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Heart Disease (Expert Forum)
Coumadin
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Coumadin
by snowman1181, Feb 01, 2003 12:00AM
Age 55, wt. 460 lbs.(now), no hist. heart problems. Weight fluctuated over adult life. Lost 110 pounds in last year, Cholestral always low (160's), low blood sugar (68) generally been in good health. Three weeks ago experienced short breath. Heart rate at 150, admitted to hosp. Diagnosed with Atrial Flutter most likely caused by severe sleep apnea. They did a TEE and cardiovert that got my heart back to normal rates and will do Ablation to cure the heart flutter. This will be done when I lose another 20-25 pounds to 'fit on their 'table'(limit 445 lbs.) Currently on Bipap and oxy nightly. Taking digoxin (0.25mg daily), Metaprolol (100 mg 2x daily), Lasix (40mg daily), Coumadin (alternate 10 and 12.5 mg daily).
My first question is about the coumadin. I'm paranoid because I have history of nose bleeds. With the Bipap I need to keep my nasal passageways clear but I'm afraid to blow my nose or sniff hard for fear of creating a nose bleed that won't stop. I have had some nosebleeds in the past that have on occasion lasted for 5 to 10 minutes bleeding moderately until finally stopping. I have had two nosebleeds in three days, both minor that stopped after applying pressure for about 5 minutes. I am stuffed up, not completely but enough to reduce the airflow. Can I cause a nose bleed that I won't be able to stop? If so, what do I do? Second Question, Doc said that there could possibly be another cause of the flutter and they won't know for sure until they do the Ablation. Should I get second opinion before or after the Ablation is done.
My first question is about the coumadin. I'm paranoid because I have history of nose bleeds. With the Bipap I need to keep my nasal passageways clear but I'm afraid to blow my nose or sniff hard for fear of creating a nose bleed that won't stop. I have had some nosebleeds in the past that have on occasion lasted for 5 to 10 minutes bleeding moderately until finally stopping. I have had two nosebleeds in three days, both minor that stopped after applying pressure for about 5 minutes. I am stuffed up, not completely but enough to reduce the airflow. Can I cause a nose bleed that I won't be able to stop? If so, what do I do? Second Question, Doc said that there could possibly be another cause of the flutter and they won't know for sure until they do the Ablation. Should I get second opinion before or after the Ablation is done.
Doctor's Answer
by CCF-M.D.-RCJ, Feb 02, 2003 12:00AM
Snowman1181,
Thanks for the questions.
(1) It is a rare nosebleed that "won't stop". If you develop a nosebleed on the coumadin, apply pressure as you normally would. If the nosebleed is profuse or lasts longer than 30 minutes to an hour, go to the nearest ER. A severe nosebleed can sometimes be a sign of too high of a dose of coumadin; the lab at an ER can check this out for you.
(2) If you are contemplating having an ablation, seek a second opinion before any procedure. It will only muddy the waters to seek an opinion after the ablation.
If you are really concerned about the afib/flutter, dropping another 150 to 200 pounds may be the best way to get rid of it -- especially if sleep apnea is the cause.
Hope that helps, and good luck.
Thanks for the questions.
(1) It is a rare nosebleed that "won't stop". If you develop a nosebleed on the coumadin, apply pressure as you normally would. If the nosebleed is profuse or lasts longer than 30 minutes to an hour, go to the nearest ER. A severe nosebleed can sometimes be a sign of too high of a dose of coumadin; the lab at an ER can check this out for you.
(2) If you are contemplating having an ablation, seek a second opinion before any procedure. It will only muddy the waters to seek an opinion after the ablation.
If you are really concerned about the afib/flutter, dropping another 150 to 200 pounds may be the best way to get rid of it -- especially if sleep apnea is the cause.
Hope that helps, and good luck.
Related discussions
At some point you will be able to stop the blood thinners and other drugs that are counterproductive to good health. No matter what the medical profession says, your blood is unhealthy on Coumadin. Unhealthy blood leads to an unhealthy cardiovascular system -- it's all one system. You can't enjoy general good health with an unhealthy cardiovascular system.
It's really a question of how much we want to live and how well we want to live. It takes a very strong and consistent desire to be healthy to oppose our addictions. The body has a tremendous restorative power, given a chance.
Best Wishes