Clots, and brief stop of anticoagulant

[Jerry_NJ]

I had a surgical procedure last Thursday that required I stop all anticoagulant (warfarin) and aspirin (low dose) 5 days before the procedure.  I recall my cardiologist being uncomfortable with the length of time I would be without clot prevention medications.  

I have permanent atrial fibrillation, so my heart is in the clot production mode 24/7.

I have been back on warfarin and aspirin for two days and believe my INR is back in the 2-3 range.  In fact I took 50% extra warfarin for the two just past days.

The thoughts crossing my mind:  I didn't have a stroke, but could there be a clot that just hasn't yet worked its way to a critical point in my body?  Now that I am back to the INR 2-3 range would any clots formed be dissolved.  

My guess is if there are any clots in my my heart (elsewhere) being in the target therapeutic anti-clot range will over time dissolve them.  Said another way, each day that passes without a clot problem results in a lower risk that there will be a problem related to my being off anticoagulant for 5 days.  I understand I am at greater risk than the general population due to AFib, but with "blood thinning" my risk is only slightly higher.

Another question comes to mind:  Can a clot form in the heart and either stick there or somewhere else in the circulatory system that does not cause a stroke or other damage?

[DeltaDawn23]

Jerry -- thanks for the input.  I take 5 mg. tablets -- 2 four days a week and 3 three days a week.  I have been pretty stable.  I may take an extra 1/2 tablet tonight.  I was pretty amazed that it went down so low in a week.  Medicare pays 80% and I thought my medi-gap policy would pick up the rest, but I'm being billed for the 20% , which amounts to $30.00 and I won't be able to pay that weekly, altho I like keeping it in tight control.  And Phillips, the company that makes the meter, says checking weekly reduces stroke risk by 35%.  But then, they're making some money in the deal=)   I was 3.4 once and that was, looking back, because I took some Pepto Bismal, not knowing that it thins the blood. Maybe I am too uptight about it.  I do get REALLY nervous thinking about a bleed.

[Jerry_NJ]

As you know, I can't give advice, but I think I can say what I do.  When I come in below the 2.0 level, even with a 1.8, my cardiologist tells me to take an extra 1/2 warfarin does for one or even two nights.  My regular is 5 mg at bedtime. Then, given my history of being stable they do not ask me for a followup check until my regular every 4 weeks.  I still go to the hospital for blood tests.

Now for me I can also say when I am over, say 3.2,  I don't have any bleeding problems that I can detect, thus my fear of going over 3.0 is minimal.  I believe people with a mechanical valve are normally in the 3.0+ range.  

[DeltaDawn23]

All good questions.  I don't have answers but will be interested to hear comments because I am also on Warfarin.  What about antibiotics?  I understand they interfere with the Warfarin, but I don't know how -- thinner or thicker blood?

My INR was 1.4 yesterday, first time since I've been on the meds it was so low.  I can't call in to drs office until Monday, but wonder if I should take an extra 1/2 pill or whole pill?  I believe it may be the margarine I use because it has one of the oils in it that is high in Vitamin K.  I take my own INR at home with a Phillips meter.  Any advice?