What concerns should I have about taking blood thinner?

Assume you are prescribed the "blood thinner" ( anti clotting) due to the afib. I had same problem and decided to do the ablation procedure which cured the afib. My concern was that while a minor surface bleed is easy to control, there is the serious danger of an internal bleed or brain bleed which is quite serious and difficult to control...The ablation procedure does not always work to control the afib but worked for me. It has been 2 years since my procedure.

Your concern and the way you want to deal with it are legit, as I can attest myself. I have been on Eliquis (apixaban) since July of 2017. I have cut myself several times, and been bashed, whether using implements or falling off my bicycle. I'm still here, typing, and even had two ablations where they asked me to stop taking apixaban the morning before the day of ablation, but loaded me up with heparin just prior to the operation. What all this means is that if the danger were that severe, it would be off the market, and nobody would take it, or pay for it if they were prescribed it.

The DOACs (Direct Oral Anti-Coagulants) only 'retard' the clotting mechanism, they don't 'prevent' it. They buy you a little time if your blood begins to circulate poorly in your left atrial appendage during an arrhythmia, and then wants to clot. This is all the DOACs do...they buy you time so that your poorly-beating heart can still clear most or all of the 'stale' blood in the appendage. Believe me, you'd rather bleed a bit messily, even internally, than have a clot travel to your own heart, your lungs, or egads...to your brain.

Wasn't it Samuel Clemens who said, 'I have feared many things in my life, most of which never happened?' If you poll 1000 people, even those with tough fears to manage, they'll rationalize when given the various choices that a stroke is almost always going to be worse than an internal bleed.

@domiha what is your CHADS score?

I have had afib for anywhere from 45 minutes to 7 hours, once a year on average, since 2015. I declined blood thinners despite pressure from my first cardiologist. He told me a few years later that I was right and they were overmedicating people (one CHADS at that time removed female gender as a point for anticoagulation).Do you have high blood pressure, diabetes, other factors? https://www.mdcalc.com/calc/801/cha2ds2-vasc-score-atrial-fibrillation-stroke-risk If you had a TUA that is a signficant risk factor.

I saw another cardiologist in the hospital who said "Just go home and forget it happened." So there is clearly some disagreement on this issue. I do understand that doctors have less liability if they prescribe then if they don't.

I will say that though a month long monitor picked up some tachcardia and bradycardia, it did not pick up afib at all. So that is a difference between you and me. How long was your afib episode on the monitor? Was there only one episode and it was short?

Some people do anticoagulant short term after an episode. I am trying to find a doctor who will prescribe that. One hospital did an echocardiogram to check for clots after an episode.

Can you ascertain how often you are having afib? Do you have a smartwatch or Kardia?

I am not questioning your doctor's advice and we all need to rely on an MD. I just get second opinions when I have uncertainty.

I didn't ask for a written copy of the Monitor report, so I don't have that information. I need to call his nurse to ask some questions, so when I do I will ask for a copy of the monitor report. Ae there different types of Afib? One that is more of a risk for strokes than another? I don't FEEL any AFib or Tachycardia. This was a total surprise.

I did have the brief episode of Aphasia which has been termed a likely TIA, so that does concern me. If I had not been talking, but instead sitting quietly, I may never have noticed it at all. The only symptom I had was the garbled syllables for a few minutes... nothing else.

This doctor was new to me, but known by my family. He did ablations on a nephew of mine when he was 19-20 because of tachycardia episodes there were extremely limiting his life. My nephew is now 29 and doing well. So he is a respected doctor.

Thanks for your questions.... and for sharing. Mike

Thank you so much for your reply! Yes, I tend to worry about things that never happen. Perhaps that means the worrying works?? 🙂 In the end, the risk of the meds is minimal compared to the risk of a stroke.
I read somewhere that once I get on this Eliquis, I cannot stop it... as that will put me at even GREATER risk.
I like John Lennon's quote: "In the end, everything will be okay. If it's not okay, then it's not the end."
Best wishes! Mike

Glad to hear the ablation worked for you!!! That may be something I will look into down the line.
Best wishes! Mike

Mike, you can stop DOACs any time you're advised to, or when you feel you simply cannot abide them any longer. It's your choice, and you CAN, indeed, stop them cold. There is no requirement for a weaning period as there is for some medications.

@gloaming when I was caring for my mother, who was on Coumadin, I did read that when stopped, risk of clotting/stroke was higher than before starting. Is this true only of Coumadin/

As with any issue, there may be many studies and I only saw one.

ps sorry folks for all my typos in previous post! TIA!

Fair question, WS. There is no danger other than you'll very shortly return to your pre-apixaban clotting capability, and that may not be desirable in those, most anyone, who was prescribed the drug to reduce risk in the first place. Please note the following:
https://www.nhs.uk/medicines/apixaban/common-questions-about-apixaban/

Thanks for your reply. Like @windyshores I had gotten the impression that if you stopped taking a DOAC there may be some rebound period when you would be in more danger of stroke or heart attack. Based on what your link indicates, your blood will simply return to the coagulation level it was at before beginning the DOAC. Though, in my case, if I'm taking it because I had a TIA and some signs of AFib, I doubt that I will ever be able to stop taking it unless there seems to be some negative side effect. Day 2 and so far all seems about the same. Best wishes! Mike