Liquor/Coumadin and INR 6.2

[Jkm7]

An out of town friend of mine called to tell me about our friend and his experience with coumadin.

This friend has a-fib and has been on coumadin for about 4 months. He has always enjoyed a cocktail or two but apparently in recent years, his drinking has gotten out of hand and due to that, his latest INR test was 6.2. His doctors have tried many programs and multiple attempts to help him control his drinking but have failed.

They know he will continue to drink and his high INR is undoubtedly headed higher so they stopped his coumadin last week.

It is so upsetting to all of us who know this person that he has chosen liquor over survival and we know there is nothing we can do about it.

We know this cannot have a good ending.

For those who ask...... Yes, liquor does have an effect on INR level. Some people's goes up and for some, it goes down. It seems to be a different amount each can safely tolerate and one can only know by 'testing' what is a safe level for them.

Thanks for providing a place I can vent a bit.

 

[Cris N]

Very sad. I have to believe that the effect of the liquor on the liver is what's causing the INR trouble. Does he realize this will either kill him or, worse yet, totally incapacitate him? Does he have family?

 

[Jkm7]

Yes. He has family and friends who really care about him, including me and my DH. He's an alcoholic, obviously, and no one has been able to get him the right help. Nothing has worked though he has been in various programs/detox.

I think he is aware of the effects on his liver but I don't know if he fully understands the risks of his being taken off coumadin. For his doctors to take him off coumadin, they have to feel the risk of his taking it is higher than the risk of not.

I'm very worried about him.

 

[Karlynn]

I'm sorry to read this. As I'm sure you know - he's not going to get the help he needs until he realizes he needs the help. I'm sure the alcohol exacerbates the a-fib too. I'll say some prayers for him. I have a few family and friends who've struggled with the disease (and alcoholism is a disease) and it does have to start and end with the individual.

 

[catwoman]

This is from the prescribing insert for Coumadin:

CONTRAINDICATIONS
Anticoagulation is contraindicated in any localized or general physical condition or personal circumstance in which the hazard of hemorrhage might be greater than the potential clinical benefits of anticoagulation, such as:

Unsupervised patients with senility, alcoholism, or psychosis or other lack of patient cooperation.

A better phrasing should be that alcohol can affect the INR. One or two drinks occasionally isn't going to affect the INR. However, someone who abuses alcohol is courting trouble. Alcohol does dehydrate the body -- thus the warning NOT to drink alcohol in very hot weather. Take in large amounts of a period of time, it affects the liver, and that's where warfarin is metabolized. It also impairs judgment and invites a fatal fall.

I can understand your angst over your friend's situation. You're between a rock and a hard place.....

 

[Eva]

I feel sorry for your friend and for his family and friends as they suffer and worry and live in fear of the bad thing to happen. I will include him in my prayers so that he wakes up and realizes he needs help and then he will accept it.

 

[Ross]

My guess is severe dehydration from the binging and probably cirrhosis beginning or getting worse. No matter how you look at it, it's not good.

 

[Jkm7]

No, of course, it isn't good.
We wait for the call that one thing or another has happened to him.
He has lovely people surrounding him, people who care and would do anything to help but he does not want the help.......now. I hope that changes before it is too late.
He's a highly educated professional and it makes no difference. The disease of alcoholism is the same no matter the 'station' in life.

My heart is breaking for him.

 

[sue943]

(O)esophageal varices is a real danger with alcoholics. My friend's husband bled out with this and he wasn't on warfarin.

 

[Ross]

You can send these types to treatment and rehab until hell freezes over and it won't do a bit of good. They have to want to quit for themselves. All we can do is pray that that happens.

 

[terodac]

So many of us have fought so hard for our lives. My doctor would like for me to drink 4 or 5oz of red wine a day but I have just not done it almost 3 years post op. I just do not want any problems, I have been on such a roller coaster ride with my INR it has just scared me to do it. I have a nutt at the doctors office that thinks she knows it all about INR. Now that I am home testing and have my chart and calculator, I might try and add me a little wine. I use to love a martini or two before my heart surgery. But I would never drink like a fish, I do know people that take lipitor and drink beer like there will not be any tomorrow. I just don't understand why some do this drinking thing after you have been given a 2nd chance at life. Not me, kind of makes me angry when I see such a disregard for life it is so precious.

 

[Ross]

I don't see anything wrong with drinking in moderation, but when alcohol rules your life, that's an entirely different matter.

 

[Cooker]

So many of us have fought so hard for our lives. My doctor would like for me to drink 4 or 5oz of red wine a day but I have just not done it almost 3 years post op. I just do not want any problems, I have been on such a roller coaster ride with my INR it has just scared me to do it. I have a nutt at the doctors office that thinks she knows it all about INR. Now that I am home testing and have my chart and calculator, I might try and add me a little wine. I use to love a martini or two before my heart surgery. But I would never drink like a fish, I do know people that take lipitor and drink beer like there will not be any tomorrow. I just don't understand why some do this drinking thing after you have been given a 2nd chance at life. Not me, kind of makes me angry when I see such a disregard for life it is so precious.

As long as your anger is directed at the disease and not he one who is sick it?s ok ... As Karlynn stated, alcoholism is a disease ... We don?t get mad at the person who has cancer ... most physicians don?t understand alcoholism and those that are not afflicted with it can not understand it ... anyone in active alcoholism has to reach a point of making a decision to seek help, no one can do it for them .... peace out

 

[catwoman]

We don’t get mad at the person who has cancer ... most physicians don’t understand alcoholism and those that are not afflicted with it can not understand it ... anyone in active alcoholism has to reach a point of making a decision to seek help, no one can do it for them .... peace out

I had 2 uncles who were alcoholics, my mother's brother and one of her brothers-in-law. During my reporter days, I was at the Dallas County Courthouse and saw a list of upcoming court cases and there was my mother's brother's name, for a DWI. Not sure if either ever got help.

On the other hand:
A friend in California was a member of AA. Mentored new AA members. I once asked about her turning point.
It came when her daughter was diagnosed with a substance abuse problem, and Catherine realized others in the family had substance abuse problems. Dtr got into Al-Anon, Catherine went to a meeting, saw that she herself needed help, and joined AA. Her husband was also an alcoholic, but he had to reach his own turning point. Unfortunately, it came after Catherine died from cancer in January 2004.
Catherine made a big impact on many people. She embraced people and extended a hand to strangers. We met at a cat show in 1990, and became friends despite the age difference (she was 17 years older). We selected shows so we could spend the weekend together -- Salt Lake City, Seattle, Denver, LA, Dallas, Galveston, Tulsa. She played golf 3-4 days a week and was a Girl Scout leader, even into her early 70s. (I was a Camp Fire leader at the time.)
We talked frequently about her alcoholism and her journey to sobriety. I think of her nearly every day and thank God that our paths crossed and that she was able to help so many people.

I wish that jkm7's friend could have known Catherine.

 

[COLLEEN S]

Wow, sorry for your friend. It is true that we can beg, cajole, insert verb here, but unless they want to help themselves and do something proactive, there is not much we can do...but pray.