Blood thinner tests

[afibtennis]

I am currently on aspirin and omega 3 because of some moderate cardiac disease. If I go back on a blood thinner because of the a-fib I am concerned about bleeding. Does anyone know of or get a type of blood test to monitor the coagulation of the the blood and modify the medications accordingly?

[pottypete1]

It depends on the type of anticoagulant you are on.

For Warfarin you would be tested regularly with the tests being less often once you settle down. The test is a blood test called an INR test.

For the other types of anticoagulants there are no tests as far as I am aware.

You should be guided by your doctors and clinic.

Nothing to be worried about in the general run of things.

Pete

[afibtennis in reply to pottypete1]

Thank you.

[Beancounter Volunteer]

Hi Afibtennis

Firstly we don't call them blood thinners, not only because they do not thin the blood at all, but also because of exactly what your question does, which is to make people worry about the bleed risk.

We call them what they are, and what they do which is anticoagulants, and we are trying hard to persuade the medical professionals to also adopt some clear thinkling over this and drop the use of the term blood thinners.

There are two main types of anti-coagulants, the first are Vitamin K Antagonists, and this contains Warfarin and Heparin, and then there are the NOACS (or DOACS) so called novel oral anti-coagulants and these include Rixaroxaban, Dabigitran, Apixiban and Edoxaban.

The first such as warfarin require a regular blood test called an INR test which literally tests the coagulation of the blood, it takes time to get to a theraputic level, (2.0 to 2.5) and you have to have a stable diet.

The second require no tests as they work within a short period after taking them, and there are no tests to check their efficacy

In both cases you should see an anti-coagulation nurse to talk through the options, and also in both cases you will need to check if aspirin should be taken alongside them. There are valid medical reasons to take aspirin and an anti-coagulant, but each case should be considered by a doctor.

The great majority of people on this forum will be on an anti-coagulant.

Aspirin by the way carries it's own bleed risk.

I hope this helps

Be well

Ian

[afibtennis in reply to Beancounter]

Thanks for your detailed response. Very helpful!

[Offcut]

I thought Aspirin was a no no now is it back in favour?

I am on Warfarin and have been since 1992 my therapeutic level, (2.5 to 3.5) 3.0 ideal. I have not had major issues with it, except every now and again it does become unstable. This can be down to the multi-conditions I have plus ever changing medications I take. Different anticoagulants seem to be age appropriate also. I will change over to a NOAC/DOAC before I am 70 as it does seem a better option then?

Be Well

[Hidden in reply to Offcut]

Hi Offcut There is another option but it is not for everyone. Your EP can explain if you are interested. Fast history" Diagnosed with AF 2011, cardioverted NSR returned and was afib-free 3 years. Went back into AF 2014. After multiple probs with med side effects had a 'pace abd ablate in 2016 and am off all cardiac meds. But was still on warfarin. Quite a few side effects with this also. For the past 2 years have self-tested weekly at home. But I don't like being on anticoagulants. To my mind they can be harsh and are not always as innocuous as docs present them. I am a retired nurse and recently found out about a procedure called closure of left atrial appendage opening (Watchman Procedure here in US). It is done through cardiac catheterization. I had it done Jan 18 of this year. Things have gone well and am in the process of weaning off anticoagulants.I'm happy I chose this route and can't wait to get off all anticoagulants. I will only have to take a 'baby'aspirin (81mg daily). As I said not for everyone but worth looking into if interested. Just my opinion and experience. Take care. irina1975

[Offcut in reply to Hidden]

Thanks for the info irina1975

Always good to know what is out in the world of medicine. I was told in 1989 by my then GP that "The strange heart beats are nothing to worry about" In 1992 I was admitted to hospital with double pneumonia however while they did their tests They asked did I know my heart is erratic? When I said what my GP told me not to worry about they were not pleased at all.

Now I am a little more complicated as I have many conditions to sort, Tachycardia, AF, PH, Emphysema and arthritics plus a few other pain producing ailments.

I was offered a Pace and Ablate but when they had a look into my right side they cancelled it /mainly because of the PH? which is now showing severe. I have to date had I Angiogram, 3 Ablations, 9 cardio versions Still get AF and tachy? I am now waiting for all my different specialists to meet to discuss my best options? I am also allergic to Iodine and the drug Dilitezem (Spelling unsure) Plus all the work that has been done though my groin has left bad scaring and was on a fem block for 4.5 hours!

Other than that I am mentally fine ( Others may disagree )

BE Well

[Hidden in reply to Offcut]

Hi Offcut. I am so sorry you have had to go through all those procedures and other health problems besides afib. AF can make treatment for other problems so much more difficult. I had side effects with diltiazem which is one reason my EP suggested the 'pace and ablate'. One thing caught my attention. 9 cardioversions? We are all different and treatment protocols differ depending on what country we live in (I'm in the US). Being able to learn what the medical thinking is and how conditions are treated elsewhere in the world is one of the reasons I very much like this site. It helps me know what questions to ask re treatment options. No one country, in my opinion, has a monopoly on good cardiac care. And while I have, for the most part, received excellent tx, I believe one thing I need to watch out for in my country is "Is this procedure being done because I need it/it will help me? or am I someone's 'bottom line? ($$$).( Pardon my cynicism but I'm a retired nurse (73) who worked in the American Healthcare system 40 years and I know how it works). Enough of my thoughts. I am wondering what the treatment goal is for you at this point. Are the docs still trying to get you back into NSR (normal sinus rhythm) or have they decided that staying in afib and working on keeping your rate stable is a viable goal? This is something I would ask my docs. What is your plan for me and what are we trying to achieve.?And, if it were me, I would be happier if there were one doc in charge of all those on your treatment team that would coordinate all the others' treatment ideas and then I would choose him/her as my info source. Sometimes 10 people can have 25 opinions. Also I am a strong believer that we (the patients) are 50% of our treatment team. You should be in on all decisions about your care. And if you don't understand the reason for a suggested plan of care then the problem is not you but that options and information for you to make informed choices have not been adequately provided. For the record, after two cardioversions and several different med changes my EP told me I would probably never go back into NSR so let's concentrate on rate control to maintain my permanent AF as stable as possib;e. I believe we have accomplished this. I feel fine, and am doing well. The hardest part of this process for me was letting go of my wish to go back to NSR. Many of us live lengthy, happy, comfortable lives in a state of well-managed afib. (BTW ignore the italics, I'm just a little computer-illiterate and sometimes press the wrong button) Learn to be an advocate for your care and remember you don't have to go through every procedure suggested for you. Demand the info you need to make your own best cholces. I could be on the wrong page re your tx but if it were me I would not be happy with so many treatments and procedures you have had. Take care and good luck getting all your docs on the same medical page for you. irina1975 (BTW there are other arteries to access your heart besides your groin.) And you sound mentally fine to me!

[Offcut in reply to Hidden]

One of the biggest issues in our NHS is the cure all doctors do not exist in the same degree and each department are now more specialist in their own field and do not breach the other departments. My GP would not change my tablets because they were prescribed by my consultant even though they were making me very ill. It was not until I ended up in A&E and then moved to Ambulatory Care for a few months that they took me off them and controlled my heart rate which was 150 at rest. Things are changing as I am now going to a specialist hospital.

healthunlocked.com/afassoci...

Be Well

[Hidden in reply to Offcut]

Hi Offcut I'm glad you are getting what you need in a specialist hospital. It's similar here re one doc not wanting to change what one of his peers has ordered even though it's clearly not working. I've sometimes stopped a med until I can see the appropriate doc. This can be dangerous and I don't recommend anyone changing anything without clearing it with a doctor.But, I admit, as a nurse, I have 'taken control of a situation'in my own way when doctors seem afraid of stepping on a colleague's toes at my health expense. I also have on occasion -with a problem I can't resolve through doctors -gone to the Emergency Room and let them resolve the issue. I understand doctors not wanting to make changes with another's decisions. Usually this is a good policy. But a phone call between the docs (good old communication!) can resolve an issue and not leaving the patient dangling!. I have actually insisted that they work something out or I will stop the med and make my own decisions. Not always the best approach but at times we have to force an issue to get the care we need! (Some docs are brilliant but they seem to have left their common sense at home. )(LOL but not really. This is just my opinion and I do recommend trying to work with our docs. Not always possible, though! Take care. irina1975 P.S. I'm sure I am not the easiest patient to treat.

[Offcut in reply to Hidden]

I had 2 of the docs arguing in the consultation room over if I should come off or stay on it? They now have me as allergic to diltiazem on my notes.

[Hidden in reply to Offcut]

Hi Offcut. I'm happy you were able to get off. I would be interested in knowing why one of the docs didn't want to discontinue the diltiazem. But I guess we'll never know. I would place a small bet-if I were a betting person-that if that doc had a few diltiazem side effects he would be off of it in a New York minute! Again. glad it's on your allergy list. Often that's the way to go. No doc wants to risk causing an allergic reaction. Take care. Burma (irina1975)

[Offcut in reply to Hidden]

The one that wanted me to stay on it was the one that put me on it in the first place. He was convinced it would improve my Lung condition as my heart tablets were blocking some of my inhalers. I think it was a little bit of pride on his side?

[Hidden in reply to Offcut]

Hi Offcut. I think you're right. There may have been other options re meds; diff inhalers etc. OR he could have asked you which if any meds had less or worse side effects and did you have a preference. Checking with the patient to see what was easier and more comfortable. What a novel idea!! Take care. Burma (irina1975)

[afibtennis]

I am on the baby aspirin because I had some coronary artery disease. I am currently, NOT on pradexa but thinking about going back on it.