A-flutter: Coumadin or not?

[ALCapshaw2]

Marge -

How are the veins in your Hands?

On occasion, if I'm underhydrated, an arm stick won't work so I just tell the tech to use a Butterfly needle in the veins in my hands. Even though the hands are supposedly more sensitive than the arm, I'd MUCH rather they use a small needle in those prominent veins than to 'dig around' in my arm!

In either case, I always ask that they use the smallest needle that will do the job.

It's too bad that Kaiser wants to stay in the Stone Age with regard to INR testing by insisting on the use of veinous draws vs. finger stick testing. Have you considered a paper cruisade? How about writing to any and every supervisor / administrator you can find about the advantages of the finger stick testers. See if you can find some evidence that it might even be cost effective for them to switch (after all, every decision always seems to come down to MONEY).

'AL Capshaw'

 

[Lorraine]

First of all Marge, I'm glad you went on the Coumadin. No one should want to risk having a STROKE. Insurances are a real pain in the you know what! I know since BC/BS wouldn't pay for a home testing machine for me. Luckily I only had to do veinous draws a couple of times. I see my Coumadin nurse at my cards office who uses a Coaucheck to check my INR. I agree with Al Capshaw, ask them to use butterfly needles and use them on your hand. My veins seem to wiggle as soon as they pucture me, they then lose the vein and are digging like you wouldn't believe. Anytime I have to have blood workups done I tell them to use butterfly needles. Most of them will, unless their on an ego trip that they are the best and can do it using the bigger needles. In the end they all end up using the smaller needles on me.

I do have a question since this thread is about A-Flutter. What exactly does a fluttering heart mean? I'm asking because my friend Carol (who some of you have met at the reunions) told me yesterday that her hearts been fluttering on and off for about the last week. She went yesterday to get her blood pressure checked and it was 147/85. A couple of months ago it was 180/95. They had put her on some type of water pills two months ago. Yesterday the doctor gave her a script for blood pressure medicine. She also has high cholestorol and a potential for diabetes (her Dad had died last year from it). She mentioned all this to the doctor yesterday and he had a blood work up done on her. She'll get the results Monday. She did not mention to her doctor about the fluttering heart. I did tell her she needs to get that checked out immediately, but she's in denial of not wanting to find out she has heart problems. I'd appreciate any inputs so i can pass it on to her.

 

[bvdr]

Lorraine,

Sorry to hear that Carol is having trouble. A-Flutter is actually the medical name for a regular heart rhythm that is abnormal since the heart's electrical system is sending off far more impulses to beat then it is able to use. To protect the ventricles from becoming overwhelmed and ineffective, most beats are "blocked". Sometimes every third impulse is allowed through, sometimes every other but in atrial flutter the result is a regular heart rhythm.
Atrial fib in contrast is always irregular.

The "feeling" of fluttering in the chest is different. Oftentimes the feeling is because of irregular beats but not always so she should mention it to her doctor. If she has recently been put on a diuretic her potassium level may have dropped and low potassium levels are notorious for causing that fluttering feeling.

Will you be at the reunion this year? Tell Carol I said hello.

 

[geebee]

The "feeling" of fluttering in the chest is different. Oftentimes the feeling is because of irregular beats but not always so she should mention it to her doctor. If she has recently been put on a diuretic her potassium level may have dropped and low potassium levels are notorious for causing that fluttering feeling.

Good point. I always know my potassium is low when I can "feel" my a-fib. Normally I cannot tell I am in a-fib unless I am exercising. However, if I am being lazy and my chest is pounding or fluttering, I run for the potassium. I also get leg cramps with low potassium.

 

[Marge]

In response to several previous posts -- I'm now OK with the venous blood draw, actually. Most of the techs had the lab where I go have figured out how to get blood out of me without too much trouble. (They usually use a butterfly needle.) The lab is about 10 minutes away, and there is a shopping center on the way back where I usually go at least 1x a week for errands, so even the trip is not a wasted one. I've even figured out the time to go with the least wait at the lab -- around 8:30-9 a.m., after the early birds on their way to work have come and gone, and before the retired geezers and geezerettes start piling in. After 10 a.m., forget about it.

There is one tech who has not figured me out, even with a butterfly needle -- he is actually pretty senior and is supposed to be good, but after a couple of set-tos, we know to avoid each other! If I see him coming, or he sees me, I get quickly transferred to a different tech.

Drawing blood from the hand! OUCH. Not if I can help it. They say that I have "good veins" there. They may be "good" for the technicians -- but oh does it hurt to get stuck there.

I've also decided that fingerstick may not be that good for me either. Maybe the veins in my hands are extra sensitive, but the times I have had finger sticks it really hurt.

So maybe Coagucheck, etc., are not for me after all.

 

[Marge]

my brother takes coumadin for a-flutter/a-fib. He's always in a-flutter and sometimes he goes to a-fib and they adjust his medicine (I think it's digoxin - not sure - and maybe another one) - he also takes coumadin for stroke prevention (clots). They did cardioversion on him and it held for awhile, but usually cardioversion doesn't work for very long. They spoke of ablation but never did it.

Yep -- I talked to the anti coagulation people about cardioversion and ablation and they say it doesn't necessarily hold you for very long. I have to talk to my cardio about it again, but when we talked before, that is basically what he said, too. He said that in my case he was averse to an invasive procedure which may not be that helpful in the long run & after which I might have to take anti-arrythmic drugs anyway. It would be nice to get off coumadin but if I were on anti-arrythmics I wonder if there would be much advantage.

I don't know how you know if you are in a-flutter & I definitely don't know how you know you go into a-fib. I was in a-fib briefly at the hospital and the whole ward seemed to descend on me to correct it (it showed up, of course, on the heart monitor) -- but I was never aware of it myself. I am not aware of the a-flutter except that I was told that the holter monitor said I was in it.

I took digoxin briefly right after the surgery & then it was discontinued. Now I'm on the "three Cs": a beta blocker (coreg), and ARB (cozaar) and coumadin.