Sensitive subject.....

[canon4me]

A little bit more about me......my wife and I have been preparing for possible things that can or may go bad in our country/world. If you wish to call me a prepper, then so be it. So that entails food, water. alternative energy, ham radio, etc. I have a huge concern - receiving a mechanical valve and if SHTF. I assume you know what that acronym means. Right now I have a years supply of my medicines put away in case this country goes over the financial cliff, etc. My worry is not having access to coumadin if society breaks down. Another concern is, although a remote one, and that is if there is a huge solar flare (CME-coronal mass ejection) i.e. such as the Carrington Event in 1859 or an EMP (electrical magnetic pulse). If one of those happened, pacemakers and implantable cardioverter-defibrillators (ICD) would/most likely be rendered toast. I am more concerned about access to coumadin. Now before you deem me paranoid, I can assure you I am not. I just like to plan for possible emergencies that could spring up. We once had a power outage that lasted three days during a blizzard. I had enough wood cut and split whereby I stayed very warm throughout. But anyway, those factors have been on my mind on the tissue vs. mechanical valve option. I'm sure I can discuss this with my surgeon, but if they get in there and find something unplanned, all bets are off the table what I will wake up with (I did say wake up).

 

[newmitral]

Hello canon4me,

See this older thread in the forum (In-case-of-Zombie-Apocalypse,etc):

http://www.valvereplacement.org/forums/showthread.php?40826-In-case-of-Zombie-Apocalypse-natural-alternative-to-warfarin-aspirin-Just-for-fun

I was more worried about storms, or other natural disasters interrupting the supply of warfarin now that it is a maintenance drug for me.

Target, Walmart and several other pharmacies will provide a 90 day supply for about $10 - no health insurance necessary - as long as your doctor will write you a prescription for it.

I now have a 4 month supply of my warfarin pills in reserve, which is plenty to give me peace of mind.
Since they do have an expiraton date (not sure if they really go bad or not), just rotate the new pills in with the old so your stockpile doesn't get too far beyond the expiration date (typically 1 year).

If you want a 1 year supply in reserve, it is easily accomplished.

Getting a home-test machine for INR testing will also give you an independent method of testing and regulating your INR if you can't or don't want to go to a lab/clinic.

 

[dick0236]

But anyway, those factors have been on my mind on the tissue vs. mechanical valve option. ).

That's a new wrinkle on the valve debate....LOL

Reminds me of the time I packed a suitcase full of clothes for my family back during the Cuban Missile Crisis of 1962. Looking back, I wonder where we could have gone, to be safe, if there had been a nuclear war over that incident...LOL

 

[canon4me]

http://i154.photobucket.com/albums/s271/photogman/photo_zps01b5e43e.jpg

Remember these? I also hid under my desk in school during air raid drills in the early 60's.

 

[Jkm7]

I always wonder if pills stored in cool dry place really do lose their efficacy in one year.
I know the Rx are all marked to discard after 12 months but I sometimes think I am throwing away medication that is still useful.

Anyone else ever consider holding on to meds a little longer.
(I have some that are 'as needed' so I don't always use them up.)

 

[canon4me]

I always wonder if pills stored in cool dry place really do lose their efficacy in one year.
I know the Rx are all marked to discard after 12 months but I sometimes think I am throwing away medication that is still useful.

Anyone else ever consider holding on to meds a little longer.
(I have some that are 'as needed' so I don't always use them up.)

http://www.health.harvard.edu/fhg/updates/update1103a.shtml

 

[Jkm7]

Great link.
Thank you.

 

[Gail in Ca]

My husband is trying to get me to think as you do. Since I live in earthquake country, I try to keep my supply of meds at least 3 mos extra. I do use Walmart for 3 of my RX's as my doc will write for as much as I ask for, I suppose.
I don't use my insurance for warfarin or metoprolol, at Walmart. And I got my strips for my Coaguchek XS machine on Ebay the last time, as my insurance only lets me get a 3 months supply.
I find the expiration date thing interesting. When I was young, I worked as a pharmacy assistant in a major drug store chain. The expiration date on the bottles given to customers was always what was on the large bottle they came from, or the prepackaged bottle had it's own expiration date. Now, I notice when I get 2 of my RX's by mail, the expiration date is always a year exactly from the fill date. This has to be wrong! But, they always seem to put the label over the date on the prepackaged bottle, don't they? Each prescription has it's own date, and it's not exactly one yr from the fill date!
I just picked up my drugs from Walmart, and they have the correct exp date, my metoprolol says 1/15 and my warfarin is 9/14. Now, the Sotalol that I just got thru the mail using insurance was listed as only a yr from the fill date.
This is an interesting piece of info. Usually, we use our meds before a yr is up, but some drugs may just be as needed. How do we know then, when to really throw it away?

 

[Guyswell]

Ask yourself what you fear most. Do you fear the SHTF - running out of Coumadin scenario more? If so, go with the tissue valve and expect another operation in your lifetime. On the other hand, if you fear a second surgery more, go with the mechanical valve and maintain an adequate supply of coumadin as others have done.

 

[Bryan B]

I have worked as a pharmacy technician in a large inpatient hospital, the outpatient clinic at the same hospital, an infusion pharmacy for a home health company, a start up company developing a proprietary automated medication dispensing product, and installing pharmacy software at hospitals nationwide. In my experiences the average expiration date on drugs received from the wholesaler were 2-4 years with some being less and some being more (and remember these expiration dates from the manufacturer are conservative (read CYA). Most pharmacists told me that with most drugs it would be safe to take them at least a year beyond their expiration date, especially if they were kept in a cool dry place and protected from light. At worst they may lose some of their potency. Depending on what the medication is used for that may or may not be a big deal, but most expired meds will not cause adverse reactions beyond losing some of their potency.

Pharmacies (at least in NC) are required to put a 12 month expiration date on all prescriptions. This is not the expiration date from the manufacturer but the date that the prescription expires. Again this is a CYA procedure because once the prescription expires, technically you should not be taking that medication unless your physician has renewed it. My PCP writes all of my prescriptions for 3 months worth as I get them filled at Walmart. I take 4 different medications that are 10 dollars for a 3 month supply.

Personally I will take a medication for about 1 year past the manufacturers expiration date but not past that as I worry about a loss of potency.

 

[pellicle]

My advice would be to go with one of the pyrolytic carbon valves as they will give you the best chance of survival without any warfarin.as I understood it most of the new ones are

Have a look at the proact study (found here) and you can see that people on no warfarin had very low thrombosis events. Assuming a SHTF scenario I would put death from lack of warfarin low down on the list of potential causes of death (you live in the USA, so rioting and general disorder would be higher on my list looking at your history).

Having a lower dose and aspirin (to suppliment) would seem a way to string out your supply for more years.

Warfarin seems a pretty stable compound to me



PS

http://www.ncbi.nlm.nih.gov/pubmed/16480016

Among the patient population, 40% were either not anticoagulated or were unsatisfactorily anticoagulated.

...

Linearized rates (for AVR, MVR and DVR, respectively) for late complications (%/ pt-yr) were: bleeding events 0.6, 1.0, and 2.3; thrombosis 0.0, 0.2, and 0.0;
... Among patients there were seven uncomplicated, full-term pregnancies.

...

The low incidence of valve thrombosis (one case) was noteworthy. These data also suggest that the On-X valve may be implanted with relative safety in women wishing to have children.

 

[Superman]

In a post-apocalypse, SHTF scenario - I think scrounging for Warfarin would be easier to do than to find a sanitary place to replace a worn-out tissue valve that's due for an update. Just sayin'.

I think it's pretty safe to say that all of us on this site live at the mercy of technology. Had we been born 50 - 100 years earlier, many of us would be long gone at this point. And that would not have even required society to collapse.

 

[canon4me]

In a post-apocalypse, SHTF scenario - I think scrounging for Warfarin would be easier to do than to find a sanitary place to replace a worn-out tissue valve that's due for an update. Just sayin'.

I think it's pretty safe to say that all of us on this site live at the mercy of technology. Had we been born 50 - 100 years earlier, many of us would be long gone at this point. And that would not have even required society to collapse.

Point is well-taken!

 

[AgilityDog]

Y'a know, I've thought about this too. I've decided that if the SHTF, I want to be at the center of the fan. Poof, no more worries.:angel:

 

[Jkm7]

Y'a know, I've thought about this too. I've decided that if the SHTF, I want to be at the center of the fan. Poof, no more worries.:angel:

I agree.
If conditions are so bad, I'd just as soon be among the first to go and not have to cope.
JMO....

 

[MarkU]

I guess I can't say too much since I stocked up on ammunition and bought a couple of extra magazines for my pistol before the Presidential election four years ago trying to stay ahead of the threat of a potential gun ban.
Living on the gulf coast and seeing the anarcy in New Orleans after Katrina got us thinking about about what-if scenarios if all public services went away for a period of time. We normally stock stuff for hurrincane season (water, batteries, canned goods) but only for about two-three weeks. My insurance lets me get up to a 90 day supply of Coumadin, but never have done so - usually just get 30-days at a time.
Mark

 

[tom in MO]

If the SHTF, I'd probably start smoking again. I'd better put up some tobaccy and papers

 

[marc_kowal]

If some researchers were able to find foods or items that grow in nature that actually raise a persons INR, they could become very rich and have a lot of happy mechanical valvers. Imagine being able to eat some foods that raised your INR and you didn't need to take warfarin anymore.

 

[TomAlbers]

Cannon4me,
I agree with Pellicle, that knowing what I know about the new mechanical valves, I just got one 7 weeks ago, I am not too worried about the Coumadin issue. According to my surgeon, the latest valves, pyrolytic carbon valves, which all new ones are made, have been used in Europe without anticoagulant therapy. He stated that they use a baby aspirin at most but believe the new valves are such a low risk for clotting that it's not worth the risk of Coumadin. He also said that in the USA we're not that cocky so we still use blood thinners but they would wait for the 10 year studies on the Europe cases and then make a decision. He said he expects that if all goes well with what they think research will show, that we won't be using coumadin on the new mechanical valves in the future.
Just my 2 cents from what I was told. I do agree, if the SHTF, coumadin will be the least of my worries I would suppose.

 

[canon4me]

Cannon4me,
I agree with Pellicle, that knowing what I know about the new mechanical valves, I just got one 7 weeks ago, I am not too worried about the Coumadin issue. According to my surgeon, the latest valves, pyrolytic carbon valves, which all new ones are made, have been used in Europe without anticoagulant therapy. He stated that they use a baby aspirin at most but believe the new valves are such a low risk for clotting that it's not worth the risk of Coumadin. He also said that in the USA we're not that cocky so we still use blood thinners but they would wait for the 10 year studies on the Europe cases and then make a decision. He said he expects that if all goes well with what they think research will show, that we won't be using coumadin on the new mechanical valves in the future.
Just my 2 cents from what I was told. I do agree, if the SHTF, coumadin will be the least of my worries I would suppose.

Tom, this is, indeed, a promising prospect if it pans out and is adopted by American cardiologists/cardiac surgeons. I wish we were ten years down the road. Is this material similar to the graphite used in fishing rods? That's what patients need, the dependability of a mechanical valve and ability to function without an anticoagulant like biological valves. I always seem to be a day late and a dollar short