Husband sent home for second time yesterday after pre med this time as no ICU beds.Consultant has swapped him onto apixaban from 9 years of warfarin. He said ok with aortic valve issues it's with mitral they use warfarin.
I think this is a fairly new transition?
Can I ask what anticoagulation regime is experienced after such an op. I'm retired nurse of 20 years,never had anything to do with heart surgery. Reason for Q apart from interest is I've unearthed a stash of warfarin!!! Shall I get rid to chemist??
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It is normal advice to return any unused medication to a pharmacy, preferably the one who supplied them. That's what I do, although in the past some pharmacies get a bit grumpy when you hand over meds they haven't provided
Haha, our Boots has closed, morphed into Jhoots which is useless, will give me great pleasure to return them. They seem to keep no stock in the pharmacy or shop.
I presume he's getting a tissue valve when he does get it done? (Otherwise it wouldn't make much sense as he'll be back on warfarin for a mechanical valve.)
My chemist said that in Ireland they pretty much only use warfarin now for mechanical valves. The new anticoagulants work just as well for other stuff, and they aren't nearly as fussy as warfarin.
I can't answer your question but I just want to say how upsetting it must be to have operation cancelled. After my operation there was 3 of us due to be discharged but we couldn't because the pharmacy had closed before they had done our medication. This resulted in us stay another 24hrs which stopped 3 people moving up from HDU, which stopped 3 people being moved out of ICU which meant 3 people had their operation cancelled. There must be a better system, but then I don't get paid loads of money to sort it out. Sorry to hijack your post, it's just that I felt dreadful stopping somebody else have their op cancelled because of me, although it was totally out of my control. Hope your husband gets his op soon.
Although it is no consolation to it's 'customers' your unfortunate experience, which could be viewed as avoidable, is sadly typical of the shambles that permeates through parts of the NHS through mismanagement of its resources. I am sure every one of us has a similar tale to tell, including me, with some worse than others. Whereas the front line medical staff and equipment are mostly first class, they and those they serve are let down in many cases by the services that backs them up. And although this could be viewed as controversial by some. and very simplistic as an example, one highly paid 'diversity manager' would have paid for a qualified pharmacist which would have solved the problem you experienced and others which no doubt followed it.
I had an AVR, LAA clip and surgical ablation nearly 2 years ago and take apixaban. It was discovered many years ago that I cannot maintain a stable INR on warfarin so the surgeon discounted a mechanical valve in favour of a bovine tissue valve removing the need to take warfarin but the surgeon, GP and myself have opted to continue with apixaban for life as not all stroke inducing clots form in the LAA.
Warfarin is the only anticoagulant for all mechanical valves.
Our daughter who has congenital heart disease and whose heart is now fully paced is on Warfarin and has been for many years.
My wife has paroxysmal AF and she was admitted to hospital via A&E last year for a pacemaker fitting (not related to her AF). She spent 5 days in ACU to allow time for the Edoxaban to dissipate from her system before they would carryout the procedure.
My Pharmacy lets me return drugs. So does the Boots branches. I have been taking Apixaban for years with no problems. Just tell his Dentist; any medical staff; complete the card that comes with the box and ensure he has it with him at all times. I keep copies in all my purses and the back of my mobile telephone. I also note on this card all my other medication.
It is good practice to return unwanted medicine, the main reason that of safety! I had thought anything returned would be forwarded to 3rd world countries but now know everything is destroyed, opened or not. I was even told by a district nurse that bandages issued at the beginning of the day for use during house calls are also destroyed - opened or not. I believe this could be a good example of health and safety working for everyone! Surely the rules on this do need some honing for it seems a terrible waste of resources?
The other issue regarding blood thinners can be explained quite easily - I believe! As has been said here on many occasions, what well meaning contributors sometimes fail to understand is that everyone is different and even with the same symptoms, ages, sex, ethnicity etc, everyone is different, hence the unique importance of ones DNA - the building blocks of the human body,
After my minor (is there such a thing) heart attack and consequent heart bypass, I had not been on any blood thinners, but once in hospital went immediately onto them, so much that a mole I clipped whilst shaving took nearly two days to heal. However, once healed and subsequently discharged after the operation, all was well. My only lasting issue is with bruising so easily and occasionally when I knock into things I can actually skin myself at the point of contact, the recipe for a very uncomfortable and lingering injury.
The only relevant fact for me was the level of trust I held the surgeon and the amasing team behind him. I had just one itch that ceased to itch once done and therefore not important any more. That referred to my voicing my concern for pain in general, including my left lower leg, where a donor vein had been harvested. After mentioning this to the surgeon he prescribed a suppository pain killer that I wrote down to mention to my family doctor if I again needed something similar when released. At home I looked up the drug and received quite a fright when I read the drug was specifically used for pain during child birth and under no circumstances should be administered to those with a heart condition!
No point in worrying since the issue had passed plus I was banking on the surgeons knowledge of such drugs was fuller than that from some US web page. Anyway, trust has to begin somewhere and as for having the operation cancelled - I was kept in hospital to await the op and for monitoring purposes and had my slot cancelled twice due to greater emergencies. Frustrating I know but that's the way the mop flops and had I been the driver with half their chest ripped open with dislodged and damaged blood flow to the heart, I think I might also qualify for immediate attention. Plus then age, sustainability, health and stamina will probably be taken into account.
Finally and with the greatest respects, the procedures I went through just 66 months ago are probably by now, antiquated compared with today. It is the development of the technology that eats up the budget plus the deplorable exploitation the drug companies inflict on the NHS that also play such a critical depletion of available funds for t he poor patient and the long suffering nurse. Apologies for the short story but hope it all might play a part in putting your mind at ease. Good luck to you both and keep smiling. You know where we are. Best wishes, J
Thank you. Icing on the cake was my hopefully minor stroke Saturday evening. Being well looked after, admittedly on a bay of men. Staff can't remember when beds so tight.
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