Is Coumadin essential?

[psychotter]

I'm new here, and hope this is an appropriate question...  While at a doctor's office recently, I had an EKG that disclosed atrial flutter. I did not feel the flutter. The doctor had me transported to the emergency room, but the flutter had stopped before I left the office, and did not resume during six and a half hours and a stress/treadmill test at the hospital. I was put on Coumadin that day. I have since seen a cardiologist who said that because of my age (71 year old female) I should stay on the Coumadin rather than rely on aspirin to prevent a stroke. I am quite active physically, riding my bike 20 miles or more four or five times a week, and usually hike several miles one day a week. I am not aware that I had ever had atrial flutter before, and am concerned that with my active lifestyle I may have a fall or injury that would cause serious bleeding because of the Coumadin. I take Maxide and Atenolol to control high blood pressure. Is Coumadin essential?

[bundleblocker]

Hi:  I came across your post from last year and wanted to comment as I'm in your age group (one year younger) and also very active (jog for at least one hour 6 days a week)

I have lone Afibs, which started a couple of years ago. I also have high BP, but am otherwise very healthy. After an episode of Afibs which lasted 36 hours the cardiologist said it is time to put me on Coumadin. Previously I was put on Metroprolol to control the heart rate, but it is now time to add the Coumadin.

My concern is that I bruise really easily. I was told I have very fragile capillaries and every time I bump myself (even lightly) I bruise under the skin. I also am clumsy (even though I run) and often cut myself on things. I have 4 dogs which I'm always exercising, playing with, etc.  This causes minor bumps and scrapes almost daily.

I also love to eat veggies, especially salads, and am concerned I can't do that anymore.

But I don't want to give up my healthy lifestyle.

I am going to mentioned the concerns to my doc and hope he will decide to put me on aspirin instead.

I haven't seen a post from you since this one; hope you are doing ok.

[psychotter]

Frenchie, again I thank you for your input. One of my questions for the cardiologist is if my apparently short-lived a-fib would cause clots, and your response indicates that it can. I've been hoping for a different answer! I appreciate your congratulations, but this whole thing has made me reevaluate my physical condition. I suddenly feel less "healthy" than I did before this diagnosis.

Julia, thank you for joining this conversation and giving me your advice. So far my INR reading hasn't gotten to the recommended 2-3 range, but I have another blood test tomorrow, so we'll see. I've been surprised that my Coumadin Clinic people have been much more lenient about my diet than I thought they would be from what I had read. Basically they are just increasing the Coumadin to counteract all the green veggies etc. that I'm continuing to eat. I've looked up the movie you mentioned, and found that it will be available via Netflix in late April, and added it to my queue. Thank you for telling me about it!

MsHolly, thanks to you, also! Your having a-fib at 26 makes me realize how lucky I really am to have reached 71 before having this kind of problem show up. It must be very difficult to have to face this sort of thing at such a young age. I'm grateful to you for adding your experience to these other voices telling me that the Coumadin is so important.

Best wishes to all of you!

[MsHolly]

I am only 26 years old, have A-Fib and on Coumadin. I used to bounce in and out of A-Fib randomly as well... I am now in chronic A-Fib. So it can change. Coumadin is importnant because, when you are in A-Fib, your Atrium does not finish emptying with each beat and that leaves blood to pool.. If the blood clots it could cause a stroke or a pulmonary embolism.. Both of which can be fatal.. So even though it's a pain to have the levels check.. and kind of a scary medicine to be on.. It's worth it.

[Brnvc]

...unfortunately. I hate it. But if you doubt that you need it, go see the wonderful movie, "The Diving Bell and the Butterfly." Nothing is worth risking that. However, I would stay at the low end of your range. My INR range is 2-3 and the clinicians love it when I'm at 2.9. Not me. I keep it as close to the bottom of the range as possible. I don't bruise myself or have any problems that way. I think you'll find a low dose will keep you safe and you'll be able to climb those mountains safely. I envy your good health and stamina. Stay well!
Julia

[jkfrench]

Hi again
I would say my mom isn't quite as active and at an injury risk as you are.  I still believe that you need to be on the blood thinner.  Your heart could be going into a-fib off and on all day. Even short lived a-fib can cause problems in that you could throw a clot.  Congratulations on being in better shape than probably most of us.  Stay well and quit banging your head!
Frenchie

[psychotter]

Thank you both for your input! I really appreciate it.

I think I'm still in a bit of shock over this diagnosis, as I have never felt any kind of flutter or fibrillation, and can't help wondering how often this flutter happens to me and how long it lasts. I've read on various websites that it takes hours (48 hours is often mentioned, although sometimes less) before clots will start to form. In this instance at the doctor's office, I can't know when it started, but do know it stopped very quickly after being detected and didn't start again during many hours at the hospital.

I've since gotten a blood pressure monitor that is supposed to detect arrhythmias, and have been using it several times a day for the past couple of weeks. Once it showed the arrhythmia symbol, but three minutes later it didn't, so I'm inclined to guess that my episodes of arrhythmia are infrequent and short lived. Of course I don't really know. I also got a Polar heart rate monitor to wear when I ride my bike, and so far it hasn't shown any abnormal heart rate.

When you say your mom is active, Frenchie, does she do things that run a risk of accidents that could cause bleeding? The cardiologist told me that a bike accident in which I hit my head, even with a helmet, which I always use, could cause fatal bleeding when I'm on Coumadin. That scares me since I ride a lot and have had a few accidents over the years. When I told him how much I ride, he wavered and said that perhaps I should be on aspirin instead. I also cut the back of one leg last summer when stepping over a log that had fallen across the high mountain trail where we were hiking. It was at least four hours before I got to an emergency room for the needed stitches, and the wound was still bleeding some then. And that was without being on Coumadin!

I'm not ready to give up riding and hiking, and the cardiologist obviously understands that. I'm supposed to go back and see him in early April, and he indicated that we would discuss the issue of aspirin vs Coumadin again then. Meanwhile, Artaud, I assure you that I'm faithfully taking the Coumadin! But I'm trying to gather as much information as possible before the cardiologist and I have to make a final decision. And I'm being extra cautious on my bike and while hiking! Of course that didn't stop me from whacking my head today as I was retrieving something from the car. Sigh.

Thanks again to both of you for your responses to my first-ever post on this kind of site!

[Artaud]

Hi,

My Daughter-in-Law's mother did not believe that Coumadin was essential. She had a stroke from which she has yet to fully recover. She was warned, but had a casual attitude towards taking the medication. She had Atrial Arrhythmias as well. I believe that my wife said that due to insufficient clearance of blood from the Atrium, due to the arrhythmia, clots can form. Blood thinners, I believe, help to reduce or eliminate that possibility.

Whether or not it needs to be Coumadin is another issue, but this is between your Doctor and yourself. It is not advisable to change medications without your Doctor's awareness.

Be well.

[jkfrench]

Hi
I believe that is is essential.  My mom takes it for A-Fib.  They check her  all the time.  She is also active and this hasn't changed her lifestyle one bit at 74.  The risk of stroke is too great and unfortunately this is something we tend to get as we get older.  The problem is, even if she is at her usual check up and is out of a-fib, they tell her that you never know when it will just kick in again and it is safer to be on the blood thinners.  She also takes Atenolol.
Frenchie