Re:message to the board: Coumadin awareness: Terry & Guy.

[Guest guest]

> In a message dated 11/27/2002 8:17:22 AM Central Standard Time,

> tmchoskey@a... writes:snip.....see below

Hello Terry and Guy: I hope you both are on blood thinners.....

(sorry, I can't go back and check all your posts).

You probably already know that while afib is occuring, the

critical time for the formation of blood clots is when the heart

slows down, as in right after conversion to NSR, and pooling of

blood may or can occur in you heart...that's why the recommended

protocol for all afib patients includes either Coumadin, Aspirin and

sometimes both (for those of us that have problems attaining an INR

of 2-3). Once an individual attains the therapeutic level of the

INR of between two and three, usually Aspirin is omitted and

Coumadin is the exclusive drug. Your INR should initially be

monitored weekly and then about every 4-5 weeks. Eating lots of high

Vitamin K vegetables counteracts the effect of Coumadin.

Please remember that Heparin IV is used also but in the US it is

used in a hospital setting only. Oral heparin is available in other

countries. Isabelle

> >

snip.............. I am also

> > interested in anyone's real experience with amiodarone. Terry

>

> I have been on amiodarone since April this year.

snip.............. It has

> been fairly effective for me but have had 2 episodes recently. One

2 days ago

> that converted on its own and 1 last night that is still going on.

Hopefully

> I will convert by myself one more time.

> Guy

>

>

>

[Guest guest]

In a message dated 11/28/2002 10:35:14 PM Eastern Standard Time,

forestbedell@... writes:

> Hello Terry and Guy: I hope you both are on blood thinners.....

> (sorry, I can't go back and check all your posts).

>

> You probably already know that while afib is occuring, the

> critical time for the formation of blood clots is when the heart

> slows down, as in right after conversion to NSR, and pooling of

> blood may or can occur in you heart...that's why the recommended

> protocol for all afib patients includes either Coumadin, Aspirin and

> sometimes both (for those of us that have problems attaining an INR

> of 2-3). Once an individual attains the therapeutic level of the

> INR of between two and three, usually Aspirin is omitted and

> Coumadin is the exclusive drug. Your INR should initially be

> monitored weekly and then about every 4-5 weeks. Eating lots of high

> Vitamin K vegetables counteracts the effect of Coumadin.

>

> Please remember that Heparin IV is used also but in the US it is

> used in a hospital setting only. Oral heparin is available in other

> countries. Isabelle

>

Isabelle, thanks for caution - my cardiologist recommends I stay on 1/2 adult

aspirn per day (I've taken this for 20 years). What is NSR and INR? Terry.

[Guest guest]

> You probably already know that while afib is occuring, the

> critical time for the formation of blood clots is when the heart

> slows down, as in right after conversion to NSR, and pooling of

> blood may or can occur in you heart...

I don't think that's the case. My understanding is that clots can

form after the blood has been somewhat stagnant in the atria due to

the inefficiency during afib, so that could be any time after the

first day or so (I forget the exact time interval). I think that

danger associated with conversion to nsr is that that's when the

heart starts beating efficiently again, and can flush the clots out

of the atria. Od course, any clots could break lose even while in

afib.

[Guest guest]

European Heart Journal (1998) 19,1294-1320

>

> " Recommendation [for prevention of embolic complications]

> Controlled trials have demonstrated that anticoagulation with

warfarin

> significantly reduces the incidence of ischaemic strokes. However,

the risk

> of haemorrhagic events is increased.

> --

> D

Hi ,

What is the difference in blood thinned with Coumadin versus

Aspirin. Wouldn't you bleed in either case? I know some tests

actually proved that permanent afibbers (without underlying heart

conditions) and readings slightly below 2.0 were just as well

protected as those with higher #'s, but had a lesser chance of

hemorrhaging (unfortunatly my doc did not want to hear of it).

/

[Guest guest]

European Heart Journal (1998) 19,1294-1320

>

> " Recommendation [for prevention of embolic complications]

> Controlled trials have demonstrated that anticoagulation with

warfarin

> significantly reduces the incidence of ischaemic strokes. However,

the risk

> of haemorrhagic events is increased.

> --

> D

Hi ,

What is the difference in blood thinned with Coumadin versus

Aspirin. Wouldn't you bleed in either case? I know some tests

actually proved that permanent afibbers (without underlying heart

conditions) and readings slightly below 2.0 were just as well

protected as those with higher #'s, but had a lesser chance of

hemorrhaging (unfortunatly my doc did not want to hear of it).

/

[Guest guest]

> " For patients with nonvalvular AF, an INR of 1.6 to 3.0 is

efficacious and

> relatively safe. For primary prevention in most AF patients under

age 75

> years and for secondary prevention, an INR of 2.5 (target range 2.0

to 3.0)

> seems reasonable. A target INR of 2.0 (target range 1.6 to 2.5) is

> recommended for primary prevention in patients more than 75 years

old. > D

Hi ,

Thanks for another excellent link. I read most of it .......

Currently my doc likes to see my #'s at abt. 2.5, but does not object

to 2.0 or even 1.95 (with a raised eyebrow).

The range listed here 1.6 to 3.0 applies to patients older than 75,

that's when one of the doctors I quizzed would switch to Aspirin.

As you said, weighing the odds.

/

[Guest guest]

Sandy wrote:

>> Does anyone know whether eating high Vit. K content

>> vegetables also affects the blood thinning effects

>> of aspirin?

>>

>> Sandy

>> 55

>> NC

>> Eating lots of high

>> Vitamin K vegetables counteracts the effect of

>> Coumadin.

>>

>>

coolsnake replired

>No asprin uses slowing of platelet aggrration

Hi Sandy - good question!

I thought about having a stab at answering this but I really didn't know

what the answer was! - I'd be only guessing so I thought I'd wait to see if

somebody else knew.

Whilst it may well be true that Vit K does not effect the antiplatelet

activity of aspirin I'm guessing you raised the question because you take

aspirin and eat lot's of green veg?

Since our concern is a clot forming perhaps the question should be does an

increase of Vit K increase the chances of a clot forming INDEPENDENT of

whether you are taking aspirin or not? (i.e. for somebody not taking

warfarin does an increase in Vit K increase the chance of a clot?)

I suspect the answer is yes but this really is only a guess on my part -

don't believe a word of it (I also suspect that the amount of Vit K found

in your average healthy diet is not a problem)

--

D

[Guest guest]

<<Good question. Does that mean you are restricting your intake of

Hi K veggies?>>

Hi , no I've not limited my hi K veggies, in fact it would be fairer to

say I've probably increased them now that I'm attempting to eat healthier.

I'm 33 with Lone AF and no other health problems so my stroke risk is pretty

low at the moment. If I'm not cured in 20 years I might give it some more

thought

--

D

[Guest guest]

Hi ,

I like your answer too ......

My current read " Reversing Heart disease " highly recommends a mostly

vegetarian diet. Trying to learn more and to improve my chances, I

am also looking for ways to eat healthier and to include more veggies

in my diet without upsetting the INR #s. When I am ready for another

experiment, I will try veggies with seasoning only, no fats - and see

what happens.

/

> <<Good question. Does that mean you are restricting your intake of

> Hi K veggies?>>

>

> Hi , no I've not limited my hi K veggies, in fact it would be

fairer to

> say I've probably increased them now that I'm attempting to eat

healthier.

>

> I'm 33 with Lone AF and no other health problems so my stroke risk

is pretty

> low at the moment. If I'm not cured in 20 years I might give it

some more

> thought

>

> --

> D