and other various injuries, maybe I don't know any better, but it's been pretty much business as usual. I may get the occasional unexplained bruising, but nothing that worries me. Bloody noses typically stop eventually. Be sensible. Don't panic at the sight of blood, but seems to me if it were unusual, a person would know when to seek additional care. I'm rather tall and have hit my head on many occasions (explains a lot). Can't think of the time I've felt compelled to have a Dr. look at it. I guess I'd watch for concussion symptoms, like any normal person would.
Regarding the other stuff- yeah - surgery is no joke. I'm all about minimizing the number of times it has to happen. It's not one of those things that gets easier as we practice, and age certainly doesn't help either. I mean, as far as your body is concerned, you were attacked, drugged, sawed open, and then closed up. Might be a while before it forgives you for this.
Regarding bruises, cuts, and other various injuries, maybe I don't know any better, but it's been pretty much business as usual. I may get the occasional unexplained bruising, but nothing that worries me. Bloody noses typically stop eventually. Be sensible. Don't panic at the sight of blood, but seems to me if it were unusual, a person would know when to seek additional care. I'm rather tall and have hit my head on many occasions (explains a lot). Can't think of the time I've felt compelled to have a Dr. look at it. I guess I'd watch for concussion symptoms, like any normal person would.
Regarding the other stuff- yeah - surgery is no joke. I'm all about minimizing the number of times it has to happen. It's not one of those things that gets easier as we practice, and age certainly doesn't help either. I mean, as far as your body is concerned, you were attacked, drugged, sawed open, and then closed up. Might be a while before it forgives you for this.
Homeskillet;n875497 said:
Weekly/bi-weekly testing may be overkill??....but it beats a stroke. Remember that most lab people are used to dealing with people, usually older people, on warfarin for reasons other than mechanical valves....usually A-fib or other blood disorders and monthly, or even quarterly, testing may be OK for them......but not me. With the low cost and convenience of self-testing it is foolish to NOT test more frequently. The inconvenience of testing is far less than long term effects of stroke...and far less expensive.
I would agree that if you receive a nasty blow to the head, especially with other symptons, go to an ER. Bruising or cuts, scrapes, may, or may not, require an ER visit.....use your common sense. BTW, I've never had a bump on the head or a bruising that required ER attention........but I have had more than a couple occasions for and ER visit for stitches.....once when I was hit it the back of my head with an operating ceiling fan.....no bleeding on the brain but a bunch of stitches and a hair cut.
Based on the condition, proper attire, boots, gloves, etc, might be a good idea.
Nose bleeds have always been a problem for me, pre and post warfarin. A few years ago a friend suggested a "sinus wash" to help clear my nose and keep it from drying out........works like a charm. Available OHC at your local drug store.
Dealing with warfarin has a pretty simple learning curve and it is not that difficult......you'll see.
Glad to read that you're on the road to recovery. If you develop problems with this valve as a result of a condition your surgeon can't pinpoint the cause of, I suggest you seek answers from other medical facilities and doctors. Hopefully you will have no reason to. Best wishes, Mary
Homeskillet
Well-known member
Thank you once again every one! Have learned a ton on this forum.
Quick follow-up question (don't mean to drag this thread out):
It sounded like the lady @ the Coumadin Clinic yesterday was saying that if I alter my diet in any way I need to let them know. Does this mean that if I go w.out donuts, cookies or cake for a few weeks, then all of the sudden get a craving for them - this will throw my INR into a tail-spin & I need call the clinic?
Same concept w. soft drinks, etc.
Similarly, after I recover I intend to get back into the gym lifting weights. This will involve pre-workout drinks, post-protein powder, etc. This will obviously be an alteration into my diet since surgery (there's really little need for these items right now). Will this alter my INR also?
Or, is she only referring to foods rich in vitamin K?
Thank you again!
Quick follow-up question (don't mean to drag this thread out):
It sounded like the lady @ the Coumadin Clinic yesterday was saying that if I alter my diet in any way I need to let them know. Does this mean that if I go w.out donuts, cookies or cake for a few weeks, then all of the sudden get a craving for them - this will throw my INR into a tail-spin & I need call the clinic?
Same concept w. soft drinks, etc.
Similarly, after I recover I intend to get back into the gym lifting weights. This will involve pre-workout drinks, post-protein powder, etc. This will obviously be an alteration into my diet since surgery (there's really little need for these items right now). Will this alter my INR also?
Or, is she only referring to foods rich in vitamin K?
Thank you again!
MartinF
Well-known member
I just saw this post. Was out of the country an not on the Internet so missed a couple weeks of posts. I have the same Epic mitral valve except 33mm. 6 months after surgery I went off Warfarin and within 2 months I had stenosis of the valve. Surgeon put me on Heparin thinking it was a blood clot. It cleared up and now I'm on Warfarin for life. My new cardiologist finally told me my body reacted to something on the valve, either a chemical on the surface or the tissue. All has been good since then. Sorry I missed posting sooner. Martin
Homeskillet
Well-known member
Have also read that caffeine is known to interact w. Coumadin and/or affect INR - yet my surgeon told me that I was fine to drink coffee?
Sooo much confusing info. :test:!
Sooo much confusing info. :test:!
Homeskillet
Well-known member
MartinF;n875524 said:
Wow. Never heard of anyone w. a tissue valve having to take Coumadin.
Again, no one has any idea what caused this...but your post is quite intriguing.
Homeskillet
Well-known member
judy bee;n875519 said:
Hope you are faring well!
Homeskillet;n875528 said:
Yep, there is a ton of uniformed and misleading info floating around about warfarin. Most things, in moderation, will not dramatically affect INR. Coffee, cookies, etc have never affected my INR. Not sure about the ingredients in some power drinks.....check ingredients and/or check INR to see if any affect. My first rule of managing INR is "dose the diet......do not diet the dose". Self-testing makes INR management very simple. I've found that keeping a consistent level warfarin in my system is the key. Take your pill at the same time each day (you choose a convenient time) and buy yourself a seven day pill box...... missed dosing or overdosing is the biggest problem with warfarin.
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pellicle
Professional Dingbat, Guru and Merkintologist
well if for instance you come out of surgery with a-fib (which is a possiblity) then its a 100% certainty you'll be on warfarin ... just for starters. Which is why I always advocate for inform yourself and this is a good place to start ... with people who have been there and done that.Homeskillet;n875529 said:
pellicle
Professional Dingbat, Guru and Merkintologist
dick0236;n875545 said:
I just wanted to second this ... INR doesn't shoot up over night, but it can climb up over a week or two if something unexpected changes. One offs are highly unlikely to have any effect (like, I ate 23 pounds of spinach for a dare) but lifestyle or medication changes may.
One to watch out for is grapefruit juice ... a glass won't have any effect, but drinking (grits teeth using yet another imperial measurement) a quart a day will.
A thread on that:
http://www.valvereplacement.org/foru...-python-moment
(sure do miss Ski Girl)
