Apixaban -v- reversal

[Tapanac]

Hello everyone

I know none of us are medically trained and you would think sitting here in the hospital I would be happy with any of their decisions, but……here goes

I fell over last week on the paving with a crash on my head and face and hand. Knowing I had to check in with the hospital if hitting my head I did.

After tests and CT scan it was found I did have bleeding on the brain

My concern is they gave me a reversal drip to stop the apixaban working and told me that to keep taking it would make the brain bleed worse, but not taking it with atrial fibrillation/tachycardia I could get clots behind my heart. Decision had to be made which way to go and doctor said it was a decision as to which would kill me first. I trust he was having a joke, but bit of a poor one if it was

Anyway I’m here thinking about it going round in circles

One doctor said they have sent the scans to St. George’s tooting to see if they think it needs the operation, then another doctor said they haven’t heard back from St. George’s so they might let me go home and keep me monitored.

My worry is that obviously I dont want another brain operation (I had brain tumour surgery in 2016) I also don’t want to live in limbo wondering g if it has stopped bleeding. I appreciate if it got worse I would probably know it by the symptoms, but again…?

I’m sorry this is such a long post, but I needed to get this off my mind

Thank you everyone for your comments

Pat x

[Hidden]

Hello Pat, what a terrible position to be in but sadly you are right, it’s not something we would dare advise on. I know it often said that stopping the occasional dose is not a problem due to the half life situation which applies to Apixaban but St George’s has to be best placed to advise particularly as they can react so quickly to any issues. I’m not sure if you are aware or even if it’s feasible but there is a hotel (I think called the Pelican) literally next to the hospital but not sure if that would help……hope things settle soon

[Tapanac in reply to Hidden]

Thank you I’m still in St. Peter’s locally at the moment who are still waiting for a reply from St. George’s. St. Peter’s said it could take up to 6 months to heal if doing the watch and wait scenario snd I was worried about all that time not taking the apixaban

Thank you for replying. That hotel might be handy save my husband keep travelling back and forth every day

All the best

[Hidden in reply to Tapanac]

👍

[Buffafly]

Woooo - scary! All I can say is try to have faith in your doctors. I’m sorry about your fall and hope you recover safely on both counts ❤️‍🩹

[Tapanac in reply to Buffafly]

Thank you

[mjames1]

Like Flapjack suggested, beyond our pay grades here.

That said, folks routinely go off thinners from time to time for various reasons, including minor and major procedures. I think it really comes down to the risk of the brain bleed vs the risk of being off thinners for six months.

As to the risks associated with the brain bleed, you have to rely on what the doctors are telling you.

As to the risk of stroke for being off thinners for six months, there should be a mathematical model that can give you a very good risk assessment of stroke both on and off thinners.

Several years ago my CHADS2 score was 2. I didn't have a brain bleed but I was involved in motor sports and preferred for safety reasons not to take thinners.

My cardiologist, after looking at some chart, put two numbers on a chalk board. The first number was my risk of stroke for the next 5 years if I took thinners. The second number was my risk of stroke if I didn't take thinners.

So yes, the risk of stroke was greater without thinners, however the OVERALL risk of stroke was still quite low over the next five years even without thinners. And I would imagine it would have been even much lower over a shorter six month period. We jointly made the decisions that at this point I would be best served not taking thinners.

You want to get those numbers and compare them to the risks of a brain bleed.

Jim

[Tapanac in reply to mjames1]

I don’t know what my chad score is I’m 78 and probably overweight

Female

I don’t know how to find that out

[Buffafly in reply to Tapanac]

mdcalc.com/chads2-score-atr...

[Singwell in reply to Tapanac]

Most likely a 3 or more. I just got an extra point for turning past 65.

[Tapanac in reply to Singwell]

Yes I checked and it was 3. Thank you

[mjames1]

Your Chads2 score is at least a 3. Here's the calculator.

mdcalc.com/cha2ds2-vasc-sco...

But don't let the numbers scare you. Remember, you're only potentially going off thinners for six months, not forever.

You really have to sit down with your doctors, listen carefully to their advice, and then come to a decision the risks versus rewards given the brain bleeding situation. But don't let them guess on your stroke risk. There are charts and tables available to them.

Please let us know what they advise.

Jim

[Tapanac in reply to mjames1]

Thank you. Yes I’ll let you know. I’ll look at the link now

Yes you’re right 3

Do let’s see what the doctors say

[Singwell]

Good grief - what an appalling manner of communication! And what a predicament too. I do hope things have stabilised and you're further on now.

[Tapanac in reply to Singwell]

Thank you

[SuziElley]

An unenviable position to be in. You’ve found your CHADS2 score so you know where you are there. As has already been said. Listen to the doctors, ask them lots of questions. Make a list of what you want to ask them. Then sit down and think about it. Maybe make a list of pro and con for each treatment option. All the very best.

[Tapanac in reply to SuziElley]

Thank you

[Camelia23]

I'm sorry you're in this limbo position. I can't offer any practical advice but I'm sending you good wishes.

[Tapanac in reply to Camelia23]

Aaah thank you and to you as wellXx