HELP with potentially wrong decision to start ELIQUIS! OUT OF TIME!

Posted by yorlik @yorlik, Sep 17, 2018

Bovine aortic valve replacement last monday (1 week go). not released for home Friday due to afib bout; given some 5mg/h drip (sounds like dillithium) and got back in rythm in an hour. First "official Atrial Fibrlillation" diagnosis. Saturday released home, this morning in Afib @ 5:30am. Went to emergency room; they checked, confirmed Afib (typically 2-3 beats close together then missing beats 2-3 then repeat 100-125bpm).

They sent me home with afib, picking to address the symptom, not the cause: gave me prescription for a month of Eliquis! Reading Eliquis papers, it says DO NOT USE with prosthetic valve replacements! Googling prosthetic says my cow valve... I DO NOT WANT TO BE ON BLOOD THINNERS! ESPECIALLY THE WRONG ONE. They gave me one pill at hospital; I have not gotten the prescription yet. My afib stopped around 3pm after 1 hour at home.

My surgeon sent me home on NEW to me meds: beta blocker LOPRESSOR 50mg pills saying they felt that would prevent afib... funny, pto reduce BP and prevent irregular heart beat. then says a side effect can be irregular heartbear!!! I am on this and CARDURA 4mg for my high BP (only issue I have) - keeping it crazy low! at emergency room 90/60 to 120/65.

For some bloating in ankles, they also started new to me for 5 days LASIX 20mg water pill: says side effect: irregular heartbeat. I am 3 days into this pill and already back to under weight I went into surgery with - no swollen left - maybe stop taking this?

I know the risk in afib i some blood sits not moving in corner of heart so can clott and then move to head for stroke. But but but!

Should I put this Eliquis in my body? I understand once started it is hard to stop! HELP please.

Interested in more discussions like this? Go to the Heart & Blood Health Support Group.

Hi @yorlik. Glad to hear you got a new valve and are dealing with getting it to settle in for the long haul. Not sure I can be of great help, because I haven't faced a valve problem. Hypertension is one of my problems, too. A-fib and its related medications are familiar to me, and I can say a few things that may help you gain confidence in your medical care.

First of all, though, I want to share my basic principle for researching medical conditions, diagnoses, treatments, and after-care: What I learn from research is never the basis for me to make changes in my treatment or medication; what I learn is only good for identifying questions that I need to have answered by medical professionals in whom I have placed my trust. Sometimes that's a second or third doctor who makes me feel s/he cares enough to take the time to help me develop my confidence.

Because of A-fib, I'm on a "blood thinner" for good and sufficient reason. My irregular heart beats threatens formation of little blood clots. And just three months ago, a clot formed and blocked blood flow to a small area of my brain -- I suffered a "small stroke." This happened even though I was taking Coumadin "blood thinner" and probably because I drank a couple glasses of wine with dinner. My fault, not the medication's.

You said you don't want to trust Eliquis. Would you consider asking about Pradaxa? Maybe Coumadin, even though that requires regular blood tests to ensure the right dosages over time. I too take a beta blocker (Carvedilol) and a "water pill" (Amiloride) that preserves potassium. I had a bad experience with Lasix, because my kidney sloughs off potassium, and the Lasix made that worse. Did your doctor explain why you have both Lopressor and Cardura treating your high blood pressure?

Do I understand that you came home from the hospital two days ago? What are chances that you could have a discussion with your doctor soon about your concerns and your feelings of uncertainty?

REPLY
@predictable

Hi @yorlik. Glad to hear you got a new valve and are dealing with getting it to settle in for the long haul. Not sure I can be of great help, because I haven't faced a valve problem. Hypertension is one of my problems, too. A-fib and its related medications are familiar to me, and I can say a few things that may help you gain confidence in your medical care.

First of all, though, I want to share my basic principle for researching medical conditions, diagnoses, treatments, and after-care: What I learn from research is never the basis for me to make changes in my treatment or medication; what I learn is only good for identifying questions that I need to have answered by medical professionals in whom I have placed my trust. Sometimes that's a second or third doctor who makes me feel s/he cares enough to take the time to help me develop my confidence.

Because of A-fib, I'm on a "blood thinner" for good and sufficient reason. My irregular heart beats threatens formation of little blood clots. And just three months ago, a clot formed and blocked blood flow to a small area of my brain -- I suffered a "small stroke." This happened even though I was taking Coumadin "blood thinner" and probably because I drank a couple glasses of wine with dinner. My fault, not the medication's.

You said you don't want to trust Eliquis. Would you consider asking about Pradaxa? Maybe Coumadin, even though that requires regular blood tests to ensure the right dosages over time. I too take a beta blocker (Carvedilol) and a "water pill" (Amiloride) that preserves potassium. I had a bad experience with Lasix, because my kidney sloughs off potassium, and the Lasix made that worse. Did your doctor explain why you have both Lopressor and Cardura treating your high blood pressure?

Do I understand that you came home from the hospital two days ago? What are chances that you could have a discussion with your doctor soon about your concerns and your feelings of uncertainty?

Jump to this post

Thank you so much Martin. Your points are spot on. I too was just trying to educate myself because everything I have read and learned so far shouted NO NO NO!!

So I research, read, ask questions to my doctors, who now tell me they are too booked to even see me for 6 weeks after surgery! WTF? Everything said i should be seen 2-3 weeks after surgery. How can they do this to their patients? I thought they took an oath to help their patients before worrying about filling their pockets with money?

I explained my quandary to "my" cardiologist secretrary who answered the phone. She said she could not believe they sent me home with afib in full force or that they would give me a prescription for blood thinner! So she promised to ask the cardiologist... took the rest of the day, but at 4:45pm she called back and said she spoke with the cardiologist and he is ok with me starting elequist. (: I wonder if he even spent 30 seconds considering MY CASE. So depressinging...
OK, maybe he is right, so i put call into my surgeon - who was emphatic all along about me NOT being on blood thinners... Of course by now their office is closed. Called their answering service, got a PA to return my call. She too sounded confused with decisions beging made and promised to call surgeon himself and relay my concern... 30 minutes later she called back and gave me his reply: heis ok with my cardiologist' decision.

I feel let down. I now feel Doctors defend each other as police with their blue shield. I feel the emergency room let me down, I feel "my" cardiologist, who I saw once, doesn't care, and my surgeon just replies to cover everyone's arse..

Martin, I am curious why you have afib. My understanding was is a short term possible result of manhandling the heart in open heart surgery and thus should go away once the heart heals from it - or it is something that remains and the fix is a pacemaker. I do not understand why a peron would be allowed to just have afib and be given blood thinner to treat the symptom instead of fix the cause!

I am so sorry to hear about your TIA; I had a 5 minute no damage one 8 months ago, it was no fun. But to be able to place the potential blame on 2 glasses of wine along with your medication is very depressing... I enjoyed my beer. It was part of me. This future with no alcohol is 100% NOT for me.

I am depressed and giving up this morning. Now even my wife is mad at me for being short with her as she leaves for the pharmacy to get my crap. I am convinced I just lost my bid for any viable future and am being forced into an old frail man. No more beer every? Why the hell bother?

REPLY
@yorlik

Thank you so much Martin. Your points are spot on. I too was just trying to educate myself because everything I have read and learned so far shouted NO NO NO!!

So I research, read, ask questions to my doctors, who now tell me they are too booked to even see me for 6 weeks after surgery! WTF? Everything said i should be seen 2-3 weeks after surgery. How can they do this to their patients? I thought they took an oath to help their patients before worrying about filling their pockets with money?

I explained my quandary to "my" cardiologist secretrary who answered the phone. She said she could not believe they sent me home with afib in full force or that they would give me a prescription for blood thinner! So she promised to ask the cardiologist... took the rest of the day, but at 4:45pm she called back and said she spoke with the cardiologist and he is ok with me starting elequist. (: I wonder if he even spent 30 seconds considering MY CASE. So depressinging...
OK, maybe he is right, so i put call into my surgeon - who was emphatic all along about me NOT being on blood thinners... Of course by now their office is closed. Called their answering service, got a PA to return my call. She too sounded confused with decisions beging made and promised to call surgeon himself and relay my concern... 30 minutes later she called back and gave me his reply: heis ok with my cardiologist' decision.

I feel let down. I now feel Doctors defend each other as police with their blue shield. I feel the emergency room let me down, I feel "my" cardiologist, who I saw once, doesn't care, and my surgeon just replies to cover everyone's arse..

Martin, I am curious why you have afib. My understanding was is a short term possible result of manhandling the heart in open heart surgery and thus should go away once the heart heals from it - or it is something that remains and the fix is a pacemaker. I do not understand why a peron would be allowed to just have afib and be given blood thinner to treat the symptom instead of fix the cause!

I am so sorry to hear about your TIA; I had a 5 minute no damage one 8 months ago, it was no fun. But to be able to place the potential blame on 2 glasses of wine along with your medication is very depressing... I enjoyed my beer. It was part of me. This future with no alcohol is 100% NOT for me.

I am depressed and giving up this morning. Now even my wife is mad at me for being short with her as she leaves for the pharmacy to get my crap. I am convinced I just lost my bid for any viable future and am being forced into an old frail man. No more beer every? Why the hell bother?

Jump to this post

@yorlik. I am 22yrs from my by pass surgery the Dr put me on 81mg aspirin I take one daily along with statin and b.p.pill Your attitude reflects on your condition so try to accept your afib and do as your cardiologist @surgeon says. when I had my chest cracked open then when the surgeon closed the nerves didn't align up this wasn't his fault but I had to have the anesthesiologist inject my chest it fixed the issue and it hurt but keeping a positive attitude and going on with your life I was all right 22yrs later so you will be o.k. ,relax the Dr knows what he is doing.

REPLY
@lioness

@yorlik. I am 22yrs from my by pass surgery the Dr put me on 81mg aspirin I take one daily along with statin and b.p.pill Your attitude reflects on your condition so try to accept your afib and do as your cardiologist @surgeon says. when I had my chest cracked open then when the surgeon closed the nerves didn't align up this wasn't his fault but I had to have the anesthesiologist inject my chest it fixed the issue and it hurt but keeping a positive attitude and going on with your life I was all right 22yrs later so you will be o.k. ,relax the Dr knows what he is doing.

Jump to this post

Thanks. I question all when they start blood thinner that clearly states do not take along with nsaids, aspirins, and other blood thinners and don't bother stopping my daily 61mg aspirin, and use an untested product in this use.

REPLY
@yorlik

Thanks. I question all when they start blood thinner that clearly states do not take along with nsaids, aspirins, and other blood thinners and don't bother stopping my daily 61mg aspirin, and use an untested product in this use.

Jump to this post

Yorlik. If possible I always ask for the older meds that are tried and true

REPLY
@yorlik

Thank you so much Martin. Your points are spot on. I too was just trying to educate myself because everything I have read and learned so far shouted NO NO NO!!

So I research, read, ask questions to my doctors, who now tell me they are too booked to even see me for 6 weeks after surgery! WTF? Everything said i should be seen 2-3 weeks after surgery. How can they do this to their patients? I thought they took an oath to help their patients before worrying about filling their pockets with money?

I explained my quandary to "my" cardiologist secretrary who answered the phone. She said she could not believe they sent me home with afib in full force or that they would give me a prescription for blood thinner! So she promised to ask the cardiologist... took the rest of the day, but at 4:45pm she called back and said she spoke with the cardiologist and he is ok with me starting elequist. (: I wonder if he even spent 30 seconds considering MY CASE. So depressinging...
OK, maybe he is right, so i put call into my surgeon - who was emphatic all along about me NOT being on blood thinners... Of course by now their office is closed. Called their answering service, got a PA to return my call. She too sounded confused with decisions beging made and promised to call surgeon himself and relay my concern... 30 minutes later she called back and gave me his reply: heis ok with my cardiologist' decision.

I feel let down. I now feel Doctors defend each other as police with their blue shield. I feel the emergency room let me down, I feel "my" cardiologist, who I saw once, doesn't care, and my surgeon just replies to cover everyone's arse..

Martin, I am curious why you have afib. My understanding was is a short term possible result of manhandling the heart in open heart surgery and thus should go away once the heart heals from it - or it is something that remains and the fix is a pacemaker. I do not understand why a peron would be allowed to just have afib and be given blood thinner to treat the symptom instead of fix the cause!

I am so sorry to hear about your TIA; I had a 5 minute no damage one 8 months ago, it was no fun. But to be able to place the potential blame on 2 glasses of wine along with your medication is very depressing... I enjoyed my beer. It was part of me. This future with no alcohol is 100% NOT for me.

I am depressed and giving up this morning. Now even my wife is mad at me for being short with her as she leaves for the pharmacy to get my crap. I am convinced I just lost my bid for any viable future and am being forced into an old frail man. No more beer every? Why the hell bother?

Jump to this post

Hi @yorlik. It sounds like you are increasingly concerned, although your doctors seem to have rallied around more consensus than before. Important facts about A-fib may be at the center of your uncertainty. If so, here's a link to a Mayo Clinic web site on A-fib: https://www.mayoclinic.org/diseases-conditions/atrial-fibrillation/symptoms-causes/syc-20350624.

A-fib is a much more general and widespread malady than just the one case of open heart surgery. It involves mainly irregular electrical impulses in the atrium, which often cause irregularities in the contraction of the ventricles (which, as you know, are the main pumps sending blood to your lungs and entire body). Nor is it always a short-term condition -- sometimes it becomes permanent. I have several personal friends who have had A-fib symptoms for years, as I have. As I understand it, A-fib as a single problem is rarely treated by a Pacemaker. Instead, treating A-fib starts with medication to regularize the heart beat, sometimes followed by "cardioversion" which resets the heart rhythm with medication or other procedures. Then "ablation" is the next level of treatment to zero out some wayward electrical currents that trigger contractions at the wrong time. Ablation can take several forms, ranging up to physical scarring of the electrical circuits, and those treatments have been successful for friends who have had them.

I also want to emphasize that "blood thinners" like Eliquis and Coumadin are NOT used to treat A-fib. They are prescribed to control the coagulation of your blood so it doesn't form blood clots when it pools for a time in the heart, awaiting good and strong signals to move on through the heart and into your body. In my case, I suffered a small stroke from a blood clot that blocked an artery in my brain. It was NOT a transient ischemic attack (TIA) but a plain old ischemic stroke in the "periventricular cells" deep in my brain. We speculate that the two glasses of wine interfered with my "blood thinners," first causing them be neutralized, then falling behind my rising coagulation level, which caused the clot to form and stay whole until it blocked circulation in a small part of my brain. Before that incident, I took a glass of wine a couple of times a week with dinner. Now I don't want to take the chance, and although I've lost some of my adventurous social spirit, that's a small price to pay for a new feeling to confidence that my medical team knows what they are doing.

Bottom line, I don't for a moment feel a loss of my future or a decline into old-man frailty. I just got back from the bowling alley and our weekly league meet, featuring 128 senior citizens aged 60 to 90 and averaging 76. I'm bowling 175 routinely now and rolled a 237 game and 565 series of 3 games last week. Not as good today, but pleased with my final game of 190. Would you like to become a substitute for our team? One or another of us has to skip out once a month, and we could use your help!

REPLY

Thanks you guys. My next studies will be to ask others with afib how long, how often, what if anything is being done for it.

REPLY
Please sign in or register to post a reply.