AFib questions

Posted by peggyd @peggyd, Mar 23, 2016

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!

@colleenyoung

Hi @billmichalski,
Welcome to Connect. Good for you with keeping up the exercise.
I moved your message to this thread so you could connect with other members with AFib. I also tag @Weedy @twptrustrek.

I have to admit, I’d be concerned if the sleeve of the suture is pointing out. Did the doctor say there was nothing to be worried about?

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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.

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@colleenyoung

Hi @billmichalski,
Welcome to Connect. Good for you with keeping up the exercise.
I moved your message to this thread so you could connect with other members with AFib. I also tag @Weedy @twptrustrek.

I have to admit, I’d be concerned if the sleeve of the suture is pointing out. Did the doctor say there was nothing to be worried about?

Jump to this post

@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.

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@colleenyoung

Hi @billmichalski,
Welcome to Connect. Good for you with keeping up the exercise.
I moved your message to this thread so you could connect with other members with AFib. I also tag @Weedy @twptrustrek.

I have to admit, I’d be concerned if the sleeve of the suture is pointing out. Did the doctor say there was nothing to be worried about?

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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

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@colleenyoung

Hi @billmichalski,
Welcome to Connect. Good for you with keeping up the exercise.
I moved your message to this thread so you could connect with other members with AFib. I also tag @Weedy @twptrustrek.

I have to admit, I’d be concerned if the sleeve of the suture is pointing out. Did the doctor say there was nothing to be worried about?

Jump to this post

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

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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?

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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

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@donaldwnelson

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?

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@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?

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What’s your sFLC, your 24hour protein, and your A1c? Sounds like misfolded protein tko me.

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@colleenyoung

Welcome @dannydamon, I moved your message here so you could meet others living with AFib. I’m also tagging @HeartPatches as she may have some thoughts about warfarin.

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Answer is when your doc says you can

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@colleenyoung

Welcome @dannydamon, I moved your message here so you could meet others living with AFib. I’m also tagging @HeartPatches as she may have some thoughts about warfarin.

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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.

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@colleenyoung

Hi @billmichalski,
Welcome to Connect. Good for you with keeping up the exercise.
I moved your message to this thread so you could connect with other members with AFib. I also tag @Weedy @twptrustrek.

I have to admit, I’d be concerned if the sleeve of the suture is pointing out. Did the doctor say there was nothing to be worried about?

Jump to this post

Why does my cadilogist insist on blood pressure Medes ,amiodarone and digoxin, which makes me really tired and sleepy. Also I take xatrito and have had two nose bleeds. Do I need these blood pressure Medes never had high bp ?

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@colleenyoung

Hi @billmichalski,
Welcome to Connect. Good for you with keeping up the exercise.
I moved your message to this thread so you could connect with other members with AFib. I also tag @Weedy @twptrustrek.

I have to admit, I’d be concerned if the sleeve of the suture is pointing out. Did the doctor say there was nothing to be worried about?

Jump to this post

Hello @woodieryan

As this appears to be your first post at Mayo Clinic Connect, I’d like to welcome you!

As you may know, at Mayo Connect we are not medical professionals and therefore cannot explain why you are being prescribed the meds. We can only speak from our own personal experiences and encourage you to find answers to questions from your own doctor.

However, from my own experience, I take BP meds and have never had a high BP but do have heart valve problems. My cardiologist said that he prescribes BP meds so that my heart doesn’t work too hard (the BP meds keep the heart more rested).

I would encourage you to talk to your cardiologist about why he is prescribing the meds. Does he know about your fatigue? Have you reported the nosebleeds? A simple call to his office to report these matters, will probably give you some answers.

I would like to invite @predictable into this conversation as well. He is also a volunteer mentor and he might be able to add some insight into your questions.

Teresa

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@colleenyoung

Hi @billmichalski,
Welcome to Connect. Good for you with keeping up the exercise.
I moved your message to this thread so you could connect with other members with AFib. I also tag @Weedy @twptrustrek.

I have to admit, I’d be concerned if the sleeve of the suture is pointing out. Did the doctor say there was nothing to be worried about?

Jump to this post

Hi @woodieryan. I’d second the suggestion from Teresa (@hopeful33250) to question your cardiologist about your meds. I noticed, for example, that you referred to the three of them as blood pressure meds. But an expert source on prescription drugs (https://www.drugs.com/amiodarone.html) identifies Amiodarone as an antiarrhythmic medication. The same is true for Digoxin. Neither is intended for treatment of blood pressure problems. In the case of Xarelto, that is an anticlotting medication, commonly prescribed to prevent clots from forming when irregular heart beats leave some blood behind in a heart chamber. Note that drugs are sometimes prescribed by doctors for off-label uses, and that’s the most important reason for having this discussion with your cardiologist. Hope your blood pressure remains stable and in a normal range; mine doesn’t if I neglect to take to medications prescribed for blood pressure. Martin

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@colleenyoung

Hi @billmichalski,
Welcome to Connect. Good for you with keeping up the exercise.
I moved your message to this thread so you could connect with other members with AFib. I also tag @Weedy @twptrustrek.

I have to admit, I’d be concerned if the sleeve of the suture is pointing out. Did the doctor say there was nothing to be worried about?

Jump to this post

Thanks for the research on the drugs, @predictable, that explains a lot.

@twptrustrek, I also appreciate the comments by you and the time needed to adjust to the meds, that was a good thought.

@woodieryan, I hope that you will be encouraged to talk with your doctor. Will you keep in touch and let us know how you are doing?

Teresa

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@colleenyoung

Hi @billmichalski,
Welcome to Connect. Good for you with keeping up the exercise.
I moved your message to this thread so you could connect with other members with AFib. I also tag @Weedy @twptrustrek.

I have to admit, I’d be concerned if the sleeve of the suture is pointing out. Did the doctor say there was nothing to be worried about?

Jump to this post

I have learned more from the feedback about my meds and I thank you .unfortunatelly my cardiologist does not return phone calls but my primary will.i am taking all meds and will exercise more on the bike, having pt to strength leg muscles too.

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