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@marybird
I think maybe about here is where I relate my experience with bleeding as a side effect of Eliquis. In my case I really believe the enhanced bleeding from the Eliquis I was taking saved my life.
As has been mentioned before, Eliquis doesn't cause bleeding out of the blue, but it does enhance any bleeding that is already occurring. So it can cause more prolonged bleeding from a cut or injury than you might see otherwise, and with capillary fragility ( often seen in older people, or those taking aspirin or other platelet function inhibitors like Plavix) cause those tiny capillaries to break in areas where the skin is bumped or pressure put on the skin those bruises or petechiae can get bigger as the Eliquis may prolong the capillary bleeding to varying degrees.
Well, in my case I started on Eliquis in June of 2021 after my cardiologist picked up a number of A-fib episodes on my pacemaker remote monitor report- I had a history of infrequent A-fib, and they were keeping an eye on the frequency and duration of the A-fib before he prescribed the Eliquis. Anyway, I had no side effects, not even increased bruising or any evidence of bleeding, no problems at all with the med. But labs done with a six-month checkup a year later with my PCP showed a drop in my hemoglobin from the last visit- 11.8g to 9.6g- over two grams. We could have assumed that this was due to the Eliquis and demanded that the cardiologist discontinue the medication, but traditional wisdom determined the cause of this drop in hemoglobin be investigated. Iron studies showed I had severe iron deficiency. This usually indicates bleeding that's gone on for a while. Fecal occult blood testing showed that bleeding was coming from my GI tract, and I had an EGD (upper endoscopy) and a colonoscopy to find that bleeding. And find it they did- there was a fairly large bleeding mass in the hepatic juncture location of my transverse colon. This was determined to be an adenocarcinoma ( cancer), and shortly after that I had a colon resection to remove the caecum, ascending colon and enough of the transverse colon to get all the cancer- which they did. They staged the cancer at 2A- spread through the colon walls but not to the lymph nodes or to any organs beyond the colon. The cancer was determined to be of a genetic type in which chemotherapy was not recommended for that stage, and my prognosis was excellent. It's four years later, and surveillance testing shows I still have "no evidence of disease" (NED).
What was scary is that I have no family history of colon cancer, my symptoms were more or less nonspecific, and I had had a screening colonoscopy four years before this cancer was picked up. No one, not my PCP, the surgeon who did my colonoscopy, or me, suspected I had cancer. It was that significant drop in hemoglobin that got our attention, and I really believe it was the Eliquis that enhanced the bleeding that was occurring with that cancer over time that dropped my hemoglobin enough to get our attention- we probably wouldn't have paid all that much attention to an 0.5 gram, or even a 1.0gram drop. I'd have continued to ignore, or rationalize the very subtle signs that there was a problem brewing in my colon, and that cancer would have continued to grow, and spread unheeded till the symptoms made it impossible to ignore. I think it's very likely I wouldn't be around today to relate the tale had that been the case. But that surgery was curative, and life is pretty much normal for me these days.
Other than a six day hiatus before and after the surgery, I'm back on the Eliquis, still with no side effects, including no unusual bruising or bleeding that I can determine. I shared this information with my cardiologist, and he pointed me to a couple of journal articles that address this issue. Apparently studies have concluded that approximately 15% of patients who experience GI bleeding with anticoagulants have been found to have cancer or other serious issues associated with GI bleeding. The take home message is to not just assume that the bleeding in these cases is due solely to the anticoagulant, but to investigate the bleeding to determine, and hopefully correct the cause.
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@marybird
Valuable info. Glad you had such a good outcome! My brother started a blood thinner after quadruple bypass and that led to a cancer diagnosis when it caused an asymptomatic malignant esophageal tumor he didn’t know he had to start bleeding. So, yes, sometimes there is a hidden reason for the excessive bleeding. I’ve been on Eliquis for afib for 10 months now and no issues. I haven’t had any more TIAs since I’ve been on it. Yay!