Nosebleeds

[Chris1945]

Been on Warfarin for 4 years without many problems but a couple of nights ago for some strange reason I had a nosebleed which was so bad it felt like someone had turned on a tap! Managed to stop eventually by holding nose, went to bed and woke at 0500 next morning when it started again - but a whole lot worse and with huge clots. Called 111 for advice who sent an ambulance which I thought at the time was a tad OTT, but they were terrific, took me to A and E who managed to staunch the flow. An ENT doc came to check me out and cauterised the nasal area, she said a hot bath or hot food can cause blood vessels in nose to dilate (never knew that!) and indeed I'd had a hot bath that night but then I do every night. She told me not eat or drink anything hot, not sure if she meant spicy as well! Anyway, was sent home with antibiotic cream to 'sniff' in and will be checked out again in a couple of weeks. Worth noting my INR was 2.4 which is kind of 'spot-on'. Anyone else had the same experience and have a different reason of what might caused it out of the blue like that? Thanks.

[Finvola]

It’s scary Chris and is taken very seriously by medics, hence the ambulance. The person at 111 will have heard the words Anticoagulation and age? if you are the same age as your name implies and decided to take no risks. I always had the same type of OTT reaction too.

I had umpteen visits to A&E, ENT and various investigations for bad nosebleeds out of nowhere - I take Apixaban and am now 74. From all this I learned-

Combined Causes were household cleaning sprays, especially glass cleaners; woodsmoke from autumn garden cleaning; perfumes; shower too hot; thinning membranes in nasal passages; touching nose with fingers; and oddest of all - irritation from Naseptin nose cream.

I banned all sprays and perfumes from the house and dealt with each of the other things I had identified. If I must be exposed to a chemical such as a plant spray, I use a full breathing mask. I also use a nasal saline spray regularly. An ENT doc told me that an irritant can produce a reaction of swollen nasal tissues and blood vessels which bleed heavily. She said that Nosebleeds are more common in the autumn/winter when blood vessels dilate and shrink as we move from warmth indoors to colder air outside. She also gave me a useful tip - to help blood vessels to shrink during a bleed, press an icecube against the roof of your mouth with your tongue. Makes breathing very difficult if you are gripping nose and trying not to drown down the back of the throat. 😀

[Chris1945 in reply to Finvola]

Hi Finvola, sorry for delay in responding have had house guests for a few days, thanks for your response. Yes, I'm 73 and on warfarin 😒 Interesting that you mention irritants as a trigger, I don't know why it didn't cross my mind at the time but last Monday I had two new windows fitted into a dining room wall and the dust that ensued whilst they used saws(!) to cut through the plasterboard and brick was astonishing, the whole place was thick with fine grey dust resembling talcum powder! So I'm thinking that might very well have been the trigger for the nosebleed on Wednesday? Yes, I was given the same tip re the ice cube and also to place a bag of frozen - whatever, across the bridge of my nose. Hmmm, ENT doc gave me Naseptin nose cream to 'sniff' 3 times a day....so far, touch wood, no further bleeds. Ever onwards!😬

[Finvola in reply to Chris1945]

That does sound feasible Chris and hopefully was the trigger.

I got quite depressed about the cause(s) of the bleeds as I tested negative for a range of common irritants, even though ENT said there was massive swelling and inflammation. Each time I bled, it was the ‘anticoagulation and your age’ refrain and it took me three years to identify all the problems by elimination.

Bleeds were so frequent that I had been using Naseptin almost continuously for 3 months when I noticed the reaction so it was probably overuse which caused more irritation.

By the way, I do believe the medics regarding the anticoagulation and age thingy but feel that there is also at least one trigger of the bleed, which in our normal past lives would have been harmless - perhaps plasterboard dust. Hope so anyway.

[cali111 in reply to Finvola]

I to was given Naseptin cream but as it is a steroid steroids thin the skin or membrane. Naseptin cream also causes hearing loss. Now as I am very deaf now I was not

[cali111 in reply to cali111]

Pressed the wrong button but to recap my deafness was due to my being given streptomycin years ago I am very wary of any drug.

[Finvola in reply to cali111]

That’s a misery for you Cali. I was prescribed Naseptin and Avamys spray but prefer not to use either. Some people use Germolene cream but I find the saline spray and a small dab of Vaseline keep the membranes moist without side effects.

[Dickydon]

Since taking Clopidogrel and Asprin, I occasionally get nose bleeds and was told these blood thinning combi meds were the cause. It’s like they sort one thing out yet can cause another often much worse problem. I’m 57 and love hot spicey food and love drinking black tea, hot obviously, but have never had nose bleeds since starting those meds four months ago.

[Barb1]

Yes but ended up in hospital for 4 days with both nostrils packed (although only one was bleeding) Horrible experience as the packing was pressing on the sinuses and causing an unbelievably bad headache. They couldn't find anything to cauterise but my INR was 5.2.

I still have nosebleeds on Edoxaban now but would be very reluctant to end up staying in hospital again.

[Chris1945 in reply to Barb1]

Sounds horrific, hope all remains well...x

[Hidden]

Interesting post.Ive been on xarelto for about a year and about 2 months ago I had a slight nosebleed from 1 nostril right out of the blue, and this has continued ever since just a slight occasional dribble of blood from 1 nostril every week or so and ive noticed an increased runny nose as well because its a slight bleed i havnt bothered to see doctor im 67 and been suffering AF for 10 years now alrhough its been stable for a year or so .

[Chris1945 in reply to Hidden]

Thanks Charlie, hope you continue to remain stable for a loooong time....

[TenorJK]

I had a nose bleed earlier this year, never had one before that I remember but this was a bad one and I ended up in hospital over a weekend. It was caused by some violent sneezing and also a strong cleansing facial. I had the nose plugged and cauterised, very painful the plug seemed to go through the top of my head !!!!!! Advice was sneeze through your mouth not your nose,keep nose moist and use Vaseline.i am on Warfarin and also 80 years old. So far so good. INR was within range ( 2 = 3).

Best of luck Jo.

[Chris1945 in reply to TenorJK]

Thanks Jo, same to you....x

[Hidden]

Interesting. My 12 year old has frequent nose bleeds. Probably something to do with his allergic rhinitis and steroid nasal spray, over vigorous nose blowing and unconscious nasal mining. He also has a thing about spicy curries.

I have suggested that his strongly positive allergy test for cat dander leads to only one possible conclusion. My wife has made it clear that if it is a choice between her cat and her husband .......🙁

[Chris1945 in reply to Hidden]

😂 Thanks Oyster made me chuckle! x