Dosing your diet...

[Dexter Bob]

Being one week post-op for AVR, I go in for a ProTime draw on Monday. Before leaving the hospital, the nurse-educator wanted to give me the drill on how my life on Comadin will change. Of course one of the first things she said "No alcohol". I nodded politely. How about Home Monitoring? "Can't be done". I nodded politely again.

Just about everyone I know who is on Coumadin drinks; not alot; one or two beverages of choice. I know I will get the same lecture when I go to the AntiCoag Clinc "education session" in a couple weeks. Obviously some pretty strong local "professional" opinons around here. How do I overcome this hurdle? I don't want to come off as a "know it all" to them or a belligerent drunk who insists on his grog everyday.

Bob

 

[Bridgette]

You could point out to them (very politely of course) that you are an intelligent human being who has taken it upon yourself to be proactive and educate yourself all about life on anticoagulation.

You could point them in the direction of this site, and if they scoff at it as being "non-professional" you could show them Al Lodwick's site.

The no alcohol thing is rubbish - everything in moderation, plus consistency, is the key, IMO anyway. I have a drink occasionally, and I'm on Warfarin - it doesn't affect my INR.

Anyway, good luck with educating the educators, LOL.

Hope your recovery is going well.

Bridgette

 

[Ross]

I would follow Bridgettes advice. If they'd come here, they might learn a thing or two. Fat chance of that happening, but either they want to be educated or they don't and if they don't, maybe you should work on trying to find some people who are or do.

The other option is, keep your mouth shut, KNOW BETTER and go on as usual.

I suppose they told you to avoid dark leafy greens too?

Just hearing "Home monitoring can't be done" sort of makes me want to rip them a new one. Perhaps you should direct them to this link, tell them they get CME credit just for watching and it's a show of the most highly respected people in the field suggesting that home testing is better and very much doable. That should really tick them off:

http://discoveryhealthcme.discovery.com/anticoagulation/anticoagulation.html

http://discoveryhealthcme.discovery.com/beyond/miniPlayer.html?playerId=1225901422

I burned the whole thing to CD, so if you want a copy to take to the miserable morons, let me know.

 

[lance]

Almost humerous

Almost humerous

"belligerant drunk"?
Over a year I would have about 2 glasses of ice wine.
In order to keep alcohol consumption "consistent" should I drink every day to remain compliant to their rules. Hmmm It's too funny to consider.

 

[Blanche]

Makes my blood run cold...

Makes my blood run cold...

Bob:
Are you sure that the misguided person is a nurse...RN or LPN? My husband's Uruologist has an assistant who claims to be a nurse and she has no education beyond high school. Graduated from the school of hard knocks I guess.

I am worried about the people who will take her information seriously.

Perhaps you can speak with your doctor about this person. S/he could be very dangerous to the people who are less prepared than you.

Regards,

Blanche

 

[Dexter Bob]

I think there is also some political/financial game being played here. When I started my climb back in October, I posed the question to the group about "Who calls the shots" in managing anticoagulation. Since being released from the hospital. that is becoming a little more clear. Both my Cardio and Surgeon think home monitoring is a great thing (guess I know where they got some CMEs). They are "outside" the group that my GP belongs to. THAT group just opened a brand new Medical Center that has the new anticoagulation clinic. My insurance is directed via PCP who is my GP.

So I think I'll just see where this lands after I get set up with clinic and see how easy it is to manage my INR, with cocktails on board to boot

 

[catwoman]

Bob:

Is this anticoagulation clinic tied to one of your doctors' practices? This woman sounds like Chicken Little!

My life hasn't really changed in the last 6+ years. I'm more attentive to being consistent with really dark green stuff and in handling cats. I'm more cautious now in handling a cat on edge. That's a greater concern for me than cutting myself while cooking!

There have been many threads here in the Anti-Coagulation forum about alcohol and warfarin. Read through those by doing a search (look at the blue toolbar).

In a nutshell:
1. Alcohol causes dehydration, which can increase your INR.
2. Alcohol can impair judgment, which can trigger falls (can you say SUBDURAL HEMATOMA?).
3. Alcoholism damages the liver. Warfarin is metabolized in the liver. Thus, injury to the liver affects warfarin's metabolism.
4. Alcohol can irritate your GI tract, if you are so prone.
5. If you go on a bender (say you're Joe 12-Pack, you're drinking your calories rather than eating them, which could affect your INR due to drop in food intake.

That said, many of us do enjoy alcohol. Margaritas and martinis are my downfall -- oops! not a downfall, but my favorite. I seldom drink more than 1 at a time.

 

[dick0236]

.... the nurse-educator wanted to give me the drill on how my life on Comadin will change. Of course one of the first things she said "No alcohol". I nodded politely. How about Home Monitoring? "Can't be done". I nodded politely again.

Your response of "I nodded politely" is the best way to handle some of these "know it all folks". Warfarin usage does not cause any major changes in lifestyle, diet or activities....unless you let it. You need only be consistent and use good judgement.....that means "no benders" or "running with knives".

FWIW, they prescribed a can (12oz) of beer (Schlitz as I recall) every day I was in the hospital post op...said it would help me not retain water. Ahhhh, those were the good ol' days. Several evenings, my beer was sidetracked and never made it to my room., and I had to remind them that I had not received my evening medication.

 

[Blanche]

Never give up!!!

Never give up!!!

Well, it looks like you have no choices....But maybe you do.

There should be some way that you can change PCPs. If your PCP condones the misinformation that the "Nurse" has given you, you need a new doctor. Maybe your current doctor directs things, but I have found in most insurance plans there are other choices for doctors. You can't continue to deal with someone who has your life in their hands and is incompetent. You have two doctors (who are much higher in the pecking order than a pcp) who can help you with this serious problem.

You have the power to direct your own life and your medical needs and concerns. You just have to see how your system of insurance works. Gosh, where is Lisa from Kady when you need her... Lisa is a women who works in the system and has much knowledge about the ways that insurance works. Perhaps she will stop by.

In the meantime, just remember....YOU ARE IN CHARGE. It might be hard, but remember, it is not impossible and you are in charge..You really are.

Another thought is that you might want to collect medical anticoagulation articles that are research based and written by the experts and prestigeous medical centers in medicine. I once convinced a dental surgeon to deal with my husband's dental concern by compiling numerous articles and research reports. He was a hard sell, but when he saw what we had compiled, he not only did surgery on my husband while he was anticoagulated, but he found several other articles for us.

Just remember, you are in charge and don't give up.

Blanche

 

[Lynlw]

Well, it looks like you have no choices....But maybe you do.

There should be some way that you can change PCPs. If your PCP condones the misinformation that the "Nurse" has given you, you need a new doctor. Maybe your current doctor directs things, but I have found in most insurance plans there are other choices for doctors. You can't continue to deal with someone who has your life in their hands and is incompetent. You have two doctors (who are much higher in the pecking order than a pcp) who can help you with this serious problem.

You have the power to direct your own life and your medical needs and concerns. You just have to see how your system of insurance works. Gosh, where is Lisa from Kady when you need her... Lisa is a women who works in the system and has much knowledge about the ways that insurance works. Perhaps she will stop by.

In the meantime, just remember....YOU ARE IN CHARGE. It might be hard, but remember, it is not impossible and you are in charge..You really are.

Another thought is that you might want to collect medical anticoagulation articles that are research based and written by the experts and prestigeous medical centers in medicine. I once convinced a dental surgeon to deal with my husband's dental concern by compiling numerous articles and research reports. He was a hard sell, but when he saw what we had compiled, he not only did surgery on my husband while he was anticoagulated, but he found several other articles for us.

Just remember, you are in charge and don't give up.

Blanche

Like Blanche, I don't know how you insurance works (and Lisa is no longer a member I think I personally would start by asking your cardiologist who they would recomend as your PCP, they usually recomend doctors on the same page as them and that they work well as part of a patients "team" When Justin was admitted for BE I was very unhappy with his ped. I asked his cardiologist to recomend a good ped and we had an appt set up before Justin was even discharged and were VERY happy him

 

[Herb M]

My life hasn't changed since taking coumadin. I do not go to a coumadin clinic. I go to the lab at the hospital which sends the results to my physician. I also call the lab for the results within the same day. The physicians office calls me in a day or two later and tells me the results (which I already have) and tells me what I neeed to do. I say nothing and do what I know I have to do, many times it is not what the Physician says.

My physician just started a coumadin clinic with technicians who know nothing. I will still go to the hospital lab which costs me nothing .

 

[mac]

I agree with Herb, lab every 2 weeks, know my results before I even get out of the chair. Doc is notified and if numbers are between 2 and 3 we leave the dose alone. Speaking of beer ( I like micro brews) I have acouple pints of beer every other day, or in the case of this weekend, both days and my numbers are always within a pt. 2.6 2.7. Next 2 week check is on Fri and I'm pretty sure it will be in is range. I havn't had 3 pints yet in 1 sitting, seems since post op, 2 is all I can handle and that's just fine with me. I was afired I would have to give up my taste for good beer forever....no so, just no more drunks with the boys at hunting camp.

Mac ....AVR.11/19/09..Mayo, Dr Suri