A friend has recently been diagnosed with AF and another friend told her one of her drugs was a blood thinner. We were on a zoom call and I chipped in saying it wasn't a blood thinner it was an anti coagulant. The friend said that her husband (with AF) was on blood thinners.
I started to doubt myself. Does Axaban thin the blood, or does it not coagulate if you do bleed?
Also, am I the only person not wearing a bracelet to indicate I am on this drug?
Best wishes, Katie
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You will find that the term blood thinners is used for ease of understanding for most people ! In fact these relatively new drugs ...the DOACs ....such as Rivaroxaban , ,Dabigatran , Apixaban etc plus of course Warfarin, a vit K antagonist, do not actually alter the viscosity of the blood at all. They are anticoagulants. Whereas Aspirin is a blood thinner.
Please don't get hung up on the terms "anticoagulants" and "blood thinners", etc. The terms are often used interchangeably. Simply ask the name of the drug your friend's husband is on. Then you can call it whatever you like
The "blood thinners" monica offends me by dumming down what the drugs do and I find it insulting but sadly it has come into general useage. No, the family of drugs do not thin blood at all and yes they slow down the clotting process. Aspirin and clopidogrel , however, do thin blood but have little benefit in stroke prevention for people with AF.
I have been on warfarin (the original anticoagulant) since 2004 and don't wear a bracelet either though I do have details in my wallet and phone under ICE (In Case of Emergency)
Hi BobD they are now finding that if you have a heart attack that adding aspirin into the mix, at least initially does help with being post heart Attack.
Aspirin has great use in some cardiac conditions, for example stents or artificial valves as well as MI. Sadly it has very little benefit as a prophylactic for stroke whilst still often casue harm ( GI bleeds for example.)
Clopidogerel is an antiplatelet. The difference between an anticoagulant and an antiplatelet comes into focus if you have a stroke. An anticoagulant is presecribed for strokes caused by a clot (I'm on Pradaxa), whereas an antiplatelet such as clopidogrel is prescribed for a stroke caused by a bleed, and for heart attacks. However, that may change. One third of the population have a mutation of the gene that metabolises clopidogrel (amongst other medications) which makes it less efficient. A study published this year by Bristol University, could indicate that it is financially viable to assesses whether a patient has a mutation of that gene. The study will be published by NICE in due course.
I wear a silicone bracelet bought on Amazon. inscribed with "ANTICOAGULANT" and "Predaxa medicated". If I had a seious bleed, paramedics should know from the bracelet that the reversing agent is Praxbind.
Clopidogrel is prescribed for clots as well. There are two ways in which clots can form and most of them are formed by platelet clumping. This will cause ischaemic strokes as well as heart attacks and the treatment to prevent this is an anti aggregant. The clots formed in afib sufferers are due to pooling of blood in the heart due to the faulty pumping when in afib. If you gave Clopidogrel to someone who was having a haemorrhagic stroke it would just increase the bleeding. They have found that there is a low risk of a further haemorrhagic stroke in patients in those who have had one if they restart an anti aggregant such as aspirin or Clopidogrel if they need these meds to prevent heart attack.
I had a look on Amazon, and the price is more than three times what I paid and, there doesn't seem to be the wide choice of medication labelling. It even mentions "blood thinners"! There wasn't a bracelet for prednisolone (corticosteroid) when I was recovering from pulmonary toxicity , so then I had to carry a warning card at all times. It is difficult to know the best place to keep a card on you.
I don't care which term lay persons use. I generally understand what's meant by either. That said, I do prefer doctors to chance using the term "anti-coagulant" to me, rather than assume that I might be too dumb to understand what it means.
Have to be careful with correcting others, though. I was with a friend last week who pointed out to another friend that the correct pronunciation for tool he was holding was "bradawl" and not "bradel". It was a mistake that especially annoyed her, apparently.
I enjoyed pointing out that the actual correct pronunciation for the tool was "gimlet". As all keen DIY carpenters would know.
Don't feel bad. They are not talking down to you at all. Doctors use the word "thinners" among themselves more than they use the word "anticoagulants" which is a mouthful!
This is how the NIH puts it and they are not talking down to anyone:
That made me smile - the bradawl bit - not a word one hears often these days.
Although most of us recognise that it’s a bit of an uphill task, many try to encourage the use of correct terminology and speaking for myself, for what I believe is very good reason. Understandably, many recently diagnosed AF patients are alarmed if they are prescribed drugs which slow down the clotting process to reduce the risk of having a life changing stroke.
Often, the term blood thinners leads them to believe that they are at risk of having a spontaneous bleed from every orifice on their body which cannot be easily stopped and consequently could cause premature death. I’m not medically trained but medics who are, will say that this is not the case. Ironically it is them that often use the term blood thinners rather than anticoagulants which, as others have said, more accurately describes what these drugs are actually designed to achieve.
In my opinion, if using the correct terminology encourages one person to take the medication as prescribed then it’s worth the effort……
I look forward to seeing a study on DOACs vs left appendage clipping. With true blood thinners it was a no brainer, left appendage clipping was superior given side effects of blood thinners. With DOACs there is not yet a comparator, will be really interesting as risk of internal bleeds etc obviously a lot lower with DOACs and I suspect there will be less of a difference between left appendage clipping and DOAC medication.
Except the jury is still out as to tehewisdom of LAAO. Many doctors believe that the left atrial appendage has an important part to play in stabilising blood pressure for example.
yes, we’ll learn more when there is more long term data, there is 30 years though so far though as been done since the open heart Cox maze. It won’t be there for nothing for sure.
Did you have yours clipped during your op? Surgeon is talking about doing mine during my surgery. Not sure whether I want him to. If he has to do a replacement rather than repair on the valve, I'll have to stay on anticoagulants anyway, so there would be no point in doing it.
No rush 😁. I've got eye surgery in a couple of weeks so, I'll have to wait for a couple of months after that before they'll touch the heart. Surgeon was a bit grumpy as he wanted me to leave the eye surgery for now but I've waited 18 months for them to sort the eye out. As he couldn't tell me when the valve surgery would be and as I'd have to wait for at least 4 months after that before they'd then do the eye, I dug my heels in a bit.Hope you're continuing to do well.x
I asked about watchman after my ablation. Only considered in Ireland if a person cannot tolerate anticoagulant meds. Insurance will not cover it in my case and EP didn't really recommend anyway
My daughter is permanently on warfarin for a blood clot in her coronary artery. A few years ago I was horrified when I discovered she had skipped some warfarin because she had nicked her finger and her 'blood was thin'. Cue a mother lecture on the difference, all the professionals treating her had referred to her being on 'blood thinners'.
FJ said: Ironically it is (Medics) that often use the term blood thinners rather than anticoagulants which, as others have said, more accurately describes what these drugs are actually designed to achieve.
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Could that have something to do with the fact that they see both the spontaneous and accidental bleeds these drugs can sometimes cause, especially in the elderly who are at a much higher fall risk? We talk about the benefit of NOACs (thinners) as we should, but sometimes overlook the reason why it is recommended we wear a bracelet on our wrist.
stop wriggling Jim and just call them anticoagulants, you know it makes sense, in much the same way as wearing a bracelet, carrying a card and/or using the ICE facility on a, I think you call them cell phones 😂.
To reinforce the benefits of carrying something, an elderly lady had been knocked down in our village and had a severe head wound. An ambulance had been called and a wait time of several hours had been given by the controller. Once I found a card showing the lady was taking an anticoagulant (or was it blood thinner) I re-rung and an ambulance arrived within 20 minutes………
I prefer "thinners" because it gives me pause before I get on a motor bike or do some other activity I probably shouldn't be doing since I'm taking them. To me, "anti-coagulation" is sugar coating the issue
that’s why it’s an uphill battle but I have to say that I’m surprised that a man of your calibre, foresight and knowledge needs to use words to keep you aware of your own mortality. Please tell me it’s a Harley!!!
Anticoagulants delay blood clotting at the beginning of the clotting cascade -
Antiplatelets - such as asprin etc - are platelet agglutination inhibitors - ie: they bust up the platelets that form clots
It is a very important distinction as FJ says - simply because of what they are used for.
To lump them together under ‘blood thinners’ is not dumming down it is ignorance on the part of medics in my view because of the reasons FJ outlined - the perception it gives patients ie; they somehow get the impression that it affects the viscosity of their blood so that they are more likely to bleed or I even talked to one person who wouldn’t take anticoagulants as they were scared that her blood would ‘leak’ out.
Blood is made up of various types of cells called platelets suspended in a liquid called serum - some of those cells sometimes clump together - then you would be taking an anti-platelet to ‘clot bust’ them apart.
If you are at high risk of forming clots as we AFer’s are, then you want to avoid the clots forming in the first place - hence anticoagulants.
But like anything else these days accuracy seems unimportant and impossible to change bad habits we have fallen into - sometimes it’s like working with the The Flat Earth Society (sic) - which is still thriving by the way.
Maybe people like Bob, FJ and myself are a bit strident simply because we were all at the same lecture back in 2013 from a leading researcher on coagulation - who left us in NO doubt of their views about naming your ‘blood thinner’.
Completely agree CDreamer. Eloquently put.Honestly I think knowledge is power & for me coming on here and having this explained when I joined was useful. Although it's not just GPs who use the term blood thinners, I find it increasingly common that many doctors do not understand the functionality of prescribed drugs. And have started generalising those now. Eg one GP who saw Ramipimil (blood pressure) Verapamil (channel calcium blocker) & Apixaban (anticoagulant) as concerning as she believed I was on three "blood thinners." wanted to stop two of them. I put her straight since which I'm very careful with any doctors suggestion of medications or dose changes. Many don't know what they are doing. I cross check it all. Clearly they don't get enough pharmacology training these days. Clearly that's been dimmed down. They might try referring to the pharmacology book that's in every surgery room helpful.... But I guess it takes them beyond their 10min allocated time. Maybe their screens doesn't tell them either. I don't know but I do find it professionally irresponsible.
That is extremely worrying. I would bet good money that many GPs have no idea of the physiological mechanism by which many of the drugs that they prescribe work.
Indeed! Despite all I just don't think many realise the interactions that occur with other drugs. A lot of this as well is down to no or minimal consultation & doctors not being familiar with their cases. Lack of time again. I find myself checking everything out, just incase someone has messed up. At the end of the day I'm the one that is left with any consequences. Can't be too careful.GPs in particular have become divorced from their patients. Mine has a fixed message that before you go any further that states if its an emergency to essentially go elsewhere, that they have limited appointments, advise you to ring every day &/or receptionists will advise you where else to go, or ring 111 who can help to get you an appointment. Not only can you not get a consistent GP you often cannot get care. And the GP Surgery take no responsibility for it. They must be missing loads. If you go private they have no access to your NHS file.
It's appalling. No wonder A&E s are choc a bloc. I am so glad we left the UK 20+ years ago. It was much better then but even so we had some thoroughly negative experiences.
I am guilty of just saying blood thinners but after this thread i defo won’t! Pure laziness on my part as that’s what my medical professionals refer to them as. DOACs it is from now on!
We were fortunate enough to have Dr Sanjay Gupta from York speak at one of our support group meetings and he said blood thinners several times. Rather tongue in cheek I challenged him (with a smile) and he vowed not to say it again! For the rest of the evening he didn’t but I doubt it lasted, but who knows 🤷♂️
I used to work in a warfarin anticoagulant clinic , patients & indeed staff would use the term blood thinners which mislead patients thinking their blood is too thin , that’s why they are cold or pale or whatever it was.
I preferred to explain it as making the blood less sticky so if it stays in the heart chambers for a tad longer than it should , it takes longer for it to form a clot and less chance of it whizzing off to cause damage.
Obviously for those who wanted a more detailed explanation I could’ve gone through the whole clotting cascade, but the ‘blood less sticky’ explanation seemed pretty helpful.
Things have moved on a lot since then thank goodness, The Warfarin Cinic used to be packed and as you know the patients had to sit and wait for the result. Our lab was a long way from the blood room and I had to run like hell with the samples then dash back to another big queue. Loved the job though. Things have changed a lot and it's all for the better. I'm taking Apixaban and have very few episodes averaging I every 10 months so I'm one of the lucky ones. M
To a certain extent I agree but I also think horses for courses. - I would ask you for an explanation of what you mean by sticky blood and you would have been there all day because one thing would lead to another…….
Absolutely, totally agree with you , some people prefer a short answer with a general idea of what warfarin was doing and others like yourself would prefer a longer more detailed and in-depth discussion. Which of course is fine too.
I also don't wear bracelet,carry card from Rivoroxaban packet in purse and have info under ICE on phone.Rivoroxaban is an anticoagulant not a thinner.🤗
I stopped wearing medical alert bracelets because I couldn’t get all the info I needed to on but I carry cards - plural - and everything is on my Emergency Info on my phone which is accessible without unlocking.
Another suggestion I picked up from another forum - make your phone’s locked screen pic your emergency info.
Good idea re phone screen CD! I used to have ID bracelet over 20 years ago but info out of date now. I've been a bit lax with carrying info on me so will adopt the phone screen method now.
Hello Katie, It’s Sandi- Fancy hearing from you here! The official name is anticoagulants as they stop the blood clotting which is very necessary on occasions like when I had a tooth extracted on Thursday and Alex, the dentist, was concerned I might be on “blood thinners” which might have prevented the necessary clotting afterwards. He knew I had paroxysmal atrial fibrillation which means occasionally my heart beats irregularly and faster than usual. If this continues for a long time it may cause stroke or clots to form in the blood which can be very dangerous and lead to death as in the case of a friend’s husband who died from a pulmonary embolism ( clot in the lung) in his sleep, after a successful hip operation - much to the disappointment of his surgeon as well as my oldest friend who thus lost her companion of over 50 years!
I wear a bracelet because I was able to add the fact that I have a pacemaker and am allergic to penicillin as well as AF and anticoagulant etc. I also have the alert cards in purses, handbags and in car central console. I have also put the alert message on my mobile lock screen. Belts and braces. 😂
Just realised you might not be Katie who I used to know (before she was famous) but chose her name as a writer you admire as I chose my “name”- could you please let me know whether you actually are Katy or not!
I seem to remember meeting you at a friend’s placenta planting party after the birth of her son - turned out she’d left it in the freezer so we had to wait some time for it to defrost if memory serves rightly - later I seem to remember your son was in a class I taught briefly at Archway when I did did a bit of supply work (OL Psychology) as my degree was in that and I have a PGCE too and the regular teacher had dropped out at a fairly crucial time!
And my son and his partner have recently had their second son born at home this time in a birthing pool as, having blood pressure taken on the previous occasion resulted in a bumpy trip to Glos Royal for the quite natural birth, it was refused this time!
Scientifically speaking, no drugs - aspirin, warfarin or the newer DOAC drugs like apixaban - “thin” the blood, as such. It’s just a helpful phrase that expresses, in layman’s terms, how some tablets work .
Some people here feel happier using a more scientific sounding jargon, and say “anti-coagulant”, which is undoubtedly more accurate, but still not really an explanation of what is happening since the blood can still “coagulate”, of course - just less easily so.
I notice that several NHS websites use the term “blood thinners” as a catch-all, so that tells us all something, I suspect!
hi i just have a card for edoxaban. I always refer to it as an anti coagulant since i have been on this forum ! When john. Was in hospital after his stroke they referred to the blood thinner as an anti platelet infusion.
I wear a bracelet. It’s just so much easier than making sure I have my card with me, and I would imagine more immediately obvious to anyone treating me.
They are anticoagulants. Blood can "stagnate" in A. fib. and thus clot. Leading to devastating strokes. Slowing clotting time can help prevent that. I've been on them for more than 13 years and other than cuts and bloody noses being messier than you'd expect I haven't had a real problem, I was even severely injured and cut to the bone in a fall and was able to stanch the blood before going to the E. R. to be stitched up. I hope you can tolerate them as well as I have.
It’s great to see all the posts from long haul folks with afib. I’ve also had to say anti coagulants, when asked are you blood thinners.
Just having had a tough 100 days of wierd fluctuations in heart rate and another try at my sixth ablation three days ago. (Right atrium six spots ablated and cardio versions back to sinus rhythm). I felt good about having the watchman installed in 2021. Previously had left appendage ablated Should I feel good about having the watchman?
Ironically or not I now take xarelto ten days before the ablation and thirty days after. I was taking 81 mg aspirin which is a blood thinner? (After the watchman)
I am Emotionally, physically, mentally and spiritually drained at present. Flying home from Austin in one hour.
I wear a medic alert bracelet, when I first went on anticoagulants the practice nurse recommended it, I also keep my phone emergency health details up to date.
I have Asthma so always carry an Inhaler. I have my info re anticoags written on piece of Paper taped round the inhaler. That way medics if needed know that I'm taking apixaban as well as being asthmatic. Covers everything in one go .
People use the term blood thinner but actually apixaban etc are all anti coagulants - they do not thin the blood. Aspirin would thin the blood and is no longer generally used for AF.
The anti-coagulants modern include apixaban among others, warfarin is the old one which needs to be kept an eye eat no greens, K vegs when on it, blood test regularly required. Modern no.
Aspirin works differently. Some take both the above and aspirin.
Folks use the term because it is an anti clot agent.
To save a stroke hopefully because AF makes an irregular heart which could form a clot which blocks the bllood getting to the brain.
The side effects can include internal or external bleeding.
Make sure it has an antidote. In case of accident etc.
Before operations I was told to stop my Pradaxa now 110mg x twice a day for 3 x 24hrs prior to operation.
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