Re visit to surgery with COVID-19 and... - Atrial Fibrillati...

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Re visit to surgery with COVID-19 and INR?

JaneChapple profile image
18 Replies

Hello

I hope everyone is keeping safe and well.

My hubby had two AF ops, the second one in 2013 which thankfully was successful. He opted to go onto warfarin at that time. He is due an INR but is worried about going to the surgery for obvious reasons and we are self isolating. He is 67. His doc phoned him as originally they said they could do it from the car to save him going into the room bit now she says they cant do this. The other option was to have a NOAC/DOAC but he has always been against these as there is no antidote and no regular check of how thin or thick the blood actually is. The other option is to come off warfarin altogether which the doc is not happy about even though his op was successful. Advice welcome.

JaneCx

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JaneChapple
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18 Replies
jeanjeannie50 profile image
jeanjeannie50

Hi Jane

At my doctors surgery they have a different area they use for people with suspect COVID19.

The other option would be for your husband to buy his own Coaguchek machine to measure his INR himself at home. Cost new is £300, but you could ask on here if anyone has one they no longer use and would be willing to sell. Your surgery should supply the lances and strips on prescription, they have for me.

Jean

JaneChapple profile image
JaneChapple in reply to jeanjeannie50

Thanks Jean

I dont think my surgery has a separate room for suspected COVID-19 patients but I will check that out. However there could be other patients walking in who are not suspected but could be walking around with symptoms or they could be a carrier. We have looked up about the machines but they are about £500 and they have either sold out or decided not to sell them as so many people are after them. Thanks for your advice though, its much appreciated.

Take care

JaneCx

jeanjeannie50 profile image
jeanjeannie50 in reply to JaneChapple

The one most people have costs £299, but yes like you say they are all sold out. That is why I recently bought one from a member on this forum. I can tell you I'm so pleased that I did.

Only one patient at a time allowed in the waiting area at my doctors surgery. The door is locked and they will only let you in 5 minutes before your appointment time. We have three different waiting areas.

BobD profile image
BobDVolunteer

Firstly the blood is not thin or thick it stays the same viscosity regardless of what anticoagulant one takes. These drugs merely slow down the clotting process. Warfarin needs regular testing since it works on stopping vitamin K from being produced whilst the DOACs work on a completely different part of the clotting process and need no regular testing. Regarding "antidote" , or more correctly reversal agents, this is very much a red herring since barring major life threatening injury, normal first aid is sufficient. Even warfarin (which I have been on since I was at school ,with Noah) can't be reversed instantly unless already in a hospital who have the special drugs available. Vitamin K injections still take time to change INR.

If this is the only choice available then I think one must accept it short term until such time as gthe current emergency is over. I definitely would not stop anticoagulation. Since my next test is not till the end of the month I don't know if this is going to be a blanket response. When I had my last test I was told they would be continuing although no other bloods were being taken.

Totally agree with Jean. I have been self testing now for some 10 years. You do need support of your GP and/or INR Nurse/clinic.

It's really no different to what a diabetic does. Different device, different reading values, different results BUT essentially the same approach. Suggest you google Roche website or Coaguchek XS I think they have an online demo video.

John

R1100S1 profile image
R1100S1

Totally agree with What BobD said re your technical worries

For myself much more confident now I am on Rivorvaxiban as I can now eat my greens with no worries about my fluctuating INR.

Keep safe

irene75359 profile image
irene75359

I really feel for you. I have my own coaguchek and a plentiful supply of strips. Where we live is a development of flats and houses, and a Facebook support group has been set up. I am aware that some residents are self-isolating as am I and can't get to their GP (may well be the same practice I am with). I emailed my doctor and asked if they would be prepared to let me have a mask and gloves, explaining it would give me the ability to test some of the residents. I haven't heard back (hardly surprising) but I don't want to take the risk without some protection. Hard times.

Fruitcake100 profile image
Fruitcake100

I am going for my INR today and they assured me I would go in a different entrance to anyone with any suspicious symptoms and go directly to a deep cleaned room. I am going to wear light weight washable clothes and disposable gloves while in there and as soon as outside dispose of gloves in bin without touching the outside of them, a lot of people get that bi wrong, I will take clothes off and put straight in the wash, possibly before I go in the house. Sounds OTT but better safe than sorry.

Thomas45 profile image
Thomas45

A word about antidotes

I'm on warfarin. A couple of years ago I had a grumbling pain below my right ribs. I saw an out of hours doctor on a Saturday lunchtime. He diagnosed appendicitis, and gave me a letter for my local hospital. I arrived there at 2.30pm, was put on nil by mouth, Canula in the arm, and a drip feed of vitamin k and antibiotics to bring my INR from 2.6to 1. That took exactly 12 hours. My bed was wheeled into the operating theatre at 2.30am, Sunday.

If I'd been on a Doac then they just would have stopped me taking them and just waited until their anti-clotting effect had worn off.

Several years ago I had a very rare side effect from one of the Doacs so went back to Warfarin. I am not prevented from eating any food. I am looking forward to today's greens with my lunch.

Mister_K profile image
Mister_K

The wait is over for an antidote to stop rare uncontrolled bleeding linked to some newer blood thinners. In the US, the FDA approved andexanet alfa (AndexXa) on May 3, 2018. It's the first and only antidote to reverse bleeding in people taking apixaban (Eliquis), rivaroxaban (Xarelto), or edoxaban (Savaysa). Another newer blood thinner — dabigatran (Pradaxa) — already has an approved antidote called idarucizumab (Praxbind). Check the latest to see if it is available in the UK.

Lilypocket profile image
Lilypocket in reply to Mister_K

Yes I take pradaxa and it is very practical now there is an antidote. X

2564 profile image
2564

Hi Jane,

It is more important to get you warfarin tested, than worrying about this virus.

I have always had my bloods taken at my Doc's, but due to the virus it has now closed.

I went to the hospital yesterday to have it done there. I must admit I was not happy, but all was good. They all had masks, and I cleansed my hands 3 times - using every one as I passed them. I also booked the 1st appointment of the day, so there more not many people around.

I have to have another test next Wednesday, so I have also booked the 1st appointment.

Hope this helps you, but please please remember how important these bloods tests are

Take care and keep safe

billllly profile image
billllly

Been on Warfarin for years and due an INR next week, not sure what the arrangements but im not going to worry about it, im sure they have things organised.

JaneChapple profile image
JaneChapple

Hi Billy,

I wouldnt leave it chance if I were you. Apparently in Isle of Wight they have stopped all INR testing. I can only assume they have put everyone on DOACs. If not, who knows?!

Our surgery still seem to be expecting people to attend the surgery but other surgeries are just closing and possibly not advising patients as to what they should do.

NHS is under complete seige at the moment understandbly, so I would not leave it to chance if it were me, but if your INR result is unchanged and at the correct level it shouldnt be such a worry, but as we know things can change regarding INR!

Take care and keep safe!

JaneCx

segaw profile image
segaw

I would suggest you ring doctor and see if they and the warfarin clinic at the hospital will let you self test. The doc has to be willing to supply the lances and the testing strips. If they all say yes then order a tester ( not cheap but we have never regretted the expense, your warfarin clinic can give you details, put in for a prescription for the strips and lances and then ring clinic. They will train you over three visits to the clinic , in normal times- not sure about now- and then if you pass the training you are away. Never need to have invasive blood tests again. A prick of the finger and send an email with your reading is all that's needed. We have found it invaluable as we travel a lot and have used it in Australia and America and Spain. As you send results by email and they send dose by email you can be anywhere in the world and do your test. An expensive outlay but we weighed it against having perhaps two blood tests done in usa and felt it more than paid for itself.

annlynne profile image
annlynne

Hi Jane, hope you are both coping with this cobid situation. I was on warfarin for 9years and there was little problem apart from varying INR when I was on antibiotics which then threw everything out of sinc. Consultant then recommended Apixoban -I agree there are no regular checks but I've been taking it for 2-3 years and all seems well. I've been on cardio ward a couple of times for fast aFib and blood tests would have thrown up problems. As it turns out it's been handy during crisis not having to go to surgery. I'm actually having to go for a blood test tomorrow morning as my liver function has been abnormal (no!I've not been on the gin) but I've every faith the health professionals will hanfle the social spacing okay. I've to wait in surgery car park till nurse comes out to me (I'm disabled adter my stroke then breaking my jip )If I were your hubby I'd get my INR checked, just ring surgery and ask what their procedure will be. keep well keep safe. this too will pass.

annlynne profile image
annlynne

excuse typos I've only one hand working. Annlynne

JaneChapple profile image
JaneChapple

Thanks AnnLynne

sorry to hear about your health issues and thanks for responding. My hubby had a asked if they would do it from the car but they said no due to insurance problems. Not sure what they mean since they are setting up COVID-19 testing areas everywhere.

Unfortunately hubby appears to be highly allergic to certain meds including ABs, ADs and BPs (although doc doesnt seem to agree). Gets high heart rate whilst on them. When he comes off, nothing!

Anyway we might be sorted now as someone on here is kindly sending us a second hand Coagucheck machine they no longer use. Fingers crossed itcworks. We will be paying her for it. It restores my faith in human nature with the many kind people there are on here, you included.

Thanks so much and please take care and keep safe. Good luck tomorrow!

JaneCx

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