Re: blood thinners

May 15, 2006

, the decision of taking aspirine vs Coumadin is based on age, cardiac

and other health, cardiac rhythm, and other factors. Each approach has potential

risks and benifits. Aspirine is often rx for those who: are younger, have lone

AF with otherwise heathy hearts, have not had heart attacks or emboli, maintain

a normal sinus rhythm most of the time. If someone has an AF breakthrough

which last 48 hrs, she is normally put on Coumadin, at least until she has been

free of AF for a specified period of time. In your case aspirine may be

appropriate, but this needs to be an individual decision made with your

cardiologist. Recent studies suggest that full strength aspirine (325 mg) is

more effective than low dose. Enteric coated asa is not as effective as non

coated, but here again there may be considerations unique to you, and your

cardiologist and you should determine what is right for you. , taking an

aspirine once a week is not going to give you any real

protection from stroke. Aspirine, when taken, does need to be taken every day.

, I suggest you contact your cardiologist today to see how much, and

what, you should take to reduced chance for stoke.

I hope your job goes well. It sure takes courage starting a new job. Best of

luck with all. Thanks for posting, and I would like to hear how it turns out

with you.

Michele michele_b@...> wrote:

Hi all,

I have been away for a very long time, busy with work and life.

My a-fib makes an appearance when I am stressed out or scared of

something....December I got it after my flu shot - what a baby

right??

Anyways, I accepted a new job that I am starting next week and the

transition must be weighing on me... or the fear of failure... I

don't know.

I am do not normally do anything special for the afib other than a

full streght aspirin at least once per week. This weekend when it

hit I called my doc and got someone else who was on call. He scared

me about the idea of having a stroke so I am trying to decide what

to do.

I am 40 years old so my cardiologist feels I am ok to use just

aspirin. I am questioning that idea now, I really do not want a

stroke...

How bad is it to go on Warafin? If my events continue to be just

twice a year is being on warfarin enough... I am trying to do my

homework before seeing the doc. Your advice is much appreciated.

-Michele in CA

50mg Toprol XL 2x's a day

plus a variety of other meds not related to afib :-)

Web Page - http://www.afibsupport.com

List owner: AFIBsupport-owner

For help on how to use the group, including how to drive it via email,

send a blank email to AFIBsupport-help

Nothing in this message should be considered as medical advice, or should be

acted upon without consultation with one's physician.

May 15, 2006

In a message dated 5/15/06 12:09:34 AM Pacific Daylight Time,

michele_b@... writes:

> I am 40 years old so my cardiologist feels I am ok to use just

> aspirin. I am questioning that idea now, I really do not want a

> stroke...

Michele - listen to YOUR doctor, not someone new. When I was first diagnosed

with a-fib, I had Kaiser and a wonderful EP. When I was in the ER I'd have

three different doctors tell me three different things regarding coumadin,

medications, etc. I asked the EP how I was supposed to sort out what I was

being

told and he said, " you don't, you listen to ME because that's why I'm the EP

and why I'm your doctor. " He explained that lots of doctors have different

views, especially on coumadin. Even my current doctor (internist) and an ER doc

who monitored my a-fib in the ER when I was there for something else, said

that coumadin used to be the " gold standard " for a-fib as a matter of course and

many doctors still feel that way. BUT, they both said that the risk of bleeds

and even strokes FROM the coumadin often did not offset the benefit of stroke

risk in a-fib. So listen to YOUR EP if you trust that person. You will get

a million different pieces of advice from doctors, ER doctors, people on this

list who share their personal experience, etc. You have to figure out who to

listen to for YOU ... do research ... take in all the input ... ask your EP

questions ... then decide for yourself. I often take a lot of what I learn on

this list and take it to my PCP to sort it out for ME ... which is what we do.

Good luck to you. By the way, I'm on two 81 mg aspirin a day, NO coumadin,

and I'm in a-fib 24/7 since last August. I worry about stroke, but I would

even if I was on coumadin based on the input from MY doctor. So I listened to

her that it's not " time " for me to be on it yet.

Toni

CA

May 15, 2006

Hi Michele

It is a bit of a dilemma, I did not know about afib and continues as

normal very little symptoms until I had a TIA (mini stroke, a warning

sign) so the decision was out of my hands and straight on to warfarin.

It is really not that bad and is a life saver. The only thing is it can

be a nuisance in the fact that you have to have your blood checked

regular (protime test) to keep your INR in range. Too high, you could

hemorrhage, to low and you could have a clot.

You are doing the right thing by being on aspirin as that could protect

you from having a major stroke. My mother was on aspirin for several

years until she has a minor stroke and the doctors said that the aspirin

has given her some protection, she is now on warfarin also.

Firstly try not to worry and speak to your doctor about your concerns,

everyone with afib is different and if there is no need for you to be on

warfarin then to be honest you are better off without it. Try to keep

calm and not to worry, good luck

ine

blood thinners

Hi all,

I have been away for a very long time, busy with work and life.

My a-fib makes an appearance when I am stressed out or scared of

something....December I got it after my flu shot - what a baby

right??

Anyways, I accepted a new job that I am starting next week and the

transition must be weighing on me... or the fear of failure... I

don't know.

I am do not normally do anything special for the afib other than a

full streght aspirin at least once per week. This weekend when it

hit I called my doc and got someone else who was on call. He scared

me about the idea of having a stroke so I am trying to decide what

to do.

I am 40 years old so my cardiologist feels I am ok to use just

aspirin. I am questioning that idea now, I really do not want a

stroke...

How bad is it to go on Warafin? If my events continue to be just

twice a year is being on warfarin enough... I am trying to do my

homework before seeing the doc. Your advice is much appreciated.

-Michele in CA

50mg Toprol XL 2x's a day

plus a variety of other meds not related to afib :-)

Web Page - http://www.afibsupport.com

List owner: AFIBsupport-owner

For help on how to use the group, including how to drive it via email,

send a blank email to AFIBsupport-help

Nothing in this message should be considered as medical advice, or

should be acted upon without consultation with one's physician.

May 15, 2006

Wondering about flu shots and a-fib...anyone notice any problems within a week

of getting one. I never had any a-fib events(at least that I know of) until a

few days after I got a flu shot last year. The event lasted 7 hours and required

me to go to the ER since I did not know what was going on and thought I was

dying. I was admitted and with the help of IV meds I was back in NSR. I have

since only had little episodes....a minute or two. So I was wondering if there

was a link between the flu shot and a-fib.

Michele michele_b@...> wrote: December I got it after my flu shot

May 15, 2006

>

> I am do not normally do anything special for the afib other than a

> full streght aspirin at least once per week. This weekend when it

> hit I called my doc and got someone else who was on call. He

scared

> me about the idea of having a stroke so I am trying to decide what

> to do.

>

> I am 40 years old so my cardiologist feels I am ok to use just

> aspirin. I am questioning that idea now, I really do not want a

> stroke...

>

> How bad is it to go on Warafin? If my events continue to be just

> twice a year is being on warfarin enough... I am trying to do my

> homework before seeing the doc. Your advice is much appreciated.

>

> -Michele in CA

> 50mg Toprol XL 2x's a day

> plus a variety of other meds not related to afib :-)

Michele,

I also experienced many well-meaning physicians (including

family members) telling me that I should be on Coumadin, but my

cardiologist insisted that if one is under 60 or 65 (I can't

remember) without any other heart problems, that aspirin is the blood

thinner of choice because there is more risk of a bleed from the

Coumadin than of a stroke. I think that doctors who were trained

many years ago or who are not up on the latest cardiology research do

strongly advocate the use of Coumadin, but they aren't as well-versed

on the subject as your cardiologist.

By the way, I did go on Coumadin prior to my ablation and am

still on it following the ablation for 6 months. It's not so bad,

but I'm glad my time on it is limited. Why don't you discuss what

the other physician told you with your cardiologist and if you are

still confused, get a second opinion from another cardiologist or EP?

Sharon

May 15, 2006

I have not found warfarin to be a problem - I have been on it for one year.

No bruising and consistently in INR range, have had my dosage tinkered with a

tad, but all in all, it's been okay. No side effects that I have noticed.

Lil

n a message dated 5/15/2006 12:09:24 A.M. Pacific Standard Time,

michele_b@... writes:

How bad is it to go on Warafin? If my events continue to be just

twice a year is being on warfarin enough... I am trying to do my

homework before seeing the doc. Your advice is much appreciated.

May 15, 2006

I've been getting flu shots for many, many years and I've never had an

afib reaction to it. I'm not aware of a link between the two. Many

doctors recommend that their older patients get flu shots particularly

because the flu and pneumonia can send older patients into afib.

-

December I got it after my flu shot

>

May 15, 2006

I am not a doctor but as I understand it, INR (International Normalized

Ratio) and your prothrombin time do not identify risk so much as they indicate

that you are at the proper balance between too " coagulated " and too

" anticoagulated " ...one, your blood may form clots, and the other, you may have

an

internal bleed. If you are IN RANGE...then you are doing A-OK, and you are much

less likely to have a stroke than someone else who has risk factors (including

persistent or chronic afib) who is not taking anticoagulants. Here is

something from an INR website, see if this helps:

<<

Since PT and INR (PT/INR) evaluate the ability of blood to clot properly,

they can be used to assess both bleeding and clotting tendencies. One common use

is to monitor the effectiveness of blood thinning drugs such as warfarin

(Coumadin). These anti-coagulant drugs help inhibit the formation of blood

clots. They are prescribed on a long-term basis to patients who have experienced

recurrent inappropriate blood clotting. This includes those who have had

_heart attacks_

(http://www.labtestsonline.org/understanding/conditions/heart_attack.html) ,

_strokes_

(http://www.labtestsonline.org/understanding/conditions/stroke.html) , and deep

vein thrombosis (DVT). Anti-coagulant therapy may also

be given as a preventative measure in patients who have artificial heart

valves and on a short-term basis to patients who have had surgeries, such as

knee replacements. The anti-coagulant drugs must be carefully monitored to

maintain a balance between preventing clots and causing excessive bleeding. >>

In a message dated 5/15/2006 11:55:48 A.M. Pacific Standard Time,

deutschmann@... writes:

Is an INR the gold standard for identifying risk? Or is it only valid when

taking Coumadin [b/c of the research of that drug when testing pools of

people at 2.5, etc?]

If, somehow you achieved INR 2.0 w/o Coumadin, are you at risk reguardles?

May 15, 2006

I totally agree. My EP doc said aspirin was fine for me as I had a lot of

unexplained bruising when I was on coumadin. My cardiologist does not agree and

every time I see her she says over and over again " I worry about you, you're

going to have a stroke. " Even though I think I am a very low risk for a stroke,

her words have gotten into my head and I hear them many time a day. It's bad

enough to have AF without your doctor trying to scare you to death. I'm going

with my EP doc and will probably try to find another cardiologist.

a

Re: blood thinners

In a message dated 5/15/06 12:09:34 AM Pacific Daylight Time,

michele_b@... writes:

> I am 40 years old so my cardiologist feels I am ok to use just

> aspirin. I am questioning that idea now, I really do not want a

> stroke...

Michele - listen to YOUR doctor, not someone new. When I was first diagnosed

with a-fib, I had Kaiser and a wonderful EP. When I was in the ER I'd have

three different doctors tell me three different things regarding coumadin,

medications, etc. I asked the EP how I was supposed to sort out what I was

being

told and he said, " you don't, you listen to ME because that's why I'm the EP

and why I'm your doctor. " He explained that lots of doctors have different

views, especially on coumadin. Even my current doctor (internist) and an ER

doc

who monitored my a-fib in the ER when I was there for something else, said

that coumadin used to be the " gold standard " for a-fib as a matter of course

and