carolinemc
Well-known member
Hate to tell you talk to your sister again, for many mechanical valvers cannot take Eliquis.
Question regarding life on anti-coagulants
- Thread starter SatoriFround
- Start date
Help Support Valve Replacement Forums:
Pellicle: You mentioned "small occasional issues which I believe are TIA's"
What kind of 'small occasional issues' are you referring to?
----
As far as bleeding when on Warfarin, we should remember that INR is an approximate comparison between clotting time on warfarin and clotting time without warfarin.
If your INR is 2.5, this means that a cut will take 2.5 times as long (NOT longer) as it would if you weren't taking warfarin. So - if you get a small cut, or a barely significant nick (razor nick?) that would clot normally in 10 seconds, the blood will take 25 seconds to clot. You won't bleed to death
Plus, if you apply pressure to the cut - maybe even putting a bandage or kleenex (or even toilet paper) on the cut and apply a little pressure, you may stop the bleed faster than someone NOT on an anticoagulant who ignores the nick.
I've occasionally found that I was bleeding - not from pain, but because of the stickiness near the 'cut' body part (blood feels sticky when it clots). Maybe I've become less sensitive to little nicks and cuts through the years, or my pain threshold has changed, or I'm just not paying attention to the 'small' things. Warfarin doesn't seem to be much of a problem for me.
What kind of 'small occasional issues' are you referring to?
----
As far as bleeding when on Warfarin, we should remember that INR is an approximate comparison between clotting time on warfarin and clotting time without warfarin.
If your INR is 2.5, this means that a cut will take 2.5 times as long (NOT longer) as it would if you weren't taking warfarin. So - if you get a small cut, or a barely significant nick (razor nick?) that would clot normally in 10 seconds, the blood will take 25 seconds to clot. You won't bleed to death
Plus, if you apply pressure to the cut - maybe even putting a bandage or kleenex (or even toilet paper) on the cut and apply a little pressure, you may stop the bleed faster than someone NOT on an anticoagulant who ignores the nick.
I've occasionally found that I was bleeding - not from pain, but because of the stickiness near the 'cut' body part (blood feels sticky when it clots). Maybe I've become less sensitive to little nicks and cuts through the years, or my pain threshold has changed, or I'm just not paying attention to the 'small' things. Warfarin doesn't seem to be much of a problem for me.
Lisa from LJ
Well-known member
When I had surgery in 1998, one of the rules they sent me home with was to use an electric razor to shave. I got one, but within a few months, it ended up in the bottom of the bathroom drawer, never to be seen again until we moved 13 years later. Any woman will tell you they just don't work that well, or at least they didn't back then. You're not going to bleed to death from a nick or even if you cut your finger off as long as you treat it quickly. In my (non-personal) experience, internal bleeding is what you need to worry about because you may not know about it until it's gone on a long time.
Over the years, there's been so much misinformation about anticoagulants. There was The Coumadin Cookbook, which avoided foods that contained Vitamin K. There were myths about not shaving with a blade because, presumably, a nick would cause you to bleed to death.
Even here, there was discussion about the safest razor to use when shaving. Again, the myth of bleeding from a nick (or a deep nick). I NEVER had good results from electric razors. If I use a new one, I still don't expect a close shave.
One of the users in that old forum suggested Harry's blades. They're okay. I've been using them for years. I grow a beard more quickly now, I think, than I used to - after a day or two, I should shave again. The best deal I found on Harry's blades is at Costco, about $1.50 a blade, plus a good handle.
I'm looking at Amazon Basics, for about $1 a blade.
But I don't expect that EITHER blade will cut me enough that I'll bleed to death.
I occasionally hear (or read) the thing about taking 'Rat Poison.' They don't use it anymore - the warfarin stays in the food chain and, FWIW, I read somewhere that there are some rats that developed a resistance to coumadin.
But these fears continue.
On-X decided to market their valve because the users of the new valve didn't need as high an INR (yeah, like there's a difference between aiming at 1.5 or so, and a safer 2-3), but the surgeons somehow swallowed that argument. (Again - warfarin fears)
I don't know what it will take to work around these ridiculous, incorrect, assumptions.
But, back to the last comment - using a blade wouldn't kill you unless, of course, you're shaving while walking across the freeway.
Even here, there was discussion about the safest razor to use when shaving. Again, the myth of bleeding from a nick (or a deep nick). I NEVER had good results from electric razors. If I use a new one, I still don't expect a close shave.
One of the users in that old forum suggested Harry's blades. They're okay. I've been using them for years. I grow a beard more quickly now, I think, than I used to - after a day or two, I should shave again. The best deal I found on Harry's blades is at Costco, about $1.50 a blade, plus a good handle.
I'm looking at Amazon Basics, for about $1 a blade.
But I don't expect that EITHER blade will cut me enough that I'll bleed to death.
I occasionally hear (or read) the thing about taking 'Rat Poison.' They don't use it anymore - the warfarin stays in the food chain and, FWIW, I read somewhere that there are some rats that developed a resistance to coumadin.
But these fears continue.
On-X decided to market their valve because the users of the new valve didn't need as high an INR (yeah, like there's a difference between aiming at 1.5 or so, and a safer 2-3), but the surgeons somehow swallowed that argument. (Again - warfarin fears)
I don't know what it will take to work around these ridiculous, incorrect, assumptions.
But, back to the last comment - using a blade wouldn't kill you unless, of course, you're shaving while walking across the freeway.
pellicle
Professional Dingbat, Guru and Merkintologist
small short duration "vision" related disturbances which at first felt like dizziness but I identified early on that this 'sensation' ceased when I closed my eyes. I later identified it was related to muscle control of one of my eyes. This ceased when I commenced taking aspirin. This began about 2016 IIRC then would resume occasionally if I ceased aspirin (it may take months for an episode to recur). So now I just take half a 300mg tablet every second day. I do not get them at all when I'm on the aspirin regime.
I'm aware, as is my sister.
Last edited:
I remember we had somebody on the forum awhile back who was given 2 mechanical valves that she never should have had because she had some kind of bleeding disorder. In fact I think she maybe was looking at having to have them replaced with tissue. Her situation really was not good. : (
pellicle
Professional Dingbat, Guru and Merkintologist
if you mean Harriet she also had a lot of co-morbidities and her OHS was not her first rodeo. I'm just mentioning this because we have some other members here with two mechanical valves (aortic and mitral) who are doing quite ok
HarrietW
July 9, 2019 Open Heart double valve replacement aortic & mitral bovine tricuspid my own tissue tissue. Approx 160 transfusion 11 since Tuesdays. Stag 3 blockage A/F possible pacemaker if it doesn't even out by July 16 are in place.
Very sm lung capacity. Possibly reintabation.
3.5 years after open heart surgery January 2016 complete heart failure. Pulmonary hypertension 90mmg tricuspid regurg mitral regurg minimal aortic valve mechanical mild regurgitation.
Surgery & first Diagnosis
Rheumatic heart disease diagnosed April 2012 Mitral regurgitation, Aortic Stenosis with a chronic upper respiratory infection recently diagnosed with interstitial lung disease waiting biopsy results. Awaiting workup for OHS see Cardiologist End Jan 2015 .. And close to go time !
More medically tech info.
Aortic R
Sever LA Enlargement /Sever Stenosis /Left Atrium Severely Diolated
Sever MR /sever regurgitation Leaflet retracted
Pericardial Effusion -
Sever AR Sever thickening
Tricuspid R
LA/mod - sev hypertrophied
LA Sev Dilated
Harriet also had quite a few other co-morbidities such as a long prior history of substance abuse ...
I've not seen here back here in quite a while (from the About link: Last seen Jun 5, 2020)
I don't know if she's passed or still with us. I hope she still is fighting the good fight
Best Wishes
Yes, Harriet. I also hope she is doing okay somehow but she had a lot to deal with. And to your original point, I thought elevated bleeding risk was one of those things.
pellicle
Professional Dingbat, Guru and Merkintologist
yes, indeed it was. I have no idea why she was talked into ignoring that risk by a surgeon, but I recall the discussions well. I had a lot of sympathy and empathy for Harriet. Her surgeon's (quite rare) predisposition for a mechanical while ignoring her diagnosed and clear (IIRC) actual contra-indications for ACT bordered on malpractice. Still, I seem to see a disproportionate amount of that coming out of Canada; perhaps its just survivor bias (those who survived can complain, those who don't are quiet).
Best Wishes
pellicle
Professional Dingbat, Guru and Merkintologist
oh
which should have totally discounted her from ACT (and thus a Mechanical). Gosh I remember well how many times she was treated for GI bleeds and that she sought a change back to a bioprosthesis (IIRC actually got it). Sure bio has lower durability but at her age and in her condition durability should not have been the prime selector (by a long shot).
So many bad calls get reported here ... its hard to watch.
Just recently I was discussing this with a friend (who used to manufacture the tools that go down catheters for interventional cardiologists) about my area of "some knowledge" (managing ACT and its statistical risks); namely the tendency to tell people "to cease ACT a week in advance of a procedure" (sometimes no mention of starting bridging) and how that almost certainly contributes something to the (actually very small) number of thrombo events found in long term studies of mech valvers. My discussion centered around the idea that these "blanket instructions" are essentially wrong (esp in the light of the procedure seldom needing INR less than 1.4 let alone 1) as they fail to take into account each patients actual INR drop in relation to dose change and or cessation.
Anyway, sorry to go off the trail here.
Best Wishses
and just to continue about harrietW, she had this:
which should have totally discounted her from ACT (and thus a Mechanical). Gosh I remember well how many times she was treated for GI bleeds and that she sought a change back to a bioprosthesis (IIRC actually got it). Sure bio has lower durability but at her age and in her condition durability should not have been the prime selector (by a long shot).
So many bad calls get reported here ... its hard to watch.
Just recently I was discussing this with a friend (who used to manufacture the tools that go down catheters for interventional cardiologists) about my area of "some knowledge" (managing ACT and its statistical risks); namely the tendency to tell people "to cease ACT a week in advance of a procedure" (sometimes no mention of starting bridging) and how that almost certainly contributes something to the (actually very small) number of thrombo events found in long term studies of mech valvers. My discussion centered around the idea that these "blanket instructions" are essentially wrong (esp in the light of the procedure seldom needing INR less than 1.4 let alone 1) as they fail to take into account each patients actual INR drop in relation to dose change and or cessation.
Anyway, sorry to go off the trail here.
Best Wishses
Last edited:
Pellicle:
Your symptoms suggest (to me, at least) that your brain was combining the images from both eyes, and failing to do so.
I wonder if you've got a problem that I've had for much of my life - my eyes sometimes diverge - giving me two images. My brain usually ignores the one on the left, or sometimes is able to merge them so I have good depth perception. If you get real close to something - maybe bringing a pen close to your face, one eye will focus on it, and the other won't.
It may also be possible that the vision in both eyes is so different that your brain only wants to recognize one eye, so you don't wind up with two wildly different images (I suspect that the vision in both eyes should be almost equal for the brain to combine images).
I don't think this is a TIA. This occasionally happens to me - and I don't think it's related to whether or not I'm taking aspirin. IIRC, being extremely tired can contribute to this happening.
Closing one eye or the other to stop this event strongly suggests that your brain had trouble dealing with both eyes at once - and that covering one eye fixed the issue. I doubt that these events were TIAs, and this is probably good news.
Your symptoms suggest (to me, at least) that your brain was combining the images from both eyes, and failing to do so.
I wonder if you've got a problem that I've had for much of my life - my eyes sometimes diverge - giving me two images. My brain usually ignores the one on the left, or sometimes is able to merge them so I have good depth perception. If you get real close to something - maybe bringing a pen close to your face, one eye will focus on it, and the other won't.
It may also be possible that the vision in both eyes is so different that your brain only wants to recognize one eye, so you don't wind up with two wildly different images (I suspect that the vision in both eyes should be almost equal for the brain to combine images).
I don't think this is a TIA. This occasionally happens to me - and I don't think it's related to whether or not I'm taking aspirin. IIRC, being extremely tired can contribute to this happening.
Closing one eye or the other to stop this event strongly suggests that your brain had trouble dealing with both eyes at once - and that covering one eye fixed the issue. I doubt that these events were TIAs, and this is probably good news.
