COUMADIN, COUMADIN, COUMADIN, If I hear that word one more time!

[bpgagirl22]

I'm a 53.5 yr old  (54 in Dec.)  female with Type II Diab. since April of 2004, Severe Fybromyalgia since 5-12-02 with CFS, Degenerative Arthritis & Had the ADOC fusion with a Titanium Spacer done 10-19-07 for the herniated disks 5-6, 6-7 & 2 shoulder surgeries this year on 4-11-08 & 8-8-08-total of 6 surgeries since 2-9-07. Big history of Angina, hypertension & Heart disease-Dad's family, bad Osteoarthritis. Mother's side is bad blood clots, GrMom had 2 have her Carotid Arteries cleaned out @ 68ish. I'm supposed to be doing PT for the Rt Shoulder HOWEVER, I was having all signs-symptoms except for coughing up blood & on 9-10-08 & wound up in the ER on 9-10-08, many tests & CT Scan w Contrast-now have a slightly less than 2cm PE in a branch of lwr Rt. lung!  Then, Lovenox shots,-weaned to Coumadin & now a new GP I've had to find tells me I can't take my pain pills for my surgeries & my Fybro because it interferes with the Coumadin!  I need a Dr. to explain:  Why does Coumadin HAVE to be taken in the evening?    Why can't I simply take 5mg in the am & 5mg in the pm?  Why does it take 72 hrs for the turn around in the blood to get a decent INR? Why can't I take my pain pills if the Discharge Dr. from the Hosp. wrote that I can but this new B---- of a Dr. says I can't because it supposedly interferes with the Cou.?   I have had my latest INR done Monday on 9-29 and it was a wonderful 2.0!  I'm not having any dizziness, no little TIA's, nothing!  Why can't I take mine the way it works for ME!?  Why couldn't they dissolve the stupid tiny clot in the hospital instead of sending me home with all this mess?  Why can't I simply do an Aspirin regimen of 325mg or 3 pills of 81mg  instead of this  stupid
"theraputic" RAT POISON!? Now the Drs. tell me if I go off of it, I'll bleed out internally!  How can that be if this is a BLOOD THINNER!?  This makes NO SENSE!   Would somebody please explain this to me?  All they want to do is say: "Here, you need to do this, or that!"

[Douglas Bogart, MD]

Warfarin has many interactions  and the other meds you take will clearly influence the INR.  After someone has a pulmonary embolus they need warfarin for at least 6 months to prevent further pulmonary emboli.  Warfarin for this indication is far better than aspirin.
The reason to take the warfarin as one dose in the evening is that the blood tests (INR)  are frequently done in the AM and then the dose can be altered that same evening if the INR indicates a change is needed.

[bpgagirl22]

Thank you!  I appreciate you taking the time to explain this simply to me so I can understand it.  I've since spoken to a friend who's also been put on War. Sod. and they found out that the hospital actually erred in the discharge statement big time and since they actually use the same Cardio. Dr. I do,  our Dr.  (who doesn't know we know each other)  now feels that something needs to be done when discharge patients are told:
You take Coumadin and then when the Rx is given out in the bottle,  come to find out it ends up being  the Warfarin Sod.  NOT the actual brand  Coumadin.  Our Dr. is a little perturbed at the hospital now!