AFib questions
Good morning! I'm almost 66 years old, with infrequent AFib and on Eliquis. Sunday evening I had a spectacular nosebleed and went to the ER, where the attending physician inserted an epistaxis nasal pack (the kind with the inflatable balloon). I'm getting it removed tomorrow. What can I expect when it comes out--besides my own reaction of dancing gleefully around the office? Blood? Clots? Scabs? A genie? Thanks for your help!
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Just be careful. I was on Coumadin, but was taken off it when I discovered that at least two of the autoimmune disease I appear to have, AL amyloidosis and aplastic anemia, can and do cause the hematuria for which I have being treated. That did not stop the bleeding, still about a quarter cup per day, but at least I do not have to drive 60 miles to have my inr checked.
@oldkarl, I have some experience here. First, a friend of mine has a-fib and has been on Coumadin for several years. He has a device that he uses to read his INR at home an a daily basis. I stop in my HMO's lab once a month for a blood draw and INR reading. I have a little hematuria, but doctors say it's after effect of a TURP procedure on my prostate a few years ago.
Second, another friend of mine who was on Coumadin fell and suffered a head injury that caused intracranial bleeding. Emergency medical technicians I called rushed him to an emergency room a mile away. However, the ER did not have a supply of Coumadin antidote on hand (do you believe it?) so they called for a helicopter to take him to a hospital 25 miles away. By the time that ER got him under their care, they could not recover him, and he bled to death.
Hi, @predictable I am not surprised by either of these. I think Coumadin (warfarin) is greatly over-prescribed. There are so many disorders that mess with the clotability of blood, and warfarin just exacerbates them. And I, just a few days ago, asked for the A1c reader. The diabetes monitor gave me some lame excuse about a reason for not providing it. But I still think I need it, and will continue to pursue it. Sad to have to fight for life
The risk of stroke can be lessened with blood thinners
Weight and diet control items
Exercising
B-P control
But there are no guarantees
Best to you
Rek
I have Afib and use cumadin. Recently I had a cut foot and we were not able to control the bleeding and so we went to the ER. They also have a problem controlling the bleed and use a "military gauze" which stopped it. Do you know what this medication is and how we can get it?
Along with my Afib I have 3 rd stage kidney disease, pre diabetic, hypertension, COPD left ventricle regurgitatation, Lyme disease, psoriasis not bad at all, neuropathy, mild traumatic brain injury, pain in back Neck and knees, broken coccyx bone, osteoarthritis. Etc. Sorry for this laundry list. Anyone can relate, an enlarged heart not too bad, 50% when I had cardiac catheter 2 years ago, cholesterol 320 8 months ago
@donaldwnelson, your comment yesterday about Coumadin raised a number of issues to deal with carefully.
First, the standard antidote for Coumadin is Vitamin K, which may be administered orally or by other means (shots or IV, for example). Choice of administration as well as of dosage is crucial and needs to be determined by a physician; this is true because there are four levels of severity of bleeding, including clear "frank" red blood out of body wounds as well as invisible internal bleeding. It also depends on whether clotting is needed immediately on an emergency basis or can be allowed to develop in a matter of up to 20 minutes or more.
The standard antidote used by the military is called QuikClot Combat Gauze. It's a heavy-duty blood coagulant for use on combat wounds or other injuries involving heavy bleeding. This may be the substance you remember from the ER treatment of your injury. Professional briefings on the antidote for Coumadin advise that most injuries call for Vitamin K. Regardless of the coagulation agent, professional papers recommend that doctors maintain complete control over the therapy involved with treatment in a medical clinic or ER whenever possible.
Did your ER medical team advise you about the rules of practice for Coumadin? Did they recommend that you consider a anticoagulant other than Coumadin, even though its antidote is not available? Did you ask for prescription for the "combat gauze" and did they provide it?
What's your sFLC, your 24hour protein, and your A1c? Sounds like misfolded protein tko me.
Answer is when your doc says you can
Not sure @dannydamon will get this message after 18 months, @robseverson, but it would be great if he did. You're dead right.
A lot of people think Coumadin/Warfarin is a treatment for A-fib when it's not. It's a blood-clot preventive. Also, many don't understand why their INR number for tracking Coumadin effectiveness jumps around. Simply this: The primary antidote for rendering Coumadin ineffective is simple old Vitamin K -- which comes in several important foods we eat frequently and in varying amounts. A big bowl of spinach salad, for example, will drop that INR in a few hours. So someone on Coumadin therapy is encouraged to maintain a steady diet of various foods so that Coumadin remains at a steady level of strength to prevent clots from forming in the upper atrium of your heart, sliding into the left ventricle, and spreading around in your body through your circulatory system.
Your bottom line is correct, @robseverson. You can reduce or remove Coumadin from your daily medication when your doctor says you can do so without adverse effects. Ask her/him! And if you still have doubts, get a second opinion from another cardiologist or hematologist.