Hi all
I just had a chat with Robert Emery MD of St Paul Minnesota about his experience with mechanical valves, one of many people I've spoken to over the last week. He strongly advises anyone who is in there 20's 30's to go for a mechanical valve if they don't participate in contact sports or have specific reasons why a mechanical valve wouldn't be suitable.. He pointed out that he is aware of a person who has had a bi leaflet valve for over 30+ years without any problems at present . Not bad considering the first one was implanted in 1977. Anyway, as we all know, valve failure itself is never really the issue but mainly the INR management.
Over the last few days I've spoken to numerous cardiologists and surgeons who think Pradaxa and another drug (which I can't recall the name of!!) will be a better alternative to Coumadin for heart valve patients in the not to distant future (very soon in fact), greatly reducing the risk of valve related events. This is all very promising.. If mechanical valves have an almost 0% failure rate and potentially less than 1% stroke/ bleeding event then mechanical valves could become a whole lot more attractive. There are two reasons for me why Pradaxa or a similar alternative would be so beneficial- First of all it seems to interact with very few drugs/ foods/ alcohol. Secondly, because of the few interactions- eating a healthy green diet, supplements such as omega 3, Q10, green tea etc won't be limited. Vitamin K intake also has the potential to reduce the risks of coronary heart disease...
However, even if Pradaxa wasn't a potential alternative and Coumadin was our only option for the rest of our lives......everyone I have spoken to mentioned that the 1-2% risk of bleeding/ stroke each year includes those who don't manage their INR well- people who have too much alcohol, forget the odd pill, take at different times of day, don't take care of what they eat, get involved in dangerous activities etc. I think this is very interesting as I'd like to see figures based on well managed INR levels (a few people have made this point on here over the last month). From my point of view I think the education on managing INR levels is extremely poor, especially in the UK. Sure, they give you the basic info but I find more info in hospitals about not using a razor and use a soft toothbrush etc etc. I don't know what others think but personally getting the odd cut which may result in bleeding for longer is irrelevant in the bigger picture. Regular home testing, consistent food intake (amount and content) at consistent times each day, being aware of other drug interactions etc all seem to be relatively overlooked. For me, managing the INR levels seem so easy (in theory.. I'll let you know how it goes when I'm at that stage!), mainly down to this great site and unfortunately a site that the majority of valve replacement patients don't know exists.
One other point.. I was amazed at how willing and how much time surgeons/cardiologists were able to give me (considering they all new I had no intention of using them as I'm in the uk). After emailing a quite a few, nearly all of them gave me their direct number to call and discuss. I was on the phone for nearly 45 mins to someone in New Jersey. I'm pretty sure if it wasn't for me having to go the conversation would have carried on much longer!
I just had a chat with Robert Emery MD of St Paul Minnesota about his experience with mechanical valves, one of many people I've spoken to over the last week. He strongly advises anyone who is in there 20's 30's to go for a mechanical valve if they don't participate in contact sports or have specific reasons why a mechanical valve wouldn't be suitable.. He pointed out that he is aware of a person who has had a bi leaflet valve for over 30+ years without any problems at present . Not bad considering the first one was implanted in 1977. Anyway, as we all know, valve failure itself is never really the issue but mainly the INR management.
Over the last few days I've spoken to numerous cardiologists and surgeons who think Pradaxa and another drug (which I can't recall the name of!!) will be a better alternative to Coumadin for heart valve patients in the not to distant future (very soon in fact), greatly reducing the risk of valve related events. This is all very promising.. If mechanical valves have an almost 0% failure rate and potentially less than 1% stroke/ bleeding event then mechanical valves could become a whole lot more attractive. There are two reasons for me why Pradaxa or a similar alternative would be so beneficial- First of all it seems to interact with very few drugs/ foods/ alcohol. Secondly, because of the few interactions- eating a healthy green diet, supplements such as omega 3, Q10, green tea etc won't be limited. Vitamin K intake also has the potential to reduce the risks of coronary heart disease...
However, even if Pradaxa wasn't a potential alternative and Coumadin was our only option for the rest of our lives......everyone I have spoken to mentioned that the 1-2% risk of bleeding/ stroke each year includes those who don't manage their INR well- people who have too much alcohol, forget the odd pill, take at different times of day, don't take care of what they eat, get involved in dangerous activities etc. I think this is very interesting as I'd like to see figures based on well managed INR levels (a few people have made this point on here over the last month). From my point of view I think the education on managing INR levels is extremely poor, especially in the UK. Sure, they give you the basic info but I find more info in hospitals about not using a razor and use a soft toothbrush etc etc. I don't know what others think but personally getting the odd cut which may result in bleeding for longer is irrelevant in the bigger picture. Regular home testing, consistent food intake (amount and content) at consistent times each day, being aware of other drug interactions etc all seem to be relatively overlooked. For me, managing the INR levels seem so easy (in theory.. I'll let you know how it goes when I'm at that stage!), mainly down to this great site and unfortunately a site that the majority of valve replacement patients don't know exists.
One other point.. I was amazed at how willing and how much time surgeons/cardiologists were able to give me (considering they all new I had no intention of using them as I'm in the uk). After emailing a quite a few, nearly all of them gave me their direct number to call and discuss. I was on the phone for nearly 45 mins to someone in New Jersey. I'm pretty sure if it wasn't for me having to go the conversation would have carried on much longer!
). He seem to think that the drug is not yet ready as an alternative to Coumadin. He thinks that the Coumadin effects can be easily managed (i.e. can easily be reversed when needed by reducing the dosage), however no such flexibility exists with Pradaxa yet.
