Warfarin should always be a concern but never a worry. I have successfully managed warfarin for a bunch of kids under 10 years old. I am currently managing four of them. I have started with them as young as 5 months.
The reason that you should not be overly concerned about nosebleeds not stopping is this. At her age she could lose about a pint of blood before she gets into real trouble. The next time you go to the store, get a pint of whipping cream. Take it home and open it and throw it all over the kitchen floor. Then try to clean it up using only Kleenex. If she spilled that much blood, I guarantee that you would have he in a hospital already. So my rule is - if the bloody nose fills 5 Kleenex then start heading for the hospital. This gives you plenty of time. With the fine medical care available in Atlanta, she will not bleed to death.
Please look at my website
www.warfarinfo.com (Ross was writing at the same time as I was)
Of particular interest will be
http://warfarinfo.com/pediatrics.htm
where my student Phillip Romero interviewed the parents of children on warfarin.
You will probably also find
http://warfarinfo.com/warfarinfor43years.htm
of interest. The person that this is about is a member of this site.
http://warfarinfo.com/outrageous.htm will inform you of some of the stupid things that people are likely to tell you.
President Eisenhower got warfarin when he had a heart attack in 1955, so we know a lot about this drug. Also, since it is so old, someone will come up with a replacement in a few years. But do not get your hopes up when you read about Exanta. It is not going to be available for heart patients any time soon.
There are several women on this site who had children after they had mechanical valves, so do not rule out that possibility.
The worst bruises I have seen on a child was when Saydie played on a Slip and Slide. Her valve had been in place for several years, so her Mom was used to letting her grow up but it still sent chills up and down her spine to she Saydie diving on her tummy down the wet plastic strip. The bruises healed in the usual amount of time.
As you already know, your daughter is amazing resilient. The guidelines for warfarin dosing are just that - guidelines. She will not instantly clot if her INR (measure of warfarin effectiveness) goes low nor will blood automatically squirt if it gets high. It will probably take a few months to get the INR consistently in range because of changing activity levels, eating, growth etc.
You will get dozens of replies to this post agreeing that warfarin will always be a concern but should not be a major worry.
Keep us posted. We will be your support. That is why Hank started this site and continues to devote much effort to it as do Ross, Rain and several others.
