Diverticulitis and Coumadin.

marc_kowal · Apr 5, 2016

So I've been in the hospital since Sunday with my first bout of diverticulitis and everything was going smoothly until we noticed some blood in my b.m. For most people, no big deal since bleeding can be a common side-effect, not so with someone on warfarin. Doctor is a little stumped on how to proceed. The bleeding needs to eventually stop, but I can' t stop taking my meds. So here we stand at an impasse.

So has anyone else been in this situation and if so, what was done?

pellicle · Apr 5, 2016

Hey Marc

sorry to hear from you under these circumstances.

I don't recall which valve you've got, but myself I'd tend to consider dropping INR to 1.5 or 1.7 for a little while

get them to do some d-dimer blood tests to check for thrombogenesis and take it easy.

There may be some possible risk of later valve surface thrombus adhesion, but I think that these can be treated with a PIC of tissue plasminogen activators

https://en.wikipedia.org/wiki/Tissue_plasminogen_activator

http://www.strokeassociation.org/ST...ment/Stroke-Treatments_UCM_310892_Article.jsp

tPA, the Gold Standard The only FDA approved treatment for ischemic strokes is tissue plasminogen activator (tPA, also known as IV rtPA, given through an IV in the arm). tPA works by dissolving the clot and improving blood flow to the part of the brain being deprived of blood flow. If administered within 3 hours(and up to 4.5 hours in certain eligible patients), tPA may improve the chances of recovering from a stroke.

I think its becoming more widely understood and adopted

harrietW · Apr 6, 2016

Oh dear

sorry for your trouble. This bleeding thing is beyond miserable. I don't have diverticulitis marc-kowal but l do have angiodysplasia which also affect the GI system throughout. I am in the same vote as far as warfrin and Asa and other meds are concerned. I am off all but heparin at the moment. Waiting for game plan also.
Hope they find a solution for you soon .

djacq · Apr 6, 2016

Oh Mark, sorry for your situation. Do you know what area the bleeding is in? Have they confirmed its from a diverticuli? Please keep us informed as the solution might be of use to us. Thanks and hope this resolves itself soon.

marc_kowal · Apr 6, 2016

Well, turns out the old saying "Time heals all wounds" applies here. The bleeding resolved itself so they didn't need to come up with a plan. Thankfully I'm being discharged this afternoon. It would have been interesting to see what they would have tried, but I'm also glad it's over with.

Seaton · Apr 6, 2016

Good news indeed.
Glad it resolved.

djacq · Apr 6, 2016

Thanks Marc for the update. Glad we don't have to use you as a "testing ground" . Good luck and imagine you are on antibiotics now?

marc_kowal · Apr 7, 2016

Yup, on Augmentin for 11 days and a "low soluble diet" for 2 weeks. Low soluble diet just means less than 13 grams of fiber per day, this gives the insides a chance to relax and heal. BUT, I also can't have any raw veggies or raw fruits or any cooked veggies that have thick skins, seeds, or strings. Needless to say , I'll be taking a vanilla Boost every day to keep my vitamin K up. On the plus side, I can steal my kids sugary cereals and hog them all for myself!

djacq · Apr 7, 2016

Glad to see you are not afraid to take Vit K but hope you INR self test or get tested at lab often until your diet stabilizes for awhile. Plus, the meds you have been on. Not sure of Augmentin interations. Sorry the mother/nurse came out. I'm sure you know the deal.

marc_kowal · Apr 7, 2016

I usually self test once a week, but I'll be checking every 2-3 days for the time being. Good thing I just had a re-supply order arrive while I was in the hospital!