? 2nd ablation on Friday

well, its been an interesting journey and I am complex. I have had AF for 15 years some times worse than others. 2 Cardioversions, 1 lasted 5 months the other 13 months. Had a ablation March 2014 but ended up in A/E in Jan 2015 and scheduled for 2nd ablation...... here the fun starts

I had weight loss surgery in 2008, a differ procedure to most called a duodenal switch which means I malabsorb some things (ie 50% protein so on high protein diet life long) - lost 15 stone and in much better place in some ways - however warfarin & I are not friends. We do have difficulty in controlling my levels.

I was scheduled to have 2nd ablation in March. INR dropped to 1.5 5 days prior to procedure so GP & I worked hard to get it back into range. Day prior to procedure it was 2.6 but on the morning it came back at 1.8 and I was cancelled (just as getting onto theatre trolley). They discussed other anticoags but decided I was not suitable for them as they can't be monitored in the same way with blood tests and they would be shooting in the dark so to say with my blood consistency.

So, deferred until 11/5/15 then was put back 4 days until 15/5/15. They recommended regular bloods (2-3 times a week) in the 3 weeks preceding procedure. My GP goes on hols and a new lady GP decides to recommend dosages I know aren't right for me but won't listen to me (she said to receptionist tell me "This is my judgement, if you don't follow my advice on your own head be it") -

so I followed her recommendations and watched it drop out of range. She then wanted to up warfarin to a level I know I go extremely high on - I expressed concern and was told the same - follow my advice...... In desperation I contacted the hospital team for advice and they totally took over my care and bloods.

I have attended 3 times a week, taken their advice and mostly stayed in range - currently 2.2 - another test tomorrow. All tests there are venous. I am terrified it will drop like it did before and was hoping it would be more like 2.8. On current dose (2mg/2.5mg alt days) I am maintaining or moving up 0.1 (from 2.1 to 2.2 in 3 days) so I snuck in an extra 0.25mg last night so it was 2.25mg instead of 2mg - eek - did I do right?

Problem now is I have developed a sore throat (Sunday night) - decided to use tyrozets but no paracetamol as not sure if it affects me. (months ago had 2 paracetamol and INR jumped to 5.2 & couldn't work out why ? paracetamol or no real reason)

Sore throat travelling into ear.... what do I do.... am seeing cardio nurse 9.30am tomorrow for bloods. Taking lots hot fluids, not really coughing but cleared throat and a little creamy phlegm

Do you I might be cancelled again - could cry

Thoughts?

13 Replies

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  • I feel for you as you have worked so hard to get everything right. I think you should relax and give in to whatever happens. You have no control over illness and will drive yourself mad worrying about something you can't control. If it is cancelled it will be for a good reason and will be done soon. If you are not having a general anaesthetic they may still do it if I.N.R. is ok . My thoughts are with you as you deserve the best. You have worked hard to help yourself.x

  • Hi -This is just my opinion and I am not agreeing with what you did, but I can't see that an extra 0.25mg will do you any harm. It depends whether you have been on the same warfarin dose for a while. I have done the same in the past and been glad that I did. If it's one of the nice nurses at my surgery when I have my next INR check I'll say what I've done, if it's the fierce one then I'm too scared to say as she'll tut, glower at me and shake her head (have told the receptionists this morning that I don't want to see that nurse again)!! I swear If she smiled her face would crack!

    I really hope that your throat problem doesn't mean that your ablation will be cancelled again, you can only wait and see what you are told tomorrow. You wouldn't want to go ahead with it if it wasn't safe to do so would you?

    Best wishes and make sure you let us know how you get on tomorrow.

    Big hug.

    Jean

  • Sorry to hear of your struggle to get your INR in line with requirements. What an up and down journey you have had and I completely understand your upset and concern.

    Tomorrow will bring an answer whether or not it is to go ahead both for INR and throat issue. You have done everything you can to prepare and all you can do now is see what tomorrow brings. Easier said than done I know. Any decision made will be in your best interests so sadly all you can do now is go with the flow. Fingers crossed it is all good for you.

  • Really feel for you and do hope that everything works out for the best.

    Try not to worry and keep your chin up.

    Shirley.

  • fingers crossed and hope all goes well- agree with all the advice above- Good luck

  • As I see it, what will happen will happen, you've got to just go with the flow and make as light of it as possible. On my second ablation, my INR dropped outside the range I was given, but they went ahead anyhow. I understand that they gave me something on the table to make up for the shortfall, I'm not totally sure about that, but I am sure they went ahead.

    Good luck with it and I hope it works whether it's soon or delayed.

    Koll

  • Hi there yoyo again. This is such a tedious situation and I do hope you'll get it sorted. You're not on your own as several of us have been in the same infuriating boat. Do try not to be too despondent in advance of something that might go your way!

    Your difficulties with warfarin must surely be partly because you are taking small doses and it's not as easy to make fine adjustments. Added to that, whilst you know yourself better than anyone else, others struggle to get the hang of how things work for your individual metabolism. I agree with the others that while it would bitterly disappoint to be unable to go ahead , waiting to get it right would be better.

  • Thanks for taking the time to reply. Very constructive comments - appreciate your advise

  • Thank you. I've been feeling I look at the forum too much and neglect mundane things that I am wading through (sorting and renaming filed data so that someone else can make sense of family history research I did years ago) so it's nice to feel time has been usefully spent.

  • Thank you for all your comments, views and well wishes. My upper respiratory tract issues are no worse - thank goodness, they don't think it will be a problem. Had blood done again today -although HCA had to dig around in both arms (this particular lovely lady had to do the same last time although she says she normally get veins 1st time, not mine though it seems).

    Despite sneaking in an extra 0.25mg in on Monday night INR has dropped from 2.2 to 1.8 which is the minimum for the procedure. Consultant has advised 3mg today (taken) and 2.5mg tomorrow. Am going to be 100% compliant and keep fingers crossed although dying to add an extra 0.25mg tomorrow night.

    So I turn up Friday and see what levels are..... will finish packing bag tomorrow night and hope for the best ... it's going to be very frustrating if history repeats itself. If they had kept to 11/5/15 I would be all done and dusted - shame that!!

  • INR back at 2.1 so just snuck in there.

    2nd ablation going ahead at 1pm today - ekkk

  • Great and good luck.

  • I'm so pleased and look forward to your next post x

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