Aspirin

[Ren912]

My sister in law languishes in a nursing home 5 years after a debilitating stroke. She refused her doctors advice to take a blood thinner and instead chose low dose aspirin which is no longer recommended by physicians to treat AFib.

[rosyG]

yes- you are right here- has she been offered a NOAC- some people refuse warfarin as have heard it called unpleasant names!!

[Ren912 in reply to rosyG]

I believe she is now on Pradaxa to prevent further strokes.

[PeterWh]

So sorry about that.

A very salutary lesson if people aren't anticoagulated using Warfarin or one of the NOACs when told to.

[Ren912]

On the subject of an antidote for the new anticoagulants, an antidote for Pradaxa has been approved and is now available. Working on antidotes for the others, should soon be available.

[BobD Volunteer in reply to Ren912]

The whole question of antidotes or to be more precise reversal agents is a red herring to be honest. There are ways of dealing with a bleed whatever anticoagulant you are on. Warfarin, again despite what people think, can't normally be reversed quickly except with a special drug which only hospitals keep.

Regarding aspirin. it was only in 2014 that this was crossed from the recommended list so five years ago it was common place for even quite a few doctors to use it.

[PeterWh in reply to BobD]

True about aspirin but I think Ren's point is her sister in law was advised to go on Anticoagulation but didn't with devastating consequences.

[Goldfish_]

We are all entitled to our own choice provided we have mental capacity and are well informed. It maybe that she doesn't want best treatment. Is she depressed?

[Ren912 in reply to Goldfish_]

No, she wasn't depressed. She simply didn't want to take Warfarin because of the inconvenience of the necessary blood monitoring. She chose Aspirin instead thinking it was adequate. Obviously it wasn't!

[Hidden]

If her doctors described the anticoagulants as blood thinners then maybe thats why she avoided them?

Very sorry to hear this.

[CDreamer]

Very sad. I agree that choice is important and that options are not always explained clearly or even offered, and I wouldn't take Wafarin but did take Pradaxa whilst I had AF but stopped 3 months after ablation and AF free.

I think many people do have an in built resistance to 'blood thinners' and I know I have corrected people sometimes but just get 'a look' - because that is the term their doctors used - so it must be right! Mmmmmmm.........

[Grannycake]

I have been on warfarin twice for long periods,eventually ended up in A&E as took a reaction to it. It seem to build up in my system. I have had frequent visits to A&E after trying numerous medications and having bad reactions to them. My cardiologist cannot find a suitable drug for my high BP or AF. The only medication I am on at the moment is Asprin,thyroxine(had parcial thyroidectomy 50 years ago)and antihistamine. I live in hope of finding a suitable drug,as my body seems to reject any medication its given

[Bridges4 in reply to Grannycake]

I have always had problems with my BP. Due to a recent heart problem I was in hospital and was prescribed a drug called EPLERENONE by the cardiologist. It is for heart failure and BP control and is the only drug that has successfully controlled my blood pressure. Best wishes

[Jamila123]

Very sad indeed , however, there are also many people on anticogualants that die from massive bleeds on brain

very difficult choice to make and a choice that i suppose needs to be respected by health proffessionals , patients choice

There are also many many people who have strokes and do not have AF

Very difficult choice indeed

[Ren912 in reply to Jamila123]

I, myself, have AFib and am on Pradaxa. As we get older falls are more common and could result in a brain bleed whether on a blood thinner or not. The likelihood of a stroke is much increased with A Fib. On a different note I was just prescribed Amiodarone and am not sure about it. It is described by the FDA as a "last resort" drug. Very toxic to many different organs. I think I'll go with the ablation instead. Any experience with this drug?

[Geza10]

so sorry to here this

[scotcitz]

So sorry to hear about your sister. Just yesterday I was talking to someone in a similar situation (her mother had a stroke after being taken off blood thinners for surgery and somehow the doctor forgot to put her back on). I think this raises the point that doctors don't seem to have the same threat/warning system for people about blood thinners -- it would seem that it is presented as an option and people aren't really aware of what a stroke can do or what the elevated risk of AF means. Fortunately or unfortunately my mother had AF and several strokes, so I knew. I really think it's not so much your sister as the whole way in which this is presented to patients. It's like they 'get' heart attacks -- if a doctor said to you 'take this pill or you may have a heart attack' I think most people would take it. But 'stroke prevention' just doesn't have the same fear factor for us ... I don't know how to change this really and I'm curious if maybe others feel that we need a much stronger message from the medical community on the dangers of not doing blood thinners ...

[398emb in reply to scotcitz]

I don't fear a heart attack, but I am petrified of a stroke. No exaggeration.

I fear being left alive, mentally alert, but physically incapacitated. If someone could promise me that I would be dead after the stroke I'd feel less afraid. The thought of being "cared for" in some sort of institution, unable to do anything for myself, is totally horrendous. A heart attack, if survivable, is unlikely to result in the same total loss of independence.

No, I fear a stroke much more than a heart attack, and I think that others should too.

[scotcitz in reply to 398emb]

Pretty much how I feel.

[PeterWh in reply to scotcitz]

You have raised some very valid points.

I think that there should be a NHS initiative to update all medics (from consultants all the way down the line) about the importance of anticoagulation and maintaining it. After all as Bob says we are in the bottom 4 in Europe on this.

[Grannycake]

Thank you Bridges4,will mention that at my next appointment with my cardiologist,and will discuss if it is suitable for me

[Grannycake in reply to Grannycake]

Ps I lasted 2 weeks on Spironolactone