They just found a bleed at the back of the eye. At a coincidental 6 monthly glaucoma test the Opthalmologist asked if I was taking Warfarin. Yes. or was I Diabetic . Not yet.
Seeing the hospital Opthalmologist on Monday. I have had Glaucoma for 10 years but not the Macular degeneration the optician also spotted which the bleed could be attributed to.Anyway they wanted me in pretty quickly after my just seeing the Glaucoma opthalmologist who asked the two questions.
Since then I wondered about the question re warfarin which I take for the AF and whether to change to an NOAC.
Have been looking at the Macular Association web site. Lots of very good leaflets. The one on foods good for eyes was interesting in that all the greens with K are good for lutin needed in the retina.
I will have to get advice from them on Monday as well as my GP who is very experienced who I try not to bother.
Any comments from you would be appreciated.Thanks.
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Echinopsis
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The only comment I would make is that I have been happy on Apixaban, doesn’t suit everyone though. It is twice a day so the half life is 12 hours.
Some of the other NOACs are once a day and a neighbour who is on Rivaroxaban, which is a once a day dose, split her toe open in the house and as it was when we were all locked in with snow last week, she couldn’t get to A&E, Another neighbour, a nurse, helped but it was 12 hours before the bleeding was stopped completely with compression banadages & elevation.
It made me think about the half life and I decided I liked the Apixaban - because of that - and of course because it isn’t a VitK antagonist - I eat plenty of greens and don’t have to think about what I eat.
Do you happen to know what your INR levels were when the bleed happened?
I am monitored by the Warfarin clinic who informed me when I was there yesterday that there is a national average they are required to go by which is 2-3 INR. A couple of times recently I decided to eat a couple of meals of Kale and also on another occasion some fermented swiss chard?! This sent the readings down to 1.8 and 1.9 respectively. But normally I am within range.
With Apixaban, is there this INR measurement? Or is that only for warfarin?
The bleed was noticed by the optician when I went for a check up a couple of weeks ago which coincidentally was just a few days before my routine six monthly glaucoma check up at the hospital with the glaucoma opthalmologist. ( Apparently they just speialise in the one thing. ie glaucoma, or another opthalmologist would deal only with macular degeneration)
I see him every six months and last saw in July 2017. So it could have happened any time, but the glaucoma opthalmologist would presumably have noticed the bleed. Anyway, they want me in pretty quick on Monday.
so I wouldn't have thought that would be a good idea in your case. However you do need to maintain your INR between 2 and 3 on warfarin. The best way to do that is to get a Coaguchek so you can monitor the results yourself. You do need a relatively steady intake of Vit K. Not go without for some days then have a plateful of chard. Can you have some high Vit K food every day such as chard, broccoli, kale, or spinach?
Yes, I could have some high vitamin K foods every day if I wanted to. The warfarin clinic have increased the warfarin dose to 3 days 7mg and four days 6mg after I told them about what I saw in the Macular Associations nutrition for eyes leaflet and also one from the RNIB. That micronutrients lutein and zeaxanthin are essential for eye health and can only be got through fruit and vegetables. And yes, you guessed it, it is all the kales, collard greens and so on high in vitamin K which are very good. But these fortunately are not the only things and peppers with yellows and orage skin and such coloured vegetables , it is these micronutrients which give them the colour.
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