Question regarding life on anti-coagulants

[SatoriFround]

I love to cook, and every once in awhile I cut my finger. Is this something to worry about while taking anti-coagulants? Or is it only bigger injuries that are an issue? This was the first thing I thought of when leaving the doctor and thinking I had made up my mind about getting a mechanical valve. We had a discussion about my nose bleeds, and how I would be fine to go mechanical even though I get them a few times a year. I believe they bleed more than the usual small cuts I get in the kitchen.

Thank you, just hoping you guys can ease my mind on this tiny issue.

 

[Deidra]

I'm on warfarin and my INR is usually around 2.5-3.0. When I nick myself shaving or accidentally cut myself doing something else, the wound bleeds a minute or two longer than it may have in the past. That's it. Small injuries will not be an issue

 

[Chuck C]

I cut up a lot of vegetables every week and cuts do happen. It's really not a big deal, just takes a little longer to stop the bleeding than before warfarin.

Clean wound, apply pressure then bandage, just as you would if you were not on warfarin.

I will say that since being on warfarin I tend to be more careful and mindful as I cut. I probably would get a cut every 4 months prior to warfarin and now it is more like once per year.

 

[dick0236]

Thank you, just hoping you guys can ease my mind on this tiny issue.

Excessive bleeding from small cuts is not a problem. Normally it will just take a few more seconds to stop the bleeding and simple first aid with a bandaid will stop any bleeding. Like Chuck C posted "we learn to be a little more careful" when handling sharp objects.

 

[Chuck C]

Like Chuck C posted "we learn to be a little more careful" when handling sharp objects.

And I have, since being on warfarin, completely given up machete juggling.

 

[SatoriFround]

And I have, since being on warfarin, completely given up machete juggling.

Darn, but it sounds like so much fun!

 

[pellicle]

Morning

this has got to be the most discussed topic here (after bio or mech) and my experience is that most people have everything totally wrong.

I love to cook, and every once in awhile I cut my finger. Is this something to worry about while taking anti-coagulants? Or is it only bigger injuries that are an issue?

The idea that a shaving nick leads to this is patently absurd

as you'd expect for life threatening injuries (leg ripped off in a car accident) the miniscule difference provided between warfarin and no warfarin is nil. So if you have a gunshot wound to the groin you're in as much trouble as anyone.

This was the first thing I thought of when leaving the doctor and thinking I had made up my mind about getting a mechanical valve. We had a discussion about my nose bleeds, and how I would be fine to go mechanical even though I get them a few times a year. I believe they bleed more than the usual small cuts I get in the kitchen.

To be honest I can't see any difference between my bleeding response now and then; it is about what it was before I was on warfarin. My dentist even remarks that when doing cleans "if I didn't know you were on warfarin I wouldn't know.

The key to this in my view is proper INR management. Proper means be actually successful of being inside the designated range ... you know 2 ~ 3.
This just does not happen (statistically speaking) for people in clinics (where 70% time in range is cause for celebration). Myself I'm in range greater than 90% so much that I call 93% a bad year and 97% a good year.

I recommend you read this blog post of mine from 2014
https://cjeastwd.blogspot.com/2014/09/managing-my-inr.html

PS: I meant to add, that my Dad used to regularly nick his arm or back of his hand and it bled a lot. He was never on warfarin or any blood thinners. I know that working with him (with steel or aluminium, drills and grinders building truck bodies or working in boats) that he did bleed more from nicks and scratches at his age than I do now at that age (also working with steel and stuff)
https://cjeastwd.blogspot.com/2018/01/raising-roof.html

I commenced warfarin in late 2011, so lets call it 2012.


Best Wishes

 

[LondonAndy]

Just keep a box of plasters in the kitchen

 

[pellicle]

Just keep a box of plasters in the kitchen

and some superglue in the fridge ...

 

[carolinemc]

I love to cook, and every once in awhile I cut my finger. Is this something to worry about while taking anti-coagulants? Or is it only bigger injuries that are an issue? This was the first thing I thought of when leaving the doctor and thinking I had made up my mind about getting a mechanical valve. We had a discussion about my nose bleeds, and how I would be fine to go mechanical even though I get them a few times a year. I believe they bleed more than the usual small cuts I get in the kitchen.

Thank you, just hoping you guys can ease my mind on this tiny issue.

You just do what you normal do for a cut, if the bleeding is excessive, you need to apply pressure to try to get it to stop. If it does not stop after applying pressure, time for the trip to a doctor. Good luck.

 

[dornole]

I was talking to my sister (a pediatrician, but still an MD right) about this because I have noticed a lot LESS bruising on Eliquis than when I was on 325 mg aspirin for the last 20 years. She said that the effects of anti-platelet medication (like aspirin) can be more noticeable to patients in terms of daily injuries than the effects of a DOAC or warfarin. Something about more impact from anti-platelet medications on the capillaries / smaller blood vessels which are what you're hitting with nicking your finger with a paring knife in the kitchen, or accidentally banging your hip into a table. Not sure I am getting her explanation perfect but it tracks with my experience.

 

[pellicle]

Hi

...I have noticed a lot LESS bruising on Eliquis than when I was on 325 mg aspirin for the last 20 years.

its interesting, I have this view that we need both platelets and also thorombin, however while we have a way to regulate the effect of our anti-thrombin medications (INR) we don't have a way to regulate the effect of our antiplatelet medications. Aspirin (as I'm sure you know) works as an antiplatelet by damaging the ability of the platelet to aggregate (link and link), which it would seem is binary rather than a continuum.

So, my approach to my own anticoagulation therapy supplement of anti-platelet is done knowing also that

• aspirins effect is quite short (because half life is quite short) but duration extends due to platelet lifespan
• platelets turn over and are produced constantly

which is why I take a lower dose but take it every second day (my administration is 150mg).

This process has resulted in good outcomes for me (less bruising while still avoiding any small occasional issues which I believe are TIA's)

(references reproduced also below)

https://www.thrombosisresearch.com/...d that aspirin and,, swelling, pain and fever

https://www.sciencedirect.com/scien...Acetylsalicylic acid (aspirin) is an,A2(TXA2)

https://www.sciencedirect.com/topic...t=Aspirin decays rapidly, with a,(7 ± 2 days)