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Scared, so many questions!

tigerlily72 profile image
23 Replies

Ok, first post in this community/forum.

I'm a 47 year old female. Other health conditions include type 2 diabetes (controlled with diet only since diagnosis in 2015), hypertension, depression & anxiety, fibromyalgia, chronic fatigue, mild concentric left ventricular hypertrophy, moderate sleep apnea, menopausal and overweight. I thought some of this information might be relevant and provide a background which is why I've included it.

Due to high blood pressure my GP referred me for an ECG which I had on Thursday. I was a bit anxious as not sure what to expect. The nurse that did it had to get the duty Dr to look at it and came back saying it was "too fast" and needed to be repeated. After the 2nd one I was asked to sit back in the waiting room whilst the Duty Dr looked at it again. I thought it would be a case of it being ok with respect to analysing it and they'd say I could go. But I was called into his office to be told I have Atrial Fibrillation and he wanted me back the following day for bloods. I was booked as an emergency appointment.

So, on Friday I saw my own Dr and bloods were taken. She prescribed apixaban (5mg) and doubled my bisoprolol that I started 2-3 weeks ago. She couldn't give me a reason as to why or what was causing it and said it was very unusual in someone of my age. She said she would make a referral to a cardiologist.

Anyway, she sent me an email that evening saying that they'd had a cardiologist visit the practice later that day to give an educational talk and she asked him about me. He also confirmed I have AFib and recommended I have an echocardiogram and more bloods. He also advised that if both are normal no further checks or tests would be needed but agreed that I need blood thinners. She also said my bloods had come back as normal.

So here's my dilemma and worries - I'm really scared to start taking the apixaban and am worried about potential side effects as well as the risks of not taking them. I'm worried about what will happen if I cut myself and having to perhaps go to hospital. I hate hospitals and am scared as to what they would need to do to me if this was to happen.

Can anyone reassure me or provide answers as my head is all over the place right now. Also, will they be able to tell the type of AFib I have? I've read there are 4 types?

Any advice or information for a scared, anxious newbie would be very gratefully received.

Thanks x

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23 Replies
Beancounter profile image
BeancounterVolunteer

Hi Tigerlily

I understand the anxiety, it's scary being prescribed a anticolagulant for the first time.

Let's start with the term Blood thinners, I know the ruddy doctors and nurse use it, but two things, it's scary and it ruddy inaccurate, none of the anticoagulants "thin" your blood even one iota, and I do wish they would stop using it.

It's scary as just as you are thinking it sounds like if you cut yourself you will bleed forever and all eight pints or so will drain out in seconds.

Nothing could be further from the truth however

Blood coagulating is a REALLY complex set of actions within your body, it's necessary of course to stop bleeds after a minor or even major cut or break in the blood vessesl, but intefereing with the process is really complicated.

They use to prescribe either Warfarion or occasionally Heparin, and both of these are actually Vitamin K Antagonists, in other words they reduce the Vitamin K in your body which is necessary for blood clotting. However to use either of these you have to have regular blood tests for what is called INR (International normalised ratio) and that can be a real pain, as maybe like me you were on weekly testing. Each test adjsuts the dosage of the warafin you take.

The new drugs are called NOACs or DOACs and they don't work on Vitamin K but rather Factor X which is at the other end of the complex coagulation process, and because of this they do not need regular blood tests to ensure they are working, but rather you just have to take them.

Most of us on this forum will now be on a DOAC the same drug you are being asked to take. Generally, and for the great majority of people, it's very simple indeed, pop the pill and forget about it. For a very few, and I do mean a few, they can suffer side effects of bleeds. So let's get them out of the way early on so you know what to look for.

Biggest side effect is stomach aches, less so with Apixiban, as you take it twice a day, and there are some much rarer ones, insie that box it will tell you what they are and they really are quite rare.

Bleeding, is possible, usually only if you are prone to it, so watch out for very dark coloured stools or urine, and it that happens let your doctor know immediately.

But cut yourself? fine, it might take a minute more to stop bleeding, maybe even you might bruise a little more easily, but you will probably not notice.

So advice take the tablets, and anti-coagulate, we are all at 5 times greater risk of stroke with having AF so it's necessary

Be well

Ian

tigerlily72 profile image
tigerlily72 in reply toBeancounter

Thank you so much for taking the time to reply and help reassure me. Yes, one of my main worries is the fear I won't stop bleeding and in my "ignorance" believed it might be really bad if I have a minor cut.

You mentioned vitamin K. I was diagnosed as vit D deficient last year. I buy and take my own vit D along with recommended co-factors which include vit K2 MK7 and two types of magnesium (mag malate and mag glycinate). So now I'm worried about whether or not I should continue taking the vit K along with the vit D. I guess with summer hopefully coming I can absorb my vit D via the sunshine but ongoing, I'm not sure what the answer is.

Blimey, it's complicated!!!

Vonnieruth profile image
Vonnieruth in reply totigerlily72

I also take vitamin D Just check with pharmacist about Vitamin K but unlike warfarin you can eat greens on Apixaban

BobD profile image
BobDVolunteer in reply totigerlily72

Carry on. No problems at all and if it makes you feel better then feven better.

Beancounter profile image
BeancounterVolunteer in reply totigerlily72

Hi Tigerlily, Vitamin K makes no difference to the workings of a DOAC, they work on an entirely different part of the clotting process.

Auriculaire profile image
Auriculaire in reply totigerlily72

Taking vit K2 should not be a problem with Apixaban. I have just gone on this after a suspected TIA ( though nothing has shown on the brain scan) . So far so good no stomach problems like I had with Pradaxa. The only thing I have noticed is the scratches I get on my right arm while cutting back perennial stalks are a bit worse and last longer.

Vonnieruth profile image
Vonnieruth

Hi lily

Like you I was scared of taking Apixaban Felt it was a life sentence Was worried about knocks and bangs at home and work Scared to cut veg or make chips Even doing gardening Anxiety with being diagnosed with PAF and then tablets I was even scared of being alone in the house .Over last few weeks I have had bloods taken three times and hardly any blood on my cotton wool after .Had no unexplained bruising I guess like me you may always have caution in your mind but you will get use to them It's a case of are you damed if you don't take or damed if you do Lot easier then warfarin

tigerlily72 profile image
tigerlily72 in reply toVonnieruth

Thank you. I guess a lot must feel like I do so at least I'm not alone. My GP did say apixaban was one of the better and safer drugs. I couldn't see the screen but am pretty sure she did a scoring criteria list before prescribing and told me if I was male she probably wouldn't be prescribing!

Vonnieruth profile image
Vonnieruth in reply totigerlily72

Yer They do a scoring When I was discharged from cardiology the sister redid it for me to see if I could come off it but my sex and age said no

I’m 53 and was diagnosed last year with AF.

Worse time ever...... but.... you get over it and used to it. I take Apixaban, Bisiprolol and Ramipril. No issues with them so far.

I felt like hell when first diagnosed.... sickly, sweaty, dizzy and breathless. My doctor told me the body could function ok with it and I believed him. Looking back I think that was just talk!

Anyway, after the shock, you make your life changes etc and get on with your living. I had a cardioversion in January this year and have been in rhythm ever since. Still on the drugs though.

I had major surgery last weekend on my stomach.... and have got through that, still in rhythm....

So yes, a horrible horrible shock to get AF but you do get used to it, believe me. Things do get better, good luck 👍❤️

tigerlily72 profile image
tigerlily72 in reply to

Thank you for sharing your experience. I think I'm in shock and perhaps a bit of disbelief as my Dr kept saying it was unusual for someone my age, as well as not knowing a cause / causes for it. I tend to want answers. I've told a couple of family members but not sure what to disclose to my employer, other than I will be taking anticoagulants (when I get my head around things and start taking them).

CDreamer profile image
CDreamer in reply totigerlily72

Personally, unless you need extended time off, don’t tell them anything as it could work against you unless it is in your contract to reveal any health issues for safety reasons. Some people become very symptomatic whilst others aren’t even aware of their AF which is only discovered by taking a pulse or ECG. If in the latter category, don’t.

tigerlily72 profile image
tigerlily72 in reply toCDreamer

Well they already know about the majority of my other health issues as I have reasonable adjustments in place. I've also had occ health consultations.

I will probably need to share and disclose with my manager and the first aiders may need to know. My worry is what happens if I become very unwell, or worse case scenerio cut myself or fall. They will most likely need to be aware of me taking the anticoagulant.

CDreamer profile image
CDreamer in reply totigerlily72

I don’t think they will - unless it is specifically stated in your employment contract. There is no need as there is be no emergency with anti-coagulants, it really isn’t a big deal unless you suffer a head injury and then you would need to inform the medics - not your employers. In my HO & experience as far as employers are concerned - the less said, the better - unless you need adjustments in place to do your job.

Many people wear Alert jewellery and or carry a card and have alerts on their mobiles.

The thoughts are far scarier than the reality and I would think you will be very surprised at just how many people take A/Cs and wouldn’t think to mention it to anyone. I don’t know the % of the population but I would guess at it being significant.

doodle68 profile image
doodle68

Hello Tigerlilly :-) welcome. I have P-AF (the type that comes and goes ) and have been on Apixaban for almost two years, I was scared to start taking it now I would be very scared not to...

Types of AF and lots of information here...

heartrhythmalliance.org/afa...

tigerlily72 profile image
tigerlily72 in reply todoodle68

Thank you. I'll have a look at your link. I do want to find out what type I have.

cassie46 profile image
cassie46

Welcome to the forum< I am on Rivaroxaban a different anticoagulant to you but I have been fine with it for 5 years. You say you are tired at the moment, what dose has your GP increased your Bisoprolol to as this can make you very tired, so monitor this as there are other beta blockers you can try. Good luck with everything.

Cassie

tigerlily72 profile image
tigerlily72 in reply tocassie46

Hi Cassie. My doctor started me on 1.25mg of bisoprolol about 3 weeks ago but has doubled this to 2.5mg. The tiredness could be attributed to other conditions as I also have fibromyalgia and OSA.

I've also now made some much needed changes to my diet as I eat too much as well as the wrong things! I plan to read up and find out more regarding diet, exercise, alcohol and alternative treatments and therapy.

No doubt you'll see me popping up a lot over the coming weeks asking questions! Xx

Hi, like you I was 47 when this AF thing hit me. I really hate it when health professionals keep telling you that you are very young to have this. What bloody help is that?

Hopefully you will be referred to an EP soon (a heart specialist that deals with the electrical signals in the heart)

Anxiety can be a side effect of having AF, and when you know this it can help you to move on with your life and create some coping strategies to ignore it .

We can help ourselves by losing weight and keeping blood pressure under control.

I am still very overweight, but working on it, and despite having ankylosing spondylitus I am walking many miles a day and I am so much fitter than when I was diagnosed 4 years ago.

tigerlily72 profile image
tigerlily72 in reply to

Hi Mike

Thanks for taking the time to reply to my post and share your experience. Yes, you're right when doctors say it's unusual in "someone your age"!

I've already started making significant much needed changes to my diet. I guess I was "getting away" with it before despite being a type 2 diabetic!

If I work hard on lifestyle changes I believe I can improve many of my health issues i.e. type 2 diabetes (I'm not on meds or insulin for this), blood pressure, sleep apnea and of course the AFib.

I'm considering asking my GP if she's prescribe Orlistat to give me a bit of help with this. I think if I can present a good case, she might!

in reply totigerlily72

Unfortunately, like myself you have many contributing factors that has led to AF . But we can still help ourselves massively with lifestyle changes.

Are you having any treatment for the sleep apnea? That is a well known trigger for AF, and definitely one of mine.

I have signed up to the 1000 mile challenge this year, and so far since January I have walked nearly 300 miles, every little helps

Hi I have PAF since Sept 2018 and was very scary still is but it gets better I'm on apixaban and bisoprolol only side effect I have is feeling sick in morning but now have some tablets for it so not as bad I just carry on try not to worry it gets better take care

tigerlily72 profile image
tigerlily72 in reply to

Hi. Thanks for sharing your experience. I'm hoping I won't feel sick. I seem to be ok on the bisoprolol but have just doubled the dose and yet to start on apixaban. I plan to later this week.

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