Anticoagulant apixaban was prescribed for my mom (68 years old).
Like any anticoagulants, there is a risk of internal bleeding, especially when someone had just begun the treatment. The doctor wasn't very chatty in explaining the risks. I was given a phone number to call in case of internal bleeding.
But how can I know if someone has internal bleeding ? Especially in the brain. I'm thinking to request a CT scan for my mom after she starts taking apixaban.
Did your doctors said anything about CT scan when they first prescribed anticoagulants ? Is there a safety protocol to ensure that patients starting anticoagulants are doing fine ?
Thank you.
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snak3eyes
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It’s great that you are looking out for your Mom and it’s not unusual for folk to be concerned about the risk of internal bleeding when prescribed anticoagulants. I’m not medically trained but it is my understanding that anticoagulants, in themselves, do not cause internal bleeding but if a bleed occurs for other reasons, then it’s likely to take a bit longer for the bleed to stem. In reality, there are millions and millions of people taking anticoagulants here in the UK and thousands of millions around the world and unless someone has a history of spontaneous internal bleeding, the risk of having a spontaneous bleed is exceedingly small and it’s certainly not normal for someone to have a CT scan. I doubt very much if the NHS would oblige but I guess there is nothing to stop you having one privately but she would probably be the first but I’m sure your Mom is one in a million already!!👍
One other thing you should be aware of. Before taking Apixaban, your Mum should have blood tests to check her liver and kidney function because this is how excess chemicals leave the body. These should be repeated annually or bi-annually. This should be arranged automatically by her doctor but if it hasn’t, it’s part of the NICE recommendations for managing anticoagulants. It’s worth reading the link below as there are all sorts of other useful advice and information about taking Apixaban ……
I’m 68 years same as your mum and manage my health care myself. What does she think to your anxiety on her behalf? I don’t think it’s unusual to not have the blood test at the beginning but maybe 6 months following the start? Majority of people don’t seem to have a problem taking anticoagulants maybe talking to your mum may help?
Caring for someone it's not anxiety.She is reluctant in taking the anticoagulant because the doctor who prescribed it was rude and unprofessional. She doesn't trust him.
Let me give you the transcript for you to get a better picture:
"-(doctor) Take your top off for the heart monitor. Lay down on your left.
-(mum) Should I be facing this way or that way ?
-(doctor) I SAID ON YOUR LEFT. DIDN'T YOU HEAR ME ? LAY DOWN I SAID.
-(mum) Ok. Excuse me doctor.
-(doctor) What beta-blocker are you taking right now ?
-(mum) I was on propranolol but just recently I was switched to nebivolol.
-(doctor) Mam, can't you hear me ??? I've asked you what you take NOW, not what you tooK before!!
-(doctor) What beta-blocker...
-(nurse at my mom) Ok. You can put your top back on now.
-(doctor at the nurse) DON'T EVER INTERUPT ME AGAIN!!!
-(mum) I'm on nebivolol doctor.
-(doctor) Show me your last EKG.
-(mum is getting up to grab the file from her purse)
-(doctor) C'MON ALREADY!!!
-(mum giving him the file in 2 seconds)
-(doctor) FINALLY!!!!
-(doctor) Ok. I'll put you on anticoagulant. Take Eliquis 5 mg twice a day.
-(mum) Are there any side effects I need to be aware of ?
-(doctor) THIS IS IMPOSSIBLE. MAM, WHAT DID I JUST SAY ? TELL ME, WHAT HAVE I JUST TOLD YOU ? TAKE WHAT I'VE GIVEN YOU. MEETING IS OVER!!!!
There will be a leaflet with the anticoagulant which will have a section on what symptoms are serious eg a ‘thunderclap’ headache would suggest bleeding in the brain but other less dramatic symptoms might suggest a slow bleed say from the bowel, and of course ‘visible blood’ should always be investigated. It’s good to be aware but not to be too anxious because the doc has prescribed the medication based on the judgement that the risk of a massive stroke is much higher than a massive bleed 💜
Hi I am 68 years old. I was changed on to Edoxaban (which is pretty similar to Apixaban) from warfarin at the beginning of lockdown 2020, because they didn't want to do INR checks at the surgery anymore. I was TOLD "you must stop taking this and start taking this!!" There was no discussion or argument!!I was not given a blood test to check my INR levels or kidney function etc. I have never been monitored. I am in permanent AF (for about 5 years now) and had a blood clot in my arm before this in 2012.
So I think you will be very fortunate if you get a CT scan for your mum...don't think this is common practice here at all?
I understand you are worried....I know from my own experience!!
Are you in UK? as you said Mom as opposed to mum???
This probably isn't much help......but monitoring seems very sketchy these days!
I'm outside of the UK. I've taken my mom to privately owned clinics so that she can get the best care but most of the time we ended up paying top dollar only to be treated like garbage. It's frustrating.
My mom also got the "start taking this, don't ask any questions" approach from the cardiologists. I only want to find a doctor that can sit down and explain to us for 2 minutes what are the side effects, what to look for and how to respond in case things don't go well.
I learned from this forum that arrhythmias like afib should be handled by the electrophysiologist (the heart electrician). I didn't know that, I've only went to see normal cardiologists. I made an appointment to an EP on 15 th of Sep. I hope to get more answers then.
I have the sealed Eliquis (Apixaban) bottle sitting on the kitchen table. I want my mom to decide whether to take it or not (she wants to wait a bit more until the EP visit).
The community here is more helpful and resourceful than many doctors I've seen, but
don't get me wrong. Not all doctors are bad, it's just that sometimes it takes a long time to find the right one.
Hi, I sympathise with your concerns. I believe the issue behind most doctors rushing you and not providing explanations is not rudeness or impatience but their lack of knowledge, which they don't understandably want to disclose. They just don't have the time to check these things even if the facts are available, preferring to focus on seeing more patients. Also, Big Pharma doesn't always disclose their research (e.g. topically today the Covid vaccine research).
Tip: If paying privately, try and see the same medic every time to build a relationship and put him/her at ease e.g. by saying up front "I appreciate the information might not be available on this, but what would you do in my position........"
I am an active 68 yo (next month) male with Lone PAF and have postponed taking anticoagulants. Why, the majority here will ask? My decision is based on 1) personal rule, only take pills when essential to maintain QOL 2) European guidelines suggest for me at present it is optional 3) my assessment is that I have several 'weak' potential bleed areas e.g. stomach 4) major bleeds are a risk factor flagged up but micro brain bleeds with attendant chronic issues are not mentioned much....and even if not spontaneous, I bang my head quite a bit working on our smallholding!
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