Coumadin question

[Bunny_Rabbit]

Howdy all.

I went to a Neurologist and she really really wants me to start on Coumadin to prevent a stroke.

I'm wondering how normal it is to be on Coumadin just as prevention.

I had an MRI and it showed several white spots on my brain that they think were caused by TIAs. right now I'm taking 81mg of asprin a day, but the doctor really wants to see me on Coumadin. I had a Valvuloplasty done in 2002, and expect to have some sort of valve replacement in the future.

My PCP, internal medicine doctor, and cardiologist haven't said a thing about taking ANY kind of medication. Is the Neurologist just trying to cover her butt, or is it REALLY necessary?

Thanks in advance.

 

[geebee]

Bunny,

Does your doctor have any idea what might be causing the TIAs? Do you have any problems with Atrial fib?

If you are having A-fib, coumadin would be indicated if it is felt that is what is causing the TIAs. In this case, TIAs can be be a pre-curser to a stroke.

I would ask a few more questions and consult with your cardio. However, it sounds like there might be a reason to be on coumadin.

 

[MarkU]

Yes, stroke prevention is why we all take Coumadin. It is not just used for patients who have already had valve replacements.
I do agree with geebee, that you need to find out what might be causing the TIAs.
Good luck,
Mark

 

[Ross]

As long as there is a valid reason to suspect that you may be susceptible to stroke, Coumadin is indicated.

 

[warrenr]

Links for Bunny

Links for Bunny

Hi Bunny,

You may not be familiar with my father's story
http://www.valvereplacement.com/forums/showthread.php?t=6933
and because of what happened to him I have done extensive research on Coumadin. Below are several links for you that may be helpfull.

http://www.chestjournal.org/cgi/con...=0&volume=126&issue=3_suppl&journalcode=chest

http://neuro-oas.mgh.harvard.edu/stopstroke/stroke_meds.htm
http://www.heartcc.com/Services_Coumadin.htm#background
http://www.healthscout.com/rxdetail/68/111/7/main.html

 

[Bunny_Rabbit]

Geebee, this is why I'm a tad confused. This Neurologist hasn't done any test or seen any of my past tests to make this decision of using Coumadin. She's only had me do a blood test for my cholesterol (which is high), and an MRI (because of a pain in my neck/head and a numb arm). The spots on my brain were totally found by accident. For all anyone knows, the spots could have been there from before my Valvuloplasty. She and I don't even know if I have a-fib.

Seeing as I work with metal, and play ice hockey, Coumadin seems like more of a risk, especially when she hasn't seen a single thing regarding my heart.

Warrenr, I read your story and it's just such a terrible thing that happened. I hope your father has a non eventful and speedy recovery. I'm very new to this Coumadin thing. I just don't want to be jumping into a medication with possible side effects, if it's just not necessary right now.

 

[geebee]

I think you need to visit your cardio and discuss the A-fib possibility. I would be concerned due to the headache/numbness in conjunction with the white spots. However, you are correct in that it is difficult to determine what caused the spots.

I have migraines and can get numbness with them so, in and of itself, numbness does not necessarily mean clotting.

I would hate to see you go on Coumadin without more info. Perhaps your cardio can do a halter monitor to see if you are having A-fib. I think the cardio and neurologist need to communicate to determine the need for Coumadin. There are a lot of factors to make that decision and I am not sure the neurologist is wrong, just may need to dig a little deeper.

 

[Guest]

Bunny,
The biggest risk for a stroke is having had a stroke. Like it or not, TIAs ARE strokes. You went to the neurologist for a numb arm. The neurologist suspected a stroke and did the MRI. The spots on your brain were not found by accident, they were found as part of the diagnostic workup for the numb arm. There is a 99% chance that the neurologist already knew what the MRI would show but just needed proof. The use of warfarin is not something to be debated in your case. You should have been on it the day this was diagnosed and then debated its use later. The spots on the MRI indicate that you already have damage to your brain. Every minute that you delay treatment is another "spin of the cylinder" in a game of Russian roulette. You have no business worrying about working with metal trying to deny this. The next stroke that hits may destroy your ability to even say, "metal". You may be throwing clots from your malfunctioning valve. You don't have to have atrial fibrillation or a mechanical valve to have a stroke. High cholesterol just adds another risk factor. I'm sorry to sound so gruff, but your life has undergone a big change and this finding proves it. You must adapt to it.

 

[Bunny_Rabbit]

Al, I appriciate your "gruff"ness, sometimes people need to be told whats best for them from time to time.

I do know that the spots were found accidentally. The Neurologist was saying carpel tunnel and a pinched nerve in my neck, so I'm sure she had no idea of the strokes. However I guess it really doesn't matter how the spots were found at this point. I'm just amazed she only found 5 of 'em.

I guess now I just have a few more questions about Coumadin, and I know that Al is the man when it comes to that.

My main concerns are with menstruation and ice hockey. I love one and hate the other. I'm 31, and expect to be dealing with the menstruation thing for many many more years. Will Coumadin affect it? and if so, how?
As far as ice hockey goes, I really don't want to stop playing. I play in a non contact, recreational womans league. Is that something that I sould be concerned with?

Any more help at this point is really appriciated.

 

[Karlynn]

Bunny, Coumadin shouldn't have much effect on your menstruation. If you had heavy periods before, you'll have heavy periods after. They should last no longer in duration, or distress (cramps, bloating).

 

[Guest]

I don't answer questions about menstruation - after last year when nearly everyone disagreed with me. Look at the recent thread "Girl Question".

The main thing is to not get pregnant. Weeks 6 to 12 are the worst for the fetus. Many women do not realize that they are pregnant until the baby has been harmed. This does not happen 100% of the time - it seems to be dose related but do not take a chance.

I don't see why you could not play hockey in a non-contact league (even the NHL is non-contact - this season. We loved our Avalanche here in Colorado.) I'm assuming that you wear headgear and a face mask. You might turn pretty shades of purple if you fall but probably no real harm. Golf even makes spectacular bruises - right Marty. Anyhow it is cheaper than a tattoo.