My 86-year-old father had a pacemaker implanted in August of this year and in September, he passed out and had to be taken to the ER by ambulance. They found that one of the pacemaker leads had "migrated" and penetrated through the wall of his heart. They admitted him to Caridac Intensive Care and next told us that they had found that he had blood clots in his legs and lungs and one on his heart (which happened to be impaled on one of the pacemaker leads!). We had no idea that he had these clots and are still not sure if they were caused by the pacemaker implantation or if they had been there for a while. The cardiologist could not put him on warfarin because the lead was poking through his heart causing bleeding. They did install an Inferior Vena Cava Filter on his first night in the hospital. His hemoglobin dropped to 8.3 at one point but the cardiologist did not want to transfuse him for some reason. After 7 days in the hospital, they put him on warfarin and sent him home to begin the fun task of trying to get his INR regulated.
Now my first question: Dad is on warfarin for blood clots and we were told that your body dissolves the clots but you need to make your blood less coagulant to allow the body to be able to dissolve these clots. The cardiologist told him his "range" was 2.3-2.5 (at least I think that's what he said.) That seems way too narrow a range. He has been taking warfarin for about 5 weeks now and his last test was 1.7 and that was down from the previous week's test of 1.9. He was only above 2 for a week or so and they are not upping his dose from 5mg on four days and 2.5mg on the other three. He has a Home Health nurse who comes once a week to test his levels and she calls somebody when she gets the reading but I'm not sure who she coordinates the numbers with. Should we be contacting the doctor about his levels?
Next question: He is going to have a "procedure" in a week or so to change his ureteral stents. Dad had bladder cancer in 2005 and, at the age of 80, had the huge surgery to remove his bladder and prostate. Scar tissue formed in his ureters so they had to put stents in to keep them open. He gets them changed every 3 or 4 months and it is not an invasive procedure. They take the old ones out and put the new ones in through his stoma. There is seldom any bleeding involved but they want him to get of his warfarin for 7 days before the procedure? Is this excessive? He is currently bleeding in his urine so we assume it is coming from the ureters or kidneys. He has told his cardiologist's office about this bleeding and their reply was to "see a urologist." I think the bleeding has to be warfarin-related. But, I'm not a doctor so what do I know?!
Dad is the bravest man I know and I want him to get better and maybe be able to stop taking the warfarin. I'm not sure that is in the cards but surely it gets easier to manage as you go! Right now, he is freaked out about what he can or can't eat and he bruises so easily and his fragile skin tears and bleeds so easily, even before the warfarin.
Thanks for any advice you can provide. I know Dad does not have a valve but I thought maybe all the warfarin "experts" here might be able to give me some advice. I've learned a lot just reading the posts here.
Now my first question: Dad is on warfarin for blood clots and we were told that your body dissolves the clots but you need to make your blood less coagulant to allow the body to be able to dissolve these clots. The cardiologist told him his "range" was 2.3-2.5 (at least I think that's what he said.) That seems way too narrow a range. He has been taking warfarin for about 5 weeks now and his last test was 1.7 and that was down from the previous week's test of 1.9. He was only above 2 for a week or so and they are not upping his dose from 5mg on four days and 2.5mg on the other three. He has a Home Health nurse who comes once a week to test his levels and she calls somebody when she gets the reading but I'm not sure who she coordinates the numbers with. Should we be contacting the doctor about his levels?
Next question: He is going to have a "procedure" in a week or so to change his ureteral stents. Dad had bladder cancer in 2005 and, at the age of 80, had the huge surgery to remove his bladder and prostate. Scar tissue formed in his ureters so they had to put stents in to keep them open. He gets them changed every 3 or 4 months and it is not an invasive procedure. They take the old ones out and put the new ones in through his stoma. There is seldom any bleeding involved but they want him to get of his warfarin for 7 days before the procedure? Is this excessive? He is currently bleeding in his urine so we assume it is coming from the ureters or kidneys. He has told his cardiologist's office about this bleeding and their reply was to "see a urologist." I think the bleeding has to be warfarin-related. But, I'm not a doctor so what do I know?!
Dad is the bravest man I know and I want him to get better and maybe be able to stop taking the warfarin. I'm not sure that is in the cards but surely it gets easier to manage as you go! Right now, he is freaked out about what he can or can't eat and he bruises so easily and his fragile skin tears and bleeds so easily, even before the warfarin.
Thanks for any advice you can provide. I know Dad does not have a valve but I thought maybe all the warfarin "experts" here might be able to give me some advice. I've learned a lot just reading the posts here.
