Fourth hospital admission for bleeding

[Kathleen]

Over the course of 27 years, 21 of those years on coumadin I seem to defy the odds that Al posts on bleeds. I was admitted this week for a fourth bleed. The first was for a hysterectomy the second for bleeding in my brain the third for a gastric bleed and finally this week for a nosebleed. My INR was 2.3 when admitted. Never having a nosebleed of this calibar I was not sure how to handle it. I finally called the doctor after two hours and they told me after 25 minutes of bending forward and pinching the nostrils for 10 minutes at a time that 25 minutes is when you seek help. I have not had a cold, I did not sneeze or bump myself it just started to run. This was the most painful of the 4 bleeds since they had to sedate me and insert a balloon that they then inflate to put pressure on the area. They kept me sedated throughout the night and into the am. Upon waking the pain was unbearable. We held the coumadin that night and the next am my INR was 2.2. I went home that night with drugs in hand. Yesterday I went to the ENT to remove the packing after having a 3.1 INR. The bleeding commenced after 5 minutes of removing the balloon. The ENT had to cauterize the bleed he could see and would need to repack if the bleeding started. I wanted to leave and once getting in the car it began again. Emotionally I knew I could not handle another packing so I had my daughter take me home and decided to hope for the best. It has now been 24 hours since the packing was taken out and I can finally say it has stopped. It has taught me how terrific these nose bleeds can be and now know what to do if one ever happens again.
Kathleen

 

[maka]

Kathleen

I?m not on coumadin but years ago I used to have nose bleedings for no reason at all. I had to go to the hospital twice. One of the doctors recommended I buy a ?gauze pack?. ( no prescription necessary). It is like a long strip of gauze impregnated with some kind of cream that you can push it up into your nostril until the bleeding stops. As the gauze has that cream (can?t remember what is)it does not stick to the inside of the nostril and can be removed very easily and painless when the bleeding stops. I used to have one of those pack with me all the time. Maybe you want to ask
your doctor about this.

 

[Karlynn]

Kathleen - I'm so sorry to hear you had this problem. And I'm also glad that your decision to not turn around to go back in for the packing worked out.

Just out of curiosity - when did the other 3 bleeds occur? Were they when Protime was the measuring standard or after INR was implimented? The use of the Protime number did make management more difficult and more incidences of bleeding occured. Since you've been on warfarin so long, I'm just wondering if a few of your bleeds can be chalked up to that.

Another thought is that, unfortunately for you, there are people that find themselves on the bad side of statistics. We look at 1st surgery statistics of 2% and breathe a sigh of relieve that it is so low. We don't often stop to understand that the 2% represents people who didn't make it through their first surgery. How frustrating for you that you find yourself on the negative side of Al's stats. You need to "step away from the dark side"!!!!

Have they ever taken a close look at your blood to see if there is some factor that causes you to be more susceptible to bleeds? Or possibly the structure of your vessels?

My bro-in-law had problems with nose bleeds. He even had one time where they were about ready to do a transfusion on him. And he wasn't a warfarin user. He had a few very fragile vessels in his nose. I remember him having to have his nose packed and knew then that it was not something I wanted to experience. Cauterizing finally solved his problem - but unfortunately it wasn't something they did right away.

 

[catwoman]

Kathleen:

Apparently one of those bleeds occurred before you began taking warfarin; seems that it was apparently the hysterectomy??

Glad you got the nosebleed stopped. They can be a little scary!

Nosebleeds can affect many people. I get them when I go to Albuquerque or Arizona. Normally I don't drink enough water and it's worse when I go to a drier area. I get nosebleeds then.
My high school boyfriend had to go to the ER with a nosebleed. It started while we were in the school library. He couldn't get it to stop. So after school, his mom took him to the nearest hospital (Presbyterian in Dallas).

 

[Ross]

My question is, why didn't he cauterize it right off the bat? Sounds to me like this is one spot that is going to be a problem from here on out.

 

[Nan]

Hi Kathleen, sorry you are on the wrong side of those odds! Let's hope that you are now going to move to the other side.

Glad that your decision to go home and not go back to be "re-packed" worked out.

My husband (not on coumadin) had a nosebleed that woudn't stop and ended up with it packed, he said it was the worst experience he ever had! It actually ended up being cauterized later on, which is why I agree with Ross. Why don't they do the cauterization right away?

hope you are feeling OK now.

 

[Kathleen]

The bleeds have been over a period of years, the first was three years after the dual mechanicals were put in. The second many years later was the oddest of all. I was taking 2.5 mg of coumadin per day and doing an INR every three weeks. I noticed that I was quite bruised and thought I better go in early for a lab and then got a call that they had rechecked my INR and it was 11. They held the coumadin for two days and rechecked and it had fallen to 1.0. Completely odd then the headaches began. I struggled with it thinking it was just a headache but then had odd symptoms at my desk and went to the ER. They did a ct scan of my head and found the bleed and then did a brain wave test of some kind and found the stroke. The third was a bleed in the upper area of my stomach, my INR was 2.5 at the time still taking 2.5 mgs. This nose thing came after my recent hospitalization for one of my stents that had closed up and needed to be piggy backed with another stent. Of course we had to do the Plavix, aspirin and coumadin cocktail which I did for not quite one month. I am still on the 2.5 mg of coumadin per day but I cannot seem to take the Plavix or aspirin. The doctors want me to do an every other day with the Plavix but I just can't seem to trust it. I will discuss that with my cardio on Thursday. When the ER doctor found the bleeding he said he saw 15 small bleeding areas and felt the cauterizing would not work on so many areas. The ear nose and throat doctor gave me his 24 hour number and before I ever have an ER doc make the decisions he did I will call my ENT first. Last year we put in a heavy duty humidifier on our furnace since I had worried about the dry air.

 

[Persianlady05]

Nose bleeder

Nose bleeder

my goodness I certainly understand what you went through ,my heart just went out to you,its hard to deal with that and having a almost normal INR ,this meds is the most diffcult I too have many problems my body rejects it many times I will keep you in our family prayers my dear I hve learned to enjoy the days when nothing goes wrong those days are wonderful arent they take care love chris

 

[Ross]

I do not care what the professional arena says, Plavix, Coumadin, and Asprin together is a very dangerous mix. I had bleeding from my lungs while on Plavix and the rest. It went away upon discontinuation of Plavix. Sorry, I do not trust that drug at all.

 

[azpam]

I know 2 men that were on plavix that almost bleed to death quickly. So please watch for bleeding in your stools or coughing up blood and then let your doctors know pronto!

 

[Kathleen]

I despise the cocktail which is why I have not taken either the aspirin or Plavix for a week. It will be interesting to see how they handle the "need" for Plavix for the rest of my life. Not a very good life as far as I can see. The 6 stents are the drug eluding ones and they are 18 months old the piggy backed stent is only one month and the bleed occurred at 3 weeks into the med regime. I did not have any bleeds for the 8 months that I took Plavix after the stents were implanted but now I don't trust it at all. I am now trying to keep an INR at 2.5. Two mechanicals, 21 years old, not 3.0, not 2.0 just 2.5. That will be interesting.
Kathleen

 

[Guest]

There are some people who are just more likely to bleed than others.

Old-timers here will remember Gisele who bled into her brain three times and the doctors finally replaced her mechanical valves with tissue valves.

One woman who comes to my clinic had so many bloody noses that she single-handedly changed the bleeding rate for my clinic by six patient-weeks. When you consider that I have 800 patients, this is quite a bit of bleeding.