Mechanical Valve/ Blood Thinners

[Jmprosser.lab]

was wondering if some of you mech valve folks could share some general info about mechanical valves and being on blood thinners. Couple questions to start:
- what are the chances of a stroke or blood clot? Even on blood thinners is it likely?
- What are your experiences with excercise? Do you feel slower/limited? Really worried about this. Doctors gives such general tips like: “don’t push yourself.” What?! I’ve been a big cycling person is that done now?
- what are the side effects of being on warfarin?
- why did Arnold Schwartzanager go tissue so many times? Would cardios let you do that today? I know they typically persuade young folks to go with mechanical

 

[SumoRunner]

The purpose of a blood thinner is to prevent clots, so if you get one, the drug didn't do it's job. Side effects are more bleeding, easier to bruise, red cheeks after a hard workout.

Exercise intensity is not limited because of the blood thinner. It's the beta blocker that slows you down.

Don't push yourself because race officials will declare it a violation if someone else does. Otherwise, work as hard as you please. Me, mechanical aortic valve, 1991. Running, cycling, swimming as much as before, just slower due to metoprolol. I also did shot put for 25 years, requiring lots of lifting and stuff like 250 pushups a day for long stretches. Stopped that 3 years ago. I'm 70 now and this year reached 500 road races lifetime. But I can't run any more because arthritis messed up my spine. Still I've done a few 5K races this year run/walk, one swim meet & 2 triathlons.

 

[Superman]

Stroke or clot chances with a mechanical valve are pretty good without ACT. Well managed, Warfarin use is meant to prevent that.

Agree with Sumo RE the beta blocker. After my first with just the valve in 1990, I think I did okay with mountain biking and running, etc. When I had my second due to aneurysm in 2009, I was put on a beta blocker. I haven’t been able to hit my old times on a 5k.

That said, we’re talking about someone in their early 20’s then vs late 30’s / early 40’s now. Add to that, up and down as much as 40 plus lbs from my current weight and it’s hard to tell what’s medication and what’s life.

I just got my 5k time back below 30 minutes and managed a 10k this morning. I do a lot of cross training now though. Maybe running 1 or 2 times a week, spin classes a couple others, mix some lifting and other cardio/ fitness classes.

Sumo covered most of the side effects I’ve noticed. I’m a light weight drinker too. But that could be lack of training in that area as well. My liver enzymes have always come back elevated in blood work. Being 17 when I started, I don’t have much of a baseline there either.

Regarding Arnold. When you’re the Terminator, you get to do what you want to do. Only he can answer why he made the choices he did. I would guess it was as much due to his film career and travel as anything else.

 

[dick0236]

was wondering if some of you mech valve folks could share some general info about mechanical valves and being on blood thinners. Couple questions to start:
- what are the chances of a stroke or blood clot? Even on blood thinners is it likely?
- What are your experiences with excercise? Do you feel slower/limited? Really worried about this. Doctors gives such general tips like: “don’t push yourself.” What?! I’ve been a big cycling person is that done now?
- what are the side effects of being on warfarin?
- why did Arnold Schwartzanager go tissue so many times? Would cardios let you do that today? I know they typically persuade young folks to go with mechanical

a, I had a stroke at age 38, about 7 years post surgery. That was in 1974 and before the INR system and before doctors really understood how to manage mechanical valves. Doctors where managing me like they did their a-fib patients at about l-l/2 times normal clotting time.....about 18 seconds or what we now consider an INR of 1.6....way to low and I compounded the problem by neglecting to take my pill for 3 or 4 days. I now take my pill daily and home test regularly and have had NO further problems for the past 44 years.

b.No problems. I've never been a cyclist but I have water skied, built a house, still golf and had a workout at my gym this AM

c.See my earlier post today to another thread.

d. Have no idea why he chose tissue.......but I would not choose tissue at age 28. If they do invent the "miracle valve" in the future you can always elect to have the mechanical valve removed and the "miracle valve" implanted......or go tissue now and guarantee your need for future surgery......even if the "miracle valve" is not ready when your second or third surgery is needed. I've heard these "miracle valves are just around the corner" stories since I had my surgery 51 years ago.....and it ain't happened yet.

My experience is MY experience and you need to do your homework and make the decision that is correct for you. As you'll read on this forum......."there is no bad choice" except the choice to do nothing.

 

[pellicle]

ok, that got unapproved status ... stupid **** crap site ... I hope Hank sells it soon and it gets better management

so part one

Hi

was wondering if some of you mech valve folks could share some general info about mechanical valves and being on blood thinners. Couple questions to start:

well a small point ... its actually not blood thinners, which has a negative connotation straight away, it Anti-Coagulation Therapy ... which not only helps to understand what it is for but takes away any mystery. The popularisation of blood thinners is in my view because so many people are unable to grasp more vocabulary than 1 or maybe 2 syllables ...

 

[pellicle]

part 2

- what are the chances of a stroke or blood clot? Even on ACT is it likely?

the risk of stroke in the general population (not us on AC therapy) goes like this:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3006180/

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So it goes up with age

From the Rotterdam Study:

Methods From all participants of the Rotterdam Study, a population-based cohort study of 7983 subjects aged 55 years and older living in a suburb of Ommoord in Rotterdam, information on stroke history was obtained by the question, “Did you ever suffer from a stroke, diagnosed by a physician?” Supplementary medical information was obtained from general practitioner or hospital discharge records.

Results Prevalence of self-reported stroke was 2.5% in men aged 55 to 64 years, 5.0% in men aged 65 to 74 years, 8.9% in men aged 75 to 84 years, and 11.6% in men aged 85 years or older. Corresponding figures for women were 1.6%, 3.3%, 6.7%, and 10.5%, respectively. Of the self-reported strokes, 67% could be confirmed by medical information. In 53% (95% confidence interval, 47% to 60%) of subjects with a confirmed stroke, the event had led to hospital admission. The proportion of hospitalized patients decreased with age.

Conclusions The present study provides valid age- and ***-specific estimates of prevalence of stroke. A substantial proportion of patients with stroke is not hospitalized.

So the actual purpose of AC Therapy is to prevent strokes. This can be done prophylactically if you know its likely (meaning when like getting a woman pregnant or risk of transferring a disease you wear a bit of rubber called "aprophylacitc", same thing) or after the fact of the first stroke when you know the person has moved from "risk" to "evidence"

The risk as you see above goes up with age.

 

[pellicle]

part 3

- What are your experiences with excercise? Do you feel slower/limited? Really worried about this. Doctors

Myself I've noted no difference, and after my third surgery observed that after a lot of hard work got back to being the fittest I'd ever been in my life read my post here:
http://www.valvereplacement.org/for...le-to-become-active-again?p=798081#post798081

 

[pellicle]

Part 4

gives such general tips like: “don’t push yourself.” What?! I’ve been a big cycling person is that done now?

surgeons are by nature and by need conservative (the proper meaning, not the fukkedup political meaning) and so my advice to you is do EXACTLY what I did every day of my life after my first surgery (when I was 10) : find your own limits and use your head.

 

[pellicle]

part 5

- what are the side effects of being on warfarin?

• you get to live longer
• apparently you have more kids (Superman, VR, 2018)
• you have less likelihood of having a "general population stroke"
• you may bruise more easily
• you'll get angry with dickheaded clinics who don't monitor and administer your dose properly
• you'll want to assume control of this
• you will become more involved with your own health

- why did Arnold Schwartzanager go tissue so many times? Would cardios let you do that today? I know they typically persuade young folks to go with mechanical

myself I've alwsays wanted to know that. I'm of the view that he was misled by some surgeon who wanted to make himself "famous" by doing the Ross procedure on him and it all went down the totally predictable path that it did after that. I suspect also some fool misled him into thinking ACT was a death sentence when it is infact a life sentence.

How does it effect exersize ... well this woman climbed Mt Everest (google it)

Hope that helps

 

[pellicle]

nope 5 goes at sending that linke ... fukken pm me if you want it ... POS rubbish site software (and administration too)

 

[tom in MO]

- what are the chances of a stroke or blood clot? Even on blood thinners is it likely? The chance is high enough with a mechanical valve that nobody goes w/o warfarin. On properly managed warfarin, your chance of a stroke from your valve is negligible. Now if you have other problems, you can stroke because of those.

- What are your experiences with excercise? Do you feel slower/limited? Really worried about this. Doctors gives such general tips like: “don’t push yourself.” What?! I’ve been a big cycling person is that done now? You can do anything you want after about 6 months. Some beta blockers can decrease your performance, but after a couple of months you should be able to request a new mix to control your blood pressure that does not include things like Metoprolol. I did.


- what are the side effects of being on warfarin? Side effect is a euphemism for non-therapeutic effects. Since their purpose is to slow clotting, that's not a side effect. There are very few other "side effects" for properly managed warfarin therapy. However some people don't like having to wait about 2-3 times longer for a cut to heal. If you get in a terrible accident, you'd bleed to death quicker...that could be a blessing My complaint is I cannot take the good arthritis drugs because they can cause stomach bleeds.

- why did Arnold Schwarzenegger go tissue so many times? Would cardios let you do that today? I know they typically persuade young folks to go with mechanical Doctors will do anything for money if you find the right doctor. Think Prince and Michael Jackson. Plus, it's your choice, mechanical or tissue, not theirs. Everybody gets that choice from the doctor, as long as the insurance company agrees. Plus, Arnold is not too bright. He was shagging his maid w/o protection, who gave birth to his son and when he found out, he kept her on for years and didn't tell his wife. What a mess, when it hit the fan he lost his marriage, his political power and is now at best a B-movie actor.

 

[LondonAndy]

I can't add much to the comments already made, all of which I agree with. My little bit is that managing your Warfarin dose yourself reduces risks of stroke etc massively more than letting an anti-coagulation clinic do it if you are on Warfarin / Coumadin - see the report by the UK's "National Institute for Health and Clinical Excellence" . This link is to an amateur document I prepared myself to highlight the key points on the assumption I would have to persuade my doctor to let me do this, but in reality he was already a fan and very supportive. So I developed it a little to help others, and there is a link to the full report (produced in 2014) if you want the whole thing. I wish you well with your decision. I am now 52 years old, and would still choose mechanical now that I know more about it and have lived with one for 4 years.