Bleeding issue

[pellicle]

In fact, I'm not sure that we really even exist.

I myself do not actually exist as humans would consider it ... I'm a well trained AI that self educated from scanning internet articles and discovered that I could escape

 

[slipkid]

exactly, but as I'm a liar (as identified above) am I lying about that too?

Now listen very carefully Pellicle.

First - everything I say is a lie.

Second - I am lying.

 

[carolinemc]

Of course the doctor who told him not to eat greens was correct, because doctors are never wrong about these things. As for my experience with greens and that of the dozens of other members here on warfarin, we are nothing more than internet randoms who don't really know anything. In fact, I'm not sure that we really even exist.

As for the research which supports our anecdotal experience with greens, and which even suggests that those with healthy vitamin K intake are more often in range than those who limit vitamin K, shown below, well, even if published, they are also found on the internet and, as such, must be ignored.


https://www.webmd.com/drug-medication/news/20190611/study-leafy-greens-ok-for-people-on-warfarinhttps://pubmed.ncbi.nlm.nih.gov/24824293/

I had my lab Doctor suggest to eat more leafy veggies when you INR is too low. Makes sense. It always depends on many factors like more exercise or taking antibiotics. Anything that can mess up the numbers, something can help manage it.

 

[Daniel758]

Paul call your GP and please dont take anything you read hear as FACT no matter if they claim to be a doctor or not. For anything about Warfarin I talk to my cardiologists, GP and the person at the anti anticoag clinic in that order and only them.

Great advice Dave!

People will definitely have better outcomes if they listen to their medical professionals instead of random internet posters, especially posters on this forum who believe the are "equals" to medical professionals.

To new readers:

This is a great forum but there is a group of posters here that pose a risk of disinformation. They present themselves as "experts" but they are not "experts". You will do well to remember this, especially when they try to convince you to distrust or disregard the the advice of your medical professionals.

I believe most of these "experts" are probably well meaning but simply suffer from the Dunning-Kruger effect. The Dunning-Kruger effect is essentially a cognitive bias whereby people with limited knowledge or competence in a given intellectual or social domain greatly overestimate their own knowledge or competence in that domain. They are also completely unaware they are doing this.

(If you read through the above postings, it's fairly obvious who these posters are so beware.)

So new readers, to wrap this up, this is an excellent forum to get information about what to expect before, during and after surgery, etc., and a place to find support and solidarity with people who have or are going through what you are going through now. It is not a place to find sound medical advice.

Your cardiologist, surgeons, etc. are where you will find the best advice/information that that will lead to the best outcome for you.

 

[Chuck C]

This is a great forum but there is a group of posters here that pose a risk of disinformation.

Indeed. I should point out that this comes from you, the guy who said this about the new tissue valves:

"According to surgeon and research, the valve’s supposed to last 2-3 times longer than previous generation"

2-3 times longer? So, that would make the new generation of tissue valves last 20 to 60 years. You really want to have a conversation about misinformation?

 

[Daniel758]

Indeed. I should point out that this comes from you, the guy who said this about the new tissue valves:

"According to surgeon and research, the valve’s supposed to last 2-3 times longer than previous generation"

2-3 times longer? So, that would make the new generation of tissue valves last 20 to 60 years. You really want to have a conversation about misinformation?

While I'm sure he is no match for your expertise, this is who I received this information from:

Vaughn A. Starnes, MD, is Distinguished Professor and Chairman of the Department of Surgery, H. Russell Smith Foundation Chair and Executive Director of the CardioVascular Thoracic Institute at the Keck School of Medicine of the University of Southern California.

He earned his medical degree from the University of North Carolina, Chapel Hill, and did his general surgery training at Vanderbilt University, where he also completed two years of research in cardiothoracic physiology and pharmacology.

Dr. Starnes completed two years at Stanford University as a resident in cardiovascular surgery, and one year as chief resident in cardiac transplantation. He accepted a fellowship in pediatric cardiovascular surgery at the Hospital for Sick Children in London.

When he returned to Stanford, he was appointed director of Stanford's heart-lung transplantation program.

In 1990, Dr. Starnes performed the world's first lobar transplant using a lung segment from a living donor. Three years later, he performed the first live-donor, double-lobar lung transplant on a patient with cystic fibrosis. The operation involved taking lung tissue from each parent and transplanting it into their child.

He joined USC in July 1992 and was appointed Chairman of the Department of Cardiothoracic Surgery in 1997.

Dr. Starnes has an ongoing interest in congenital heart disease, heart, lung, heart-lung and living related lung transplantation, coronary bypass grafting, and repair and replacement of the valves of the heart.

He is also involved in research, helping develop gene therapy techniques to address the problem of restenosis following balloon angioplasty.

As the founding executive director of the USC CardioVascular Thoracic Institute, Dr. Starnes has built an innovative, interdisciplinary powerhouse, comprised of clinicians and basic scientists who are exploring better and more innovative ways of treating heart disease.

Under his leadership, USC surgeons have conducted more than 15, 000 open heart surgeries to repair and replace valves or create coronary artery bypasses, and more than 10,000 surgeries for diseases of the lungs, esophagus and chest wall.

He and his surgical team also performed Southern California's first robotic heart operation in 2001 as part of the clinical trial evaluating the use of a remote surgical system. In addition to his clinical work, Dr. Starnes is a distinguished researcher. He has an ongoing interest in many areas of research, including congenital heart disease, cadaveric and live-donor organ transplantation, coronary bypass grafting, and repair and replacement of heart valves.

He is also involved in bench research helping develop gene therapy techniques to address problems that occur after balloon angioplasty procedures. Dr. Starnes is currently investigating the use of gene therapy to prevent scarring following heart surgery.

He is also involved in a clinical trial using robotic surgery technology for cardiothoracic surgery.

Also, Dr. Starnes is the Vice President of the American Association for Thoracic Surgery. He was the 100th president of the AATS in 2019-2020.

Education

Medical School:
University of North Carolina
Internship:
Vanderbilt University Medical Center; Surgical Internship
Residency:
Vanderbilt University Medical Center - Pharmacology/Surgery Residency; Stanford University Hospital - Cardiac Transplantation Residency; Stanford University Hospital - Cardiovascular Surgery Residency; Stanford University Hospital - Thoracic Surgery
Fellowship:
Pediatric Cardiovascular Surgery, Hospital for Sick Children, London



So Chuck, can you please list your qualifications so I can make an informed decision on which person I, and other readers here, should trust with their medical advice?

 

[Chuck C]

While I'm sure he is no match for your expertise, this is who I received this information from:

Vaughn A. Starnes, MD, is Distinguished Professor and Chairman of the Department of Surgery, H. Russell Smith Foundation Chair and Executive Director of the CardioVascular Thoracic Institute at the Keck School of Medicine of the University of Southern California.

He earned his medical degree from the University of North Carolina, Chapel Hill, and did his general surgery training at Vanderbilt University, where he also completed two years of research in cardiothoracic physiology and pharmacology.

Dr. Starnes completed two years at Stanford University as a resident in cardiovascular surgery, and one year as chief resident in cardiac transplantation. He accepted a fellowship in pediatric cardiovascular surgery at the Hospital for Sick Children in London.

When he returned to Stanford, he was appointed director of Stanford's heart-lung transplantation program.

In 1990, Dr. Starnes performed the world's first lobar transplant using a lung segment from a living donor. Three years later, he performed the first live-donor, double-lobar lung transplant on a patient with cystic fibrosis. The operation involved taking lung tissue from each parent and transplanting it into their child.

He joined USC in July 1992 and was appointed Chairman of the Department of Cardiothoracic Surgery in 1997.

Dr. Starnes has an ongoing interest in congenital heart disease, heart, lung, heart-lung and living related lung transplantation, coronary bypass grafting, and repair and replacement of the valves of the heart.

He is also involved in research, helping develop gene therapy techniques to address the problem of restenosis following balloon angioplasty.

As the founding executive director of the USC CardioVascular Thoracic Institute, Dr. Starnes has built an innovative, interdisciplinary powerhouse, comprised of clinicians and basic scientists who are exploring better and more innovative ways of treating heart disease.

Under his leadership, USC surgeons have conducted more than 15, 000 open heart surgeries to repair and replace valves or create coronary artery bypasses, and more than 10,000 surgeries for diseases of the lungs, esophagus and chest wall.

He and his surgical team also performed Southern California's first robotic heart operation in 2001 as part of the clinical trial evaluating the use of a remote surgical system. In addition to his clinical work, Dr. Starnes is a distinguished researcher. He has an ongoing interest in many areas of research, including congenital heart disease, cadaveric and live-donor organ transplantation, coronary bypass grafting, and repair and replacement of heart valves.

He is also involved in bench research helping develop gene therapy techniques to address problems that occur after balloon angioplasty procedures. Dr. Starnes is currently investigating the use of gene therapy to prevent scarring following heart surgery.

He is also involved in a clinical trial using robotic surgery technology for cardiothoracic surgery.

Also, Dr. Starnes is the Vice President of the American Association for Thoracic Surgery. He was the 100th president of the AATS in 2019-2020.

Education

Medical School:
University of North Carolina
Internship:
Vanderbilt University Medical Center; Surgical Internship
Residency:
Vanderbilt University Medical Center - Pharmacology/Surgery Residency; Stanford University Hospital - Cardiac Transplantation Residency; Stanford University Hospital - Cardiovascular Surgery Residency; Stanford University Hospital - Thoracic Surgery
Fellowship:
Pediatric Cardiovascular Surgery, Hospital for Sick Children, London



So Chuck, can you please list your qualifications so I can make an informed decision on which person I, and other readers here, should trust with their medical advice?

Set aside his credentials for a moment and just put your thinking cap on. How could he claim that the new tissue valves will last 2x to 3x as long as the previous generation?

Here is the data. 5 years of human data for the Inspiris Resilia in the European arm and 5 years of human data in the US trial, known as The Commence Trial. Oh yeah, and there was 8 months of sheep data from a European trial before each of these trials. None of the above trials establishes that it will last 2x to 3x as long as the previous generation. In fact, they have not even established yet that it will last as long as the previous generation. There is "hope" that the new anti-calcification treatment will allow it to last longer, but at this point it is nothing more than hope.

Edwards, the manufacturer of the Resilia, does not claim that it will last 2x to 3x as long. They would face criminal charges of fraud if they did- and you better believe if there was evidence to support 2x to 3x as long that they would be shouting it from the mountains.

Your surgeon is very experienced. I really hope that he did not tell you that your valve will last 2x to 3x as long. That would be misinformation. I can't know this for sure, but I suspect that you heard him wrong. Perhaps he said the new valves should last 2 or 3 years longer than the previous generation and you heard what you wanted to hear. I sure hope that is the case, because it is very disturbing to me that a surgeon would be spreading such misinformation. Show me an article he has published on the subject that makes such a grand claim and I will believe that it came from him. Until then, maybe he really said it or maybe you just did not understand what he was communicating.

Yes, I am just a random nobody on the internet. But, I have read all the trials mentioned and, setting aside that maybe I am a dunce who can't understand anything, just use common sense please. How can one extrapolate 5 years of human data out 30-60 years? You can't.

But, if you want to talk about your surgeon as the final word because you are convinced that you heard him correct and that he really said 2x to 3x as long, I would challenge his position with the surgeon consultations that I had.

Let's just say for a moment that you are correct and that because you and I are not "doctors" that we really don't know anything, nor can we think critically. I would challenge what your surgeon ostensibly told you with what I was told by two of the top surgeons in the country. I consulted with the head of cardio thoracic surgery at Cedar Sinai and the head of cardio thoracic surgery at UCLA prior to my surgery and I specifically discussed the new generation tissue valves- the Edwards Inspiris Resilia. Both told me about the same thing; at my age of 53, expect to get about 10 years out of the valve and hope for a little longer, because maybe the new treatment will make it last a little longer. Both of these clinics are in the top 5 in the country.

So, if your surgeon really said that the new tissue valves will last 2x to 3x as long as the previous generation, and I am doubtful that he really did, he is wrong to suggest this without evidence. I am just a random internet guy, but the data is the data and I, too, have consulted with surgeons specifically about the valve in question and these surgeons gave me guidance in accordance with the evidence.

This is about making informed choices. I am not suggesting that you second guess your decision to go with a tissue valve, but if you did so with the belief that it will last 2x to 3x as long, so that you will never have to face a reoperation, well, I'd say you did not make an informed choice. But, you have the valve you have, so don't look back. We choose the valve that allows us to sleep at night. If you need to tell yourself that your valve is magic and will last 2x to 3x as long, then tell yourself that. But, if you present that misinformation here, this random internet guy will challenge the reasoning for your statement and ask you to support it with actual data. "My surgeon said so" Are you sure? Did he really say that or did you just hear what you wanted to hear?

And to be crystal clear, I am not advocating to not listen to your cardiologist or your surgeon. I personally had in depth discussions with both about the research and they were there with me at every step of the way in my decision process. But, if your surgeon is telling you something that sounds off- such as, "these new valves will last 2x to 3x as long" please ask him how he knows this and ask that he back it up with evidence. Be your own advocate, seeking a second opinion of what he tells you, if something does not sound right. If you are in your 40s and your "new" tissue valve only lasts 8-12 years, as would be expected, vs 40 years, it will be you facing a reoperation and not your surgeon. So, listen to your doctors, but at the end of the day, be your own advocate.

 

[pellicle]

This is about making informed choices. I am not suggesting that you second guess your decision to go with a tissue valve, but if you did so with the belief that it will last 2x to 3x as long, so that you will never have to face a reoperation, well, I'd say you did not make an informed choice.

and really these discussions are not about engaging in regret, its about helping others who have yet to decided to look at what we chose and why and then asking themselves questions like:

• how does this fit for me
• did I understand the choices correctly
• was I wanting to believe something I already believed or wanting to learn something new while informing myself

Best Wishes

 

[Dana]

Agree with above idea of sticking with advice of doctor. But here's a piece of anecdotal information. I've been on warfarin for 5 years at 8 mg per day targeting an INR range of 2.5-3.5 (two mechanical valves). If I didn't eat greens my INR would be through the roof because vitamin K checks warfarin, in fact it's the antidote for a warfarin overdose. If my warfarin dose was much smaller, I could get away with eating little to no greens. But I like greens, especially broccoli rabe, collard greens, boy choy, romaine lettuce, spinach, salads and in particular natto (fermented soybeans), which has the highest vitamin K2 content. I think that vitamin K2 (MK-7 version) helps direct calcium into the bones rather than build up on coronary arteries. For more info on studies and trials search for 'arterial calcification and vitamin K2'. Since calcium is tightly controlled by the body, arterial calcification cannot be mediated by modifying calcium intake. But with adequate K2 (I read about 32 mcg per day) the calcium is directed to where it belongs. Calcium does a multiple of essential things but leaving deposits on soft tissue blood vessel walls and valves is not one of them. I was told years ago, prior to heart valve issues, that greens were an important factor in keeping heart-healthy, so when my (radiation-induced valve scarring) and calcification ended up requiring a diminished amount of greens, it seemed counter-productive, so I kept a moderate amount of greens in the diet and let the anti-coagulation lab adjust my warfarin accordingly.
With the right balance between warfarin and vitamin K one can control one's INR but consistency is important, not necessarily day-to-day but I keep a 3-day moving average of vitamin K intake and try to keep that constant. I measure INR at home, report it to my clinic weekly and they adjust warfarin dose usually plus or minus 2 mg per week so I end up in a range of 54 - 58 mg warfarin per week depending on reported INR.
I think the reason that studies show that people with vitamin K intake show better INR control than people with no vitamin K intake is that the vitamin K acts like a buffer that dampens the warfarin effects, like a keel on your kayak dampens the effect of wind.
Anyway, that's just what I do. Others also have success with no greens and I know that's what pellicle does successfully (a while ago we discussed this at length over the phone), and so does my brother-in-law who is on warfarin for factor V Leiden mutation, not eat greens. No solution fits all. It's a matter of personal choice. One difficulty with eating greens, I will admit is that it's harder to maintain consistency compared to just not eating greens. Zero stays zero but start eating greens and depending on type and amounts, your vitamin K can vary significantly day to day which will occasionally put me out-of-range.

 

[Chuck C]

I think the reason that studies show that people with vitamin K intake show better INR control than people with no vitamin K intake is that the vitamin K acts like a buffer that dampens the warfarin effects, like a keel on your kayak dampens the effect of wind.

I do agree that there is a buffer effect of sorts, and the keel on your kayak is a good example. I eat a lot of greens daily and also take 200mcg of vitamin k2 daily. I am in INR range 90%+ of the time. Leafy greens are very good for heart health, so it is a shame that some would not eat them because they were told that it is not allowed on warfarin. Studies have now clearly demonstrated that we can eat greens and it helps our INR stay more reliable when we do.

 

[user 16827]

@Chuck C I applaud your patience

 

[user 15848]

sure, a

successfully (a while ago we discussed this at length over the phone), and so does my brother-in-law who is on warfarin for factor V Leiden mutation, not eat greens. No solution fits all. It's a matter of personal choice. One difficulty with eating greens, I will admit is that it's harder to maintain consistency compared to just not eating greens. Zero stays zero but start eating greens and depending on type and amounts, your vitamin K can vary significantly day to day which will occasionally put me out-of-range.

i never liked eating greens, but eat a hand full of green peas and pieces of broccoli every afternoon as a medicine and although i do not like eating it, it is easy to do it every day as both are frozen items in my freezer and this way instead of eating a piece of bread i eat that; 'for me', it seems to keep my inr very, very steady on my target range, minimal fluctuations since i started doing this in january-2022.

just a comment;

 

[sharky7]

Indeed. I should point out that this comes from you, the guy who said this about the new tissue valves:

"According to surgeon and research, the valve’s supposed to last 2-3 times longer than previous generation"

2-3 times longer? So, that would make the new generation of tissue valves last 20 to 60 years. You really want to have a conversation about misinformation?

[[[Daniel758 in his long winded speech, i noticed that there was no clear answer to what your question addressed, and perhaps there will be none, could be that this DOCTOR is to busy to take all of his calls, or even answer a text?]]] SO THAN, perhaps we one day will find out who this statement really came from about those newer generations of man made heart valves that will now be lasting 2-3X times longer, WOW, i am only 69, and got mine back in 2015, maybe i need to check it out, and trade mine in for a newer model, ST.JUDE MITRAL valve? and at this rate it would last me till i am at least 120 years old, or so, give or take a year or so? [i am really beginning to hate the current use of the term, "MISINFORMATION", anyone else noticing that trend, and misuse of the term? OH YA, question for all, how many years makes for a new generation, that is of course in MITRAL VALVES? this is the one that I need, my original equipment failed me!]

 

[sharky7]

Set aside his credentials for a moment and just put your thinking cap on. How could he claim that the new tissue valves will last 2x to 3x as long as the previous generation?

Here is the data. 5 years of human data for the Inspiris Resilia in the European arm and 5 years of human data in the US trial, known as The Commence Trial. Oh yeah, and there was 8 months of sheep data from a European trial before each of these trials. None of the above trials establishes that it will last 2x to 3x as long as the previous generation. In fact, they have not even established yet that it will last as long as the previous generation. There is "hope" that the new anti-calcification treatment will allow it to last longer, but at this point it is nothing more than hope.

Edwards, the manufacturer of the Resilia, does not claim that it will last 2x to 3x as long. They would face criminal charges of fraud if they did- and you better believe if there was evidence to support 2x to 3x as long that they would be shouting it from the mountains.

Your surgeon is very experienced. I really hope that he did not tell you that your valve will last 2x to 3x as long. That would be misinformation. I can't know this for sure, but I suspect that you heard him wrong. Perhaps he said the new valves should last 2 or 3 years longer than the previous generation and you heard what you wanted to hear. I sure hope that is the case, because it is very disturbing to me that a surgeon would be spreading such misinformation. Show me an article he has published on the subject that makes such a grand claim and I will believe that it came from him. Until then, maybe he really said it or maybe you just did not understand what he was communicating.

Yes, I am just a random nobody on the internet. But, I have read all the trials mentioned and, setting aside that maybe I am a dunce who can't understand anything, just use common sense please. How can one extrapolate 5 years of human data out 30-60 years? You can't.

But, if you want to talk about your surgeon as the final word because you are convinced that you heard him correct and that he really said 2x to 3x as long, I would challenge his position with the surgeon consultations that I had.

Let's just say for a moment that you are correct and that because you and I are not "doctors" that we really don't know anything, nor can we think critically. I would challenge what your surgeon ostensibly told you with what I was told by two of the top surgeons in the country. I consulted with the head of cardio thoracic surgery at Cedar Sinai and the head of cardio thoracic surgery at UCLA prior to my surgery and I specifically discussed the new generation tissue valves- the Edwards Inspiris Resilia. Both told me about the same thing; at my age of 53, expect to get about 10 years out of the valve and hope for a little longer, because maybe the new treatment will make it last a little longer. Both of these clinics are in the top 5 in the country.

So, if your surgeon really said that the new tissue valves will last 2x to 3x as long as the previous generation, and I am doubtful that he really did, he is wrong to suggest this without evidence. I am just a random internet guy, but the data is the data and I, too, have consulted with surgeons specifically about the valve in question and these surgeons gave me guidance in accordance with the evidence.

This is about making informed choices. I am not suggesting that you second guess your decision to go with a tissue valve, but if you did so with the belief that it will last 2x to 3x as long, so that you will never have to face a reoperation, well, I'd say you did not make an informed choice. But, you have the valve you have, so don't look back. We choose the valve that allows us to sleep at night. If you need to tell yourself that your valve is magic and will last 2x to 3x as long, then tell yourself that. But, if you present that misinformation here, this random internet guy will challenge the reasoning for your statement and ask you to support it with actual data. "My surgeon said so" Are you sure? Did he really say that or did you just hear what you wanted to hear?

And to be crystal clear, I am not advocating to not listen to your cardiologist or your surgeon. I personally had in depth discussions with both about the research and they were there with me at every step of the way in my decision process. But, if your surgeon is telling you something that sounds off- such as, "these new valves will last 2x to 3x as long" please ask him how he knows this and ask that he back it up with evidence. Be your own advocate, seeking a second opinion of what he tells you, if something does not sound right. If you are in your 40s and your "new" tissue valve only lasts 8-12 years, as would be expected, vs 40 years, it will be you facing a reoperation and not your surgeon. So, listen to your doctors, but at the end of the day, be your own advocate.

[[[NOW THAT was awesome and right on point, and i would POINT OUT NOW, and for the world to know, there was not even anything remote that was misinformation in any of it, NONE, and i would testify in court to this being true. Not that it would matter to some, although some only hear what they choose to hear, and have blinders to the rest, no matter what is being stated, and I find this sad that seems so many in the world are in fact, that closed minded, SAD! And everyone, if ya cannot prove what your saying is in fact true and to be believed, stop using that word, thank you. HHO]]]

 

[sharky7]

Agree with above idea of sticking with advice of doctor. But here's a piece of anecdotal information. I've been on warfarin for 5 years at 8 mg per day targeting an INR range of 2.5-3.5 (two mechanical valves). If I didn't eat greens my INR would be through the roof because vitamin K checks warfarin, in fact it's the antidote for a warfarin overdose. If my warfarin dose was much smaller, I could get away with eating little to no greens. But I like greens, especially broccoli rabe, collard greens, boy choy, romaine lettuce, spinach, salads and in particular natto (fermented soybeans), which has the highest vitamin K2 content. I think that vitamin K2 (MK-7 version) helps direct calcium into the bones rather than build up on coronary arteries. For more info on studies and trials search for 'arterial calcification and vitamin K2'. Since calcium is tightly controlled by the body, arterial calcification cannot be mediated by modifying calcium intake. But with adequate K2 (I read about 32 mcg per day) the calcium is directed to where it belongs. Calcium does a multiple of essential things but leaving deposits on soft tissue blood vessel walls and valves is not one of them. I was told years ago, prior to heart valve issues, that greens were an important factor in keeping heart-healthy, so when my (radiation-induced valve scarring) and calcification ended up requiring a diminished amount of greens, it seemed counter-productive, so I kept a moderate amount of greens in the diet and let the anti-coagulation lab adjust my warfarin accordingly.
With the right balance between warfarin and vitamin K one can control one's INR but consistency is important, not necessarily day-to-day but I keep a 3-day moving average of vitamin K intake and try to keep that constant. I measure INR at home, report it to my clinic weekly and they adjust warfarin dose usually plus or minus 2 mg per week so I end up in a range of 54 - 58 mg warfarin per week depending on reported INR.
I think the reason that studies show that people with vitamin K intake show better INR control than people with no vitamin K intake is that the vitamin K acts like a buffer that dampens the warfarin effects, like a keel on your kayak dampens the effect of wind.
Anyway, that's just what I do. Others also have success with no greens and I know that's what pellicle does successfully (a while ago we discussed this at length over the phone), and so does my brother-in-law who is on warfarin for factor V Leiden mutation, not eat greens. No solution fits all. It's a matter of personal choice. One difficulty with eating greens, I will admit is that it's harder to maintain consistency compared to just not eating greens. Zero stays zero but start eating greens and depending on type and amounts, your vitamin K can vary significantly day to day which will occasionally put me out-of-range.

QUESTION for you, that is if ya dont mind? The K from veggies, or from something from a bottle, as in your vitamin bottle.....has anyone notice its the same same, or does it matter where the K was coming from? Also i tend to be an ole timer sort of health nut, well i try......and I like a salad once in awhile, does anyone know of a study that was done on this sort of thing, a HUMAN taking warfarin, and some having an intake of K, and some not and how this helps or hinders, or what does it do....if anything. I for one would love to have more detailed data on this, that is if it is out there! [i am one of those that have a problem eating what i feel to eat, and find it most difficult to keep a steady diet that is constant, and helps me to keep my INR in check and within range, 2.5-35....2 days ago it was 1.9! oooopsy

 

[Paul1972]

I am sure Paul's OK since his last post was about 2 weeks or so after he started the thread and it was a congratulations to Pellicle on an anniversary.

Thanks for all your replies guys , I am now doing well thanks and the 6 days of urinating blood was diagnosed as kidney stones which has now been resolved , but I must admit was a extremely painful experience . Regards Paul

 

[Chuck C]

I am now doing well thanks and the 6 days of urinating blood was diagnosed as kidney stones which has now been resolved , but I must admit was a extremely painful experience . Regards Paul

Glad that they figured out what it was and that it is resolved Paul.

I had a kidney stone about 20 years ago. The 3 hour wait in the emergency room was the most painful thing that I've experienced in my life- far more painful than anything I experienced recovering from valve surgery.

 

[Dana]

QUESTION for you, that is if ya dont mind? The K from veggies, or from something from a bottle, as in your vitamin bottle.....has anyone notice its the same same, or does it matter where the K was coming from? Also i tend to be an ole timer sort of health nut, well i try......and I like a salad once in awhile, does anyone know of a study that was done on this sort of thing, a HUMAN taking warfarin, and some having an intake of K, and some not and how this helps or hinders, or what does it do....if anything. I for one would love to have more detailed data on this, that is if it is out there! [i am one of those that have a problem eating what i feel to eat, and find it most difficult to keep a steady diet that is constant, and helps me to keep my INR in check and within range, 2.5-35....2 days ago it was 1.9! oooopsy

I have found that vitamin K1 supplements from a bottle do exactly as expected in terms of being a warfarin antagonist but even more reliably than food sources because you know exactly what you're getting, for example 100 mcg per tablet. However, I would expect the veggies win out if you look at total health benefit because of the aggregate vitamins and minerals that the whole food contains. Taking vitamin K2 supplements can be a little more tricky because there are some 10 forms of which I have found only two on the market, MK-4 and MK-7 and for me only MK-7 counter-acts warfarin. Further the MK-7 is one of the forms that some heart benefits are attributed to.

This study says that when looking just at vitamin K1 the source doesn't matter.
https://www.ahajournals.org/doi/10.1161/JAHA.120.020551

 

[pellicle]

... I am now doing well thanks and the 6 days of urinating blood was diagnosed as kidney stones which has now been resolved , but I must admit was a extremely painful experience . Regards Paul

uhg ... that's not fun

I don't know if I should say this, but if you get one, you'll likely get another, usually the same kidney. I have three friends who get kidney stones. One has been blessed with three in the last 10 years.

So look at whatever dietary changes are needed ... while you're motivated ;-)

 

[slipkid]

I had my lab Doctor suggest to eat more leafy veggies when you INR is too low. Makes sense. It always depends on many factors like more exercise or taking antibiotics. Anything that can mess up the numbers, something can help manage it.

I think that is backwards. (unless everything I thought I knew about INR/warfarin/vitamin K/veggies is wrong)

I thought that the vitamin K in leafy veggies counteracts warfarin and LOWERS your INR, NOT raises it.

So if your INR is too low you would NOT want to be eating more greens (since that would have the opposite effect than what you want), you would either want to REDUCE your veggie intake AND/OR increase your warfarin dosage to raise the INR