Coronary Calcium and Coumadin

[neil]

sometimes to many studies and info can muddy the waters, you gotta go with what your comfy with, you cant choose on what other people may think or not think, nocturne when your time comes you will make your choice, then when you do don't second guess yourself,

 

[dick0236]

Nocturne,

All you can do is make the best decision for you with the information that you have available. That's it. It's what we all had.......

........I'm 44, and have spend 26 years on warfarin. Depending on your faith, Lord willing (or leave it to science), I'll be the dick0236 of this community someday talking about 60 plus years on warfarin and still ticking.

Superman, your first sentence says it all......

......and our 60 year "throwdown" is something I've never thought about, I've always thought of 50 years as my goal.........but, what the hell, i'm game for the 60 year challenge.......now, if only my money holds out.

 

[Superman]

Superman, your first sentence says it all......

......and our 60 year "throwdown" is something I've never thought about, I've always thought of 50 years as my goal.........but, what the hell, i'm game for the 60 year challenge.......now, if only my money holds out.

Just remember, I had a 14 year head start. I believe you were 31? With all due respect and admiration, whatever you get to, I better beat it by at least a decade! But we did lose a relative recently that lived to be 102. Should you get there, I may tap out.

 

[Lisa2]

sometimes to many studies and info can muddy the waters, you gotta go with what your comfy with, you cant choose on what other people may think or not think, nocturne when your time comes you will make your choice, then when you do don't second guess yourself,

Exactly, Neil. Nocturne, I'm sure you've thought of this as much as you possibly could; but, I feel like you are paying interest on a debt you may never owe.

 

[Agian]

sometimes to many studies and info can muddy the waters, you gotta go with what your comfy with, you cant choose on what other people may think or not think, nocturne when your time comes you will make your choice, then when you do don't second guess yourself,

Studies can be useful, but everytime someone 'proves' something, there's usually a whole bunch of people that assert the opposite.
I get lost on the statistical terminology.
AVR is not a 'cure' for stenosis, nor is there a 'pure' drug that doesn't have potential pitfalls.
We can try every trick in the book to keep the ball in play, but eventually it will be 'Game Over'. At the end of the day, we're all just marking time.

 

[pellicle]

Hi

AVR is not a 'cure' for stenosis, nor is there a 'pure' drug that doesn't have potential pitfalls.

I believe that it is best phrased in 2009 . I have bolded the most significant part
URL here:
http://circ.ahajournals.org/content/119/7/1034.full

Prosthetic Heart Valves

Selection of the Optimal Prosthesis and Long-Term Management


Despite the marked improvements in prosthetic valve design and surgical procedures over the past decades, valve replacement does not provide a definitive cure to the patient. Instead, native valve disease is traded for “prosthetic valve disease,” and the outcome of patients undergoing valve replacement is affected by prosthetic valve hemodynamics, durability, and thrombogenicity. Nonetheless, many of the prosthesis-related complications can be prevented or their impact minimized through optimal prosthesis selection in the individual patient and careful medical management and follow-up after implantation.

 

[Nocturne]

Some good comments and ideas, thanks.

I just noticed that my original post in this thread did not have my name on it for some reason -- it is labelled "Guest". But actually, if it was not obvious, I was the OP.

 

[Nocturne]

And if I was not clear before -- I don't think this issue of Coumadin accelerating coronary calcification is likely to matter much for most people. But I think it is certainly something to keep tabs on and be aware of for people like me, who have extremely high CAC scores for our age and have not yet had AVR.

 

[neil]

like your take on it Agian

 

[neil]

like your take on it Agian

 

[neil]

don't know what happened there, sorry

 

[Agian]

like your take on it Agian

Why, thank you young man.

 

[cldlhd]

And if I was not clear before -- I don't think this issue of Coumadin accelerating coronary calcification is likely to matter much for most people. But I think it is certainly something to keep tabs on and be aware of for people like me, who have extremely high CAC scores for our age and have not yet had AVR.

I can see that as a possibility. I'm not convinced one way or the other as to whether or not Warfarin leads to calcification but I can see it being possible that let's say 60% is genetic and the other 40% is diet and exercise. As for diet maybe medications like warfarin could be included, as to what percent who knows. So if you have a genetic predisposition to accelerated calcification maybe it will make a difference? While others who are predisposed to not have calcification can take warfarin for 60 years with hardly any difference.

 

[Nocturne]

Exactly.

And as an aside, last night I noticed that I had accidentally put Anastrazole pills into my pill planner last week in place of the baby aspirin I am supposed to take. Ordinarily I take one quarter of an Anastrazole every four days, so this means that over the last week I have taken over three months' worth of Anastrazole (as I was taking my usual dose too). This happened because I ran out of my statin and aspirin at the same time, picked up my refill and saw the statin name on the bag but did not check the other pill bag because I assumed it must be the aspirin, and just didn't notice when I filled the planner (the pills are about the same size).

Anyway, as a result I most likely tanked my estrogen levels, which explains why I have been feeling so anxious, depressed, and weepy this week -- especially in the last few days.

And in the back of my mind was this thought -- "You feel like crap now because of this mistake, but imagine if it had been Coumadin you had fucked up with..."

 

[Nocturne]

Exactly.

And as an aside, last night I noticed that I had accidentally put Anastrazole pills into my pill planner last week in place of the baby aspirin I am supposed to take. Ordinarily I take one quarter of an Anastrazole every four days, so this means that over the last week I have taken over three months' worth of Anastrazole (as I was taking my usual dose too). This happened because I ran out of my statin and aspirin at the same time, picked up my refill and saw the statin name on the bag but did not check the other pill bag because I assumed it must be the aspirin, and just didn't notice when I filled the planner (the pills are about the same size).

Anyway, as a result I most likely tanked my estrogen levels, which explains why I have been feeling so anxious, depressed, and weepy this week -- especially in the last few days.

And in the back of my mind was this thought -- "You feel like crap now because of this mistake, but imagine if it had been Coumadin you had fucked up with..."

 

[dick0236]

And in the back of my mind was this thought -- "You feel like crap now because of this mistake, but imagine if it had been Coumadin you had fucked up with..."

Yep.....that could be a BIG problem.

 

[pellicle]

Hi

I'm inclined to pehaps disagree with dick0236 on this point. However as he did say "could" and not "would" I think it is important to clarify why, not just for Nocturne but for any casual reader.

...so this means that over the last week I have taken over three months' worth of Anastrazole (as I was taking my usual dose too). This happened because
...
And in the back of my mind was this thought -- "You feel like crap now because of this mistake, but imagine if it had been Coumadin you had fucked up with..."

I would say that there is as much chance that you'd be fine and that you would simply pick this up at the next INR test (which underscores why I always bang on about weekly testing).

You would have gone "holy ****, is that right, INR = 9? You could then have chosen to post here (and most likely get good advice) or go to your cupboard and take out some vitamin K pills and take a bunch or go to the hospital and get vitamin K pills or an injection there.

Unlike the drug you mistook warfarin is readily reversible and the antidote is well known around the world - Vitamin K ... its actually simple. Were you doing that with one of the new "wonder drugs" that everyone bangs on about you would probably face a few days on dialysis or be dead because they are NOT reversible.

I recommend the following post:
http://www.valvereplacement.org/foru...-python-moment

Like Ski Girl I am no merchant for panic, instead I suggest plans and actions.

I'd suggest from your situation you put in place some physical "double checks" of what you do. For instance I test my INR on a different day to when I dish out my pills, so if something has changed I know about it sooner. In my case I take 3 capsules of antibiotics (one every 8 hours) and warfarin every day. I have phone alarms go off to remind me and I take them. However I also double check this by having my days antibiotics shifted into a single dispenser (which in the morning must be empty or I've missed my evening dose) and I fill that and take one. Then when the last alarm goes off (9:30pm) I also check my warfarin (timed for 7pm) and thus double check that I have taken my warfarin. In the morning is also a further "triple check".

My "dally" container is actually a translucent 35mm film container, so that I can see the contents (as shadows) when I hold it up. It was free (as I still use film and have kept a number, but you can get them given to you if you walk into a place that develops film still). I chose it (over the black ones) because of that aspect (visual check) and as they are waterproof I've used them camping and hiking for decades as matches storage containers.

I always carry a small day pack (which contains my wallet and phone too) and so I usually slip the film container into the side netting of that so that I can go freely about my day and be able to access it when my alarm goes off on my phone ... oh, and its phone alarm, no "fancy" app needed. All phones made after 2009 support alarms (even my Nokia E72 ;-)

So to summarise:

• when on drugs for your life and health be organised (even with Statins and cholesterol drugs)
• be organised and plan ahead so that you can then relax and enjoy the other moments
• make your organisation self checking
• if you are on warfarin (and I don't care how fucking long you're stable for) test weekly because its part of your double check system too

 

[Nocturne]

Those are all good points and good pieces of advice, Pellicle. And I actually live with a hematologist, which would probably make correcting a mistake like that go more smoothly (couldn't hurt). OTOH, said hematologist has advised me to keep off Coumadin if at all possible -- but being a hematologist she has Seen Some **** that is maybe more disturbing than typical.

I had considered the easy reversibility of Coumadin. Yep, would be nice to pop a pill and have my estrogen levels zip back up to normal! Just knowing WHY I feel crappy has made me feel better, though -- and I tell you, it feels GREAT to have something wrong with me that I know will get BETTER with time!

I'm pretty organized with pills too, and counting supplements and vitamins, I take a lot of them. I use three weekly planners, as I take pills three times a day. I sort all my pills once a week. I organize them so that if I miss a dose, whatever it is that I missed will be easy to just take with the next pill popping part of the day. This mistake was a freak occurrence that only happened because of refill timing, and no doubt a mistake on the part of the pharmacy to neglect to refill the aspirin at the same time as the statin, and my failure to check to make absolutely sure it WAS aspirin, and the fact that the aspirins are about the same size, shape, and color as the anastrazoles.

Still, it happened, and that's scary. You're right in all you say, but something like that happens with a blood thinner, and you're only one more coincidence away from death.

Which is not to scaremonger about Coumadin, despite my concerns that it might not be right for ME. No doubt the years before I need AVR will tell us more, and provide more options.

 

[pellicle]

...but something like that happens with a blood thinner, and you're only one more coincidence away from death.

My friend teaches accident analysis for mine safety officers. We are all just one coincidence away from death every day. That is why safety is about multiple layers, so one can fail and it doesn't cause a death.

Drive a car on the roads?