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Bonnie
N
nadi
Toothpaste
Toothpaste
I have always used toothpaste to help draw them out. my daughter thought I was nuts when I told her to use toothpaste. That is until the day of her prom. Woke up with one just coming up was gone by 5pm. I found the cheapest is the best, it dries quicker.
Toothpaste
I have always used toothpaste to help draw them out. my daughter thought I was nuts when I told her to use toothpaste. That is until the day of her prom. Woke up with one just coming up was gone by 5pm. I found the cheapest is the best, it dries quicker.
I bruise easier with Coumadin. Mostly minor stuff. Yes, I am more conscious of sharp stuff and I tend to go barefoot a little less and walk around in the dark a little less.
I's ironic that I sometimes have trouble drawing enough blood for my home coagucheck.
I's ironic that I sometimes have trouble drawing enough blood for my home coagucheck.
S
Sierra Bob
I get cut if I even look at some thing sharp. Bleeding has never been a problem. It's always stopped within a few minutes------until last month!! On September 22, I had a tooth pulled due to a broken bridge. (Don't ask!!!) There was no bleeding at all. Then on 9/27 the dam broke and I began bleeding profusely from the gum cavity. I checked my INR and it was 3.1 (My cardiologist wants mine between 3.0 & 4.0. Much higher than most on this list.) As my dentist was out of town and his fill-in would not handle this type of problem, I went to the hospital Emergency Room. The ER doc applied silver nitrate and the bleeding stopped----- until the next morning, then it started all over again. So, back to the ER. This time the ER doc applied surgical Gel Foam. That stopped the bleeding, until I got home. My wife contacted an oral surgeon and he said it would not stop bleeding until I was off of Coumadin. I stopped the Coumadin, and the bleeding finally stopped on October 1. My INR was then 1.4.
I have ordered four packages of "Bleed X", which was mentioned in another forum, in case I do get a really bad cut. The company says it could also be applied to a bleeding gum due to a pulled tooth.
I have ordered four packages of "Bleed X", which was mentioned in another forum, in case I do get a really bad cut. The company says it could also be applied to a bleeding gum due to a pulled tooth.
G
Guest
There is something going on here besides the INR issue. You should hardly be able to notice any difference between an INR of 1.4 and 3.1.
S
Sierra Bob
Al---Are you suggesting there is very little difference in the coagulation time between an INR of 1.4 and 3.1? If so, why does my cardiologist want mine so high (3.0 to 4.0). Or, is it because of plaque adhearing to the mechanical valve? Awaiting your reply. Bob
I don't mean to pile on but my understanding is that since the INR is a ratio, that 1.0 is the base. Thus 1.4 and 3.1 appear to be vastly different. If they are similar, then why bother taking Coumadin at all?
G
Guest
The difference in clotting time that you are shooting for is very small. Little enough that you should not notice much change if you just nick your finger for instance. Say you got a cut that used to take 15 seconds to stop bleeding. With warfarin you should bleed for about 30 to 45 seconds. Enough to make a difference in clotting on your valve but not enough that you should be concerned about bleeding to death from a little scratch or even one tooth being pulled. Day after day every heart beat, there is a difference between 1.4 and 3.1 but not life and death as far as scratches are concerned.
If you have plaque on your valve, your are in line for a new valve, not more warfarin.
I have no idea why a doctor would choose a target INR of 3 to 4 unless you have a clotting disorder or already ruined a valve while anticoagulated at 2.5 to 3.5. It certainly is not in any guideline for the US since at least 1997 when I started this full time. Some of the old guidelines and those in use in Eastern Europe might recommend this, but not currently in the US.
If you have plaque on your valve, your are in line for a new valve, not more warfarin.
I have no idea why a doctor would choose a target INR of 3 to 4 unless you have a clotting disorder or already ruined a valve while anticoagulated at 2.5 to 3.5. It certainly is not in any guideline for the US since at least 1997 when I started this full time. Some of the old guidelines and those in use in Eastern Europe might recommend this, but not currently in the US.
Al,
Thanks for the explanation. BTW my target is 2.5-3.5.
Thanks for the explanation. BTW my target is 2.5-3.5.
S
Sierra Bob
Thanks Al---You hit my numbers pretty close. My ProTime Microcoagulation System indicates a prothrombin time of 18.3 seconds for an INR of 1.4 and 40.5 seconds for an INR of 3.1.
In thinking about why I started bleeding five days after the tooth extraction, it may be because I inadvertently and unconsciously tore open the cavity with my tooth brush. I have no salivary glands as a result of radiation to the head and neck to the maximum nonlethal dose for an unknown primary squamous cell carcinoma. Consequently, I'm pretty aggressive in my brushing so I don't develop cavities. Since I use a prescription tooth paste, I'm not suposed to rinse after brushing. I didn't know I was bleeding until my wife asked what was all over my mouth. It was blood! And, as I said earlier, it did not stop until I discontinued Coumadin in spite of an application of silver nitrate, then Gel Foam. Do you have any suggestions as to what else may be going on, since you don't believe it was affected by the difference in my clotting time?
Regarding why my cardiologist wants my INR between 3.0 and 4.0, could it because I have one of the St. Jude Silzone mechanical valves. Could the silver coating on the sewing cuff be more susceptible to plaque formation?
Thanks in advance. Bob
In thinking about why I started bleeding five days after the tooth extraction, it may be because I inadvertently and unconsciously tore open the cavity with my tooth brush. I have no salivary glands as a result of radiation to the head and neck to the maximum nonlethal dose for an unknown primary squamous cell carcinoma. Consequently, I'm pretty aggressive in my brushing so I don't develop cavities. Since I use a prescription tooth paste, I'm not suposed to rinse after brushing. I didn't know I was bleeding until my wife asked what was all over my mouth. It was blood! And, as I said earlier, it did not stop until I discontinued Coumadin in spite of an application of silver nitrate, then Gel Foam. Do you have any suggestions as to what else may be going on, since you don't believe it was affected by the difference in my clotting time?
Regarding why my cardiologist wants my INR between 3.0 and 4.0, could it because I have one of the St. Jude Silzone mechanical valves. Could the silver coating on the sewing cuff be more susceptible to plaque formation?
Thanks in advance. Bob
G
Guest
SB,
You already answered what else was going on. I was pretty sure that a 3.1 INR would not cause that much bleeding by itself. However, once it got started the warfarin undoubtedly kept it going. Especially in the mouth where it would be impossible to keep your tongue from brushing the scab every time it started to form. You also did what you had to do by holding the Coumadin until that problem was solved.
You already answered what else was going on. I was pretty sure that a 3.1 INR would not cause that much bleeding by itself. However, once it got started the warfarin undoubtedly kept it going. Especially in the mouth where it would be impossible to keep your tongue from brushing the scab every time it started to form. You also did what you had to do by holding the Coumadin until that problem was solved.
S
Sierra Bob
Thanks Al. I feel much better. Any thoughts on the Silzone coated sewing cuff and my cardiologist's desire to have my INR between 3.0 & 4.0?
G
Guest
Nothing that I know of.
Are there INR range guidelines for people who have had strokes? Albert had a stroke while on Coumadin. His INR target range was changed to 3.0-4.0. He had been on anticoagulation therapy for 10 years and 2 months when he had his first stroke.
Many thanks,
Blanche
Many thanks,
Blanche
G
Guest
Warfarin doesn't eliminate the risk of strokes, but it does cut it down.
When somebody who is taking warfarin has a stroke, it is important to find what the INR is at the time of the stroke. If it is low, then the person is not truly anticoagulated. Therefore, the need to raise the target INR is in question. Nobody has ever done a study on the effect of raising the INR level on anyone who had a stroke, but it seems to make sense.
When somebody who is taking warfarin has a stroke, it is important to find what the INR is at the time of the stroke. If it is low, then the person is not truly anticoagulated. Therefore, the need to raise the target INR is in question. Nobody has ever done a study on the effect of raising the INR level on anyone who had a stroke, but it seems to make sense.
S
Sierra Bob
Blanche---May I ask why Albert was on Coumadin for ten plus years.
H
Herb M
I have been on Coumadin for 13 years. I do bruise easily but excessive bleeding has not been a problem. When I get a cut I just put pressure on the area and do not observe excessive or bleeding for long times. Infrequently I do get a nose bleed when some crusty material is dislodged from my nose. I use some pressure and stuff a tissue up my nose. The bleed doesn't last for more than a couple of minutes.
So in my case ordinary scrapes and cuts are nothing to worry about.
So in my case ordinary scrapes and cuts are nothing to worry about.
Sierra Bob:
Al had his mitral valve replaced with a St. Jude's on October l8, 1990. Ten years later, on December 15, 2000, he had his first stroke, which doctors said was a TIA. While having lunch at the local "watering hole" with friends, he passed out and remained unconcious for several hours. The following day he showed no ill effects from the stroke, so the hospitalist, a DO,said it was just a "little hiccup of the brain." Two days after being released from hospital, he had another stroke. This time, they agreed that it was a CVC, a full blown stroke. When he was released from the hospital this time the neurosurgeon and the cardiologist told him to increase his INR range to 3.0 - 4.0.
Al had his mitral valve replaced with a St. Jude's on October l8, 1990. Ten years later, on December 15, 2000, he had his first stroke, which doctors said was a TIA. While having lunch at the local "watering hole" with friends, he passed out and remained unconcious for several hours. The following day he showed no ill effects from the stroke, so the hospitalist, a DO,said it was just a "little hiccup of the brain." Two days after being released from hospital, he had another stroke. This time, they agreed that it was a CVC, a full blown stroke. When he was released from the hospital this time the neurosurgeon and the cardiologist told him to increase his INR range to 3.0 - 4.0.
S
Sierra Bob
Hi Blanche: As you can see from my previous posts on this subject, my cardiologist has always wanted my INR at 3.0 to 4.0. So far no TIA's or full blown strokes. As I posted, I did have bleeding five days after I had a tooth pulled last month, but I really think now that was due to aggressive brushing and unknowingly opening up the cavity with the tooth brush. Regards, Bob
ALCapshaw2
Well-known member
Another question for Al Lodwick re TIA's
I recall my Card saying that he preferred his patients who experience TIA's to keep their INR around (or presumably above) 3.0 and not to let it drop into the 2.5 to 3.0 range. Al, do you concur with that philosophy?
And a word for Kevin
I'm cleaning up (trimming, cutting, and loading) the limbs from another pine tree 'harvest'. I've got little nicks and scrapes all over my forearms. ONE of them lasted a little longer than I would expect for someone not on Coumadin. NO BIG DEAL. I just wiped it with an alcohol wipe and didn't even put a bandaid on it. It formed a scab well within the hour.
'AL'
I recall my Card saying that he preferred his patients who experience TIA's to keep their INR around (or presumably above) 3.0 and not to let it drop into the 2.5 to 3.0 range. Al, do you concur with that philosophy?
And a word for Kevin
I'm cleaning up (trimming, cutting, and loading) the limbs from another pine tree 'harvest'. I've got little nicks and scrapes all over my forearms. ONE of them lasted a little longer than I would expect for someone not on Coumadin. NO BIG DEAL. I just wiped it with an alcohol wipe and didn't even put a bandaid on it. It formed a scab well within the hour.
'AL'
