Coumadin Rash?

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LUVMyBirman

LUVMyBirman

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Question for Al, or anyone else that may have experienced the 'coumadin rash'.

Al, I will be very honest with you. Was vacationing in the Bahamas. Averaged my 2 tropical drinks a day. Maybe a wee bit more here or there. The drinks included pineapple juice. I have just proved to myself four times over that pineapple juices effect my INR. Anyway, just tested a 4.7. I will attribute this to my change in diet and indulgence the past week.

Last night, and prior to testing my INR as we were still on vacation. Noticed a red, almost like broken blood vessels on the outside and inside of both feet. We did a lot of walking. More so than I would during a usual week. Have never had anything like this happen. My INR was not that high so this seems like an unsolved mystery.

Thanks
 
Gina,
I get the coumadin rash often. I get it on my feet but also other parts mainly ankles and stomach under and around my breasts and my knees. Some people are more prone to get it than others. My INR does not have to be real high and I also walk and exercise often and I think that contributes to a higher INR. I know the first time my doctor saw it he really got in action. He had me skip my dose. So it is a definite sign of something wrong. Either high INR or reaction. Now I don't panic I just get my blood work and act accordingly. I probably could just about do it without the blood work. I have been through it so much. LOL. I wouldn't...
I don't know about it from a professional viewpoint. Just the patient..
Isn't the Bromalaine (spelling) or something like that in pinapple a blood thinner? I may have the word wrong but I know it has something in it.
Missy
 
Gina,
I did have the name right just couldn't remember everything.
I read up on bromelain and it is a digestive enzyme similiar to papain which is in papaya. Maybe some of your tropical drinks contained that also. They are both useful in cardiovascular disease. It ihibits platelet aggregation and promotes the break down of fibrinogin. Preventing blood clots. Papain is also used in meat tenderizer. There are so many hidden ways that we get these things. Papaya and bromelain have been used in surgery in primitive settings. They are considered to be blood thinners.
 
Hi Missy

How have you been? Have not talked in a long time.

Thanks for your response. Can you elaborate on your blood work. Is it more than a check of your INR when you get the rashes?

Maybe it was my brisk walking accompanied by a higher than usual INR. I will keep an eye on it and report to my doctor if it keeps occurring.

BTW, how much Coumadin do you take? Have been thinking about some of us here that live in the warmer climates. We do appear to take more Coumadin. When the heat is on, it messes me up big time. Add some pinnapple juice and it's up up up. :rolleyes:

Interesting Missy, thank you.
bro´mê-län) any of a group of proteolytic and milk-clotting enzymes derived from the pineapple plant, Ananas sativus. In the plural, a concentrate of these enzymes, used as an anti-inflammatory agent. Also used in tenderizing meat, preparing protein hydrolysates, and chill-proofing beer.
 
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My guess is that they are the beginnings of bruises. A slightly high INR and extra walking could do this.
 
Hi Gina,

Hmmm... I think you need to change your vacation destinations to some place cold, where you have to bundle up with extra layers of clothing, and boots,( padding for the feet), and where sipping on a tropical drink would be the last thing on your mind.

Just kidding, but I do notice a trend developing here. You go to the islands every year, and every year you drink the tropical drinks, (was it pineapple juice or grapefruit juice last year), and have the same results. Hmmm... Those drinks must be real good !

Great to see you on the boards again! Hope you had a great vacation and your INR gets back to your range.

Rob
 
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Go North, Young Lady!

Go North, Young Lady!

Gina, Rob is right. Alice and I went north to Burlington, Vermont to visit a son in January. They were having one of the warmest winters in history but there was still snow and occasional dips into single digits. It was invigorating and we drank a lot of vodka-
and ......no rashes and a steady 3.0 INR!
 
Hummmmm, Tropics or freezing cold?:cool:

Can't give up those vacations. I may have to avoid my tropical drinks. Or just have one or two for the entire duration. Pineapple juice is the culprit for me. I asked this time as they mixed my drink. Remember my Hawaiian punch post? Bit of that in there also.

Also had 4-5 salads during the week. Could you imagine what my INR would have been without that!!!

Just have to remember. Moderation. But you know, it's soooooo hard.:( Took me two years to let loose again.
 
Did you have mango? The Puerto Ricans find that when mango is ripe the INRs go up.
 
Gina,
When I get the rash I usually have to skip a dose or take half a dose depending on how high the INR. The rash seems to appear quickly and disappear quickly after adjustment. There have been a couple of times that I just ate a little lettuce. I have become used to it and it doesn't scare me as much as much as it used to. In fact I have kind of come to consider all of these things that I put up with on the coumadin as warning signals that maybe I am lucky to have in a way.
I only take 4 mg. daily at 5:00 P.M. before dinner and then wait at least an hour to eat. It doesn't take much coumadin for me as long as I stay on a steady diet. I know there has been times that I have eaten hidden things like when I eat out or something and my INR has been low but normally I just need this much.
How much do you take?
 
pineapple and INR

pineapple and INR

:) hi gina, i havea juicer and drink pineapple alot never had a problem with the INR maybe it's the alcohol .
Be well, Dara
Tricuspid valve replacement
Dr VAlentin Fuster ( my angel)
Dr Randall Greipp.
Mt sinai Hospitla New York City
 
My husband has had the petecchia (msp?) rash from coumaden a number of times. We live in New England. He takes 8.25mg daily of coumaden. INR ranges 3.0-3.5 fairly consistently. We don't worry about the rash when it appears now. It seems to coincide when he is retaining more fluid.

Just thought I'd add the above !!!!

Marybeth
 
Thanks all. Rash is down. Like you said Missy, quickly. It's defiantly not the alcohol. Only happens when I drink a pineapple based juice.
 
I have also noticed that Joe has a rash on the top of his feet and a little on the ankles. He thought it was left over from his serum sickness episode, but now I'm wondering. It sure sounds like the rash described here.

It doesn't hurt or itch, so it can't be cellulitis.

His doctor has just recently decided to keep him at the high end of the INR scale, closer to 3.5.
 
Petechiae are just tiny bruises. They are far enough apart that you can see individual spots. They seem harmless. Just one of the warfarin "badges of honor".
 
Pin Point red dots

Pin Point red dots

Are you referring to pin-point red dots that appear anywhere on the body, but do not go away? I thought that was the name for those ?? Curious about mine..

Joan
 
Dots

Dots

Hi Janie,

I've always had some little pin point dots..but have noticed an increase the last few years. Been on coumadin for 4 yrs. Don't know if there is a connection. I thought they were called 'Petechiae' but they certainly are not a rash. I'm confused, too. Yes, lets hope Al can clarify and especially tell us it's NOT due to 'old age'..LOL!

Joan
 
I thought that I did clarfy them a few entries back in the thread. I've always ignored them as a serious sign. Janie kinda proved the point when she had to go looking for them.
 
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