On-X Aortic Heart Valves: Safer with Less Warfarin On-X Aortic Heart Valves: Safer with Less Warfarin

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  • Random Questions from a New Coumadin User

    First, I cannot say how helpful this site has been. Much appreciated. Am now 2 weeks post-op. w. an ON-X mitral valve. I have a few questions to ask of those far more learned in this topic than I am. I freely admit that after reading some of these threads my nerves tick up quite a bit about the possibility of stroke (which has always been my worst nightmare). And, to be perfectly transparent, I currently waffle between anger, depression & acceptance. Thus, a few pin-pointed questions:

    1. How critical is it that I take the Coumadin at the same time each night (when I take mine personally). I pastor a church & am very frequently out late at night after meetings, counseling, etc. It is really going to be hard to take it at the exact same time each night. However, if I take it when I wake up, I will have the same problem since I may wake up at 9:00 a.m. or 11:00 a.m. (I am an extreme night owl). I guess my question is, how much "grace" time do I have from day to day? 1, 2, 3 hours...or 30 min.?

    2. As I asked on another thread, let's say I go for 2 weeks w. no cookies, cokes, chocolate, etc. Then, one night I get a hunkering for some & go all out. Is this going to throw my INR way out of whack? Or, are they only worried about leafy greens rich in vitamin K?

    3. I have read that it is important to remain hydrated on Coumadin. Fact or myth?

    4. Though some may laugh at this, I have spent a total of approx. $500 on blood sealant powders, nose plugs, coban wrap & sterile gauze. I have put them in zip-lock bags & put them in both vehicles, my gym bag, our bathroom & kitchen. But, what do I do if I start rectal bleeding? I have read no tips on how to stop that?

    5. Will fasting for religious purposes affect my INR? To illustrate, I usually eat no food at all for 24 hours, then resume my regular eating habits. If I did this once or twice per week will this cause problems, or is this a no-no altogether?

    6. I have never been one to eat greens anyway & actually despise salads personally. So, the vitamin K issue is really a non-issue for my anyway. But, what other foods are rich in vitamin K that we might not usually consider to be so?

    Finally, my surgeon stated to me that because of the ON-X valve, in a few months he hopes to shoot for a lower target INR range. My range is currently at 2.5-3.5. I am anticipating it to be much higher tomorrow since I've been bridging w. Lovonox & taking a Coumadin dosage of 11.25 for the last 3 nights (I have been stalled at 2.1 for several days).

    My question is, I have read that an INR below 2.0 is asking for a stroke, but am wondering if this is still considered the case w. the ON-X mitral valve?

    Thank you again for taking the time to educate me on these topics. Tremendous information on here!

  • #2
    Oh, also, the home testing thing seems to be quite a ways off in the distance & thus I am currently at the mercy of the Coumadin Clinic, who does not seem too adamant at all regarding weekly testing. Have no earthly idea how I will get this going?

    And, if-when I do acquire a home testing kit, how-where do I get the machine calibrated, what size strips, where to buy them, how to use, how accurate compared to clinic results, etc.

    Honestly, it just seems like soooo much of a lifestyle adjustment at this point. Was so depressed last night I just laid back in the recliner & went to sleep early.

    But, I really had little-to-no other choice than to go w. a mechanical valve this time around (had a tissue valve placed back in Oct. 2015 - & it failed in a year and a half!).

    Comment


    • #3
      I am surprised that your Coumadin Clinic is not testing you more frequently - considering that you had your surgery so recently. I bought my meter and test strips 6 weeks post OP on Ebay/Amazon and stopped going to the clinic after 3 months. There is only one product available - the Coagucheck XS. This is a great device from Roche (actually made in Germany) that requires no calibration. My Coumadin clinic used it as well so I observed how they tested me and knew exactky how to test myself - which saves me time and money. I have a HSA with a high deductible and buying my own supplies is the most cost effective solution.

      Comment


      • #4
        Originally posted by Juli View Post
        I am surprised that your Coumadin Clinic is not testing you more frequently - considering that you had your surgery so recently. I bought my meter and test strips 6 weeks post OP on Ebay/Amazon and stopped going to the clinic after 3 months. There is only one product available - the Coagucheck XS. This is a great device from Roche (actually made in Germany) that requires no calibration. My Coumadin clinic used it as well so I observed how they tested me and knew exactky how to test myself - which saves me time and money. I have a HSA with a high deductible and buying my own supplies is the most cost effective solution.
        I called them tonight & left them a message, but I am almost certain that I have to have a Drs. order to get the machine?

        Did not know the Coagucheck XS did not have to be calibrated every 3 months. Good to know.

        Thank you for the response!

        Comment


        • #5
          Originally posted by Homeskillet View Post
          but I am almost certain that I have to have a Drs. order to get the machine?
          from what little I know of the American system - only if you want to claim it on insurance.


          Did not know the Coagucheck XS did not have to be calibrated every 3 months. Good to know.
          not intended as any sort of disparaging remark, but it seems to me that almost everything you "knew" about warfarin and monitoring was wrong ... so did you want to just write it out now so we can go though and clear up further misconceptions?

          I mean with "knowledge" like this out there its no wonder people can't make informed decisions (and I'm certain you aren't alone there)

          Comment


          • #6
            [

            1. How critical is it that I take the Coumadin at the same time each night (when I take mine personally). I pastor a church & am very frequently out late at night after meetings, counseling, etc. It is really going to be hard to take it at the exact same time each night. However, if I take it when I wake up, I will have the same problem since I may wake up at 9:00 a.m. or 11:00 a.m. (I am an extreme night owl). I guess my question is, how much "grace" time do I have from day to day? 1, 2, 3 hours...or 30 min.?

            *I've been told that its simply better to take at the same time everyday so you remember, I guess you could carry your days dose with you? Sometimes I might go 4-5 hours past my normal time of 6.30pm and I've never noticed an apreciable difference

            2. As I asked on another thread, let's say I go for 2 weeks w. no cookies, cokes, chocolate, etc. Then, one night I get a hunkering for some & go all out. Is this going to throw my INR way out of whack? Or, are they only worried about leafy greens rich in vitamin K?

            *I think it's only vit K that you will notice, if I haven't had any substanial veges for several days I certainly see a change in my INR going up, but generally its like 0.2-0.6 up, it's not like it's going to sky rocket over 4.0 or more I don't think

            3. I have read that it is important to remain hydrated on Coumadin. Fact or myth?

            *Don't know whether warfarin makes a difference but dehydration headaches aren't nice so I can't see how warfarin would change that, warfarin is affecting clotting time remember not actually blood "thinner" where as dehydration headaches is actually from thicker blood from what I understand

            4. Though some may laugh at this, I have spent a total of approx. $500 on blood sealant powders, nose plugs, coban wrap & sterile gauze. I have put them in zip-lock bags & put them in both vehicles, my gym bag, our bathroom & kitchen. But, what do I do if I start rectal bleeding? I have read no tips on how to stop that?

            *I haven't read tips on that either and I hope to never need them, from what I understand you have to have a massively high INR for this to happen unless you have other problems internally, I have had an INR of 7.7 and had no bleeding anywhere, I remember reading an article from a doctor that said he had picked up early cancers in some of his patients on warfarin because of bleeding, so perhaps a blessing in disguise in some cases.

            5. Will fasting for religious purposes affect my INR? To illustrate, I usually eat no food at all for 24 hours, then resume my regular eating habits. If I did this once or twice per week will this cause problems, or is this a no-no altogether?

            * My guess is fasting could have an affect as theres no vit K intake, others may know more, thats where regular testing would tell you how your body would react to it, it's like alcohol affects some INRs greatly and others it doesn't , so everyones different

            6. I have never been one to eat greens anyway & actually despise salads personally. So, the vitamin K issue is really a non-issue for my anyway. But, what other foods are rich in vitamin K that we might not usually consider to be so?

            * not sure on this , I think it's in most fruit and veges but google will tell you, I think cranberry juice and grapefruit juice can be big influences
            all I can advise is eat your normall diet, thats all I ever do

            Finally, my surgeon stated to me that because of the ON-X valve, in a few months he hopes to shoot for a lower target INR range. My range is currently at 2.5-3.5. I am anticipating it to be much higher tomorrow since I've been bridging w. Lovonox & taking a Coumadin dosage of 11.25 for the last 3 nights (I have been stalled at 2.1 for several days).

            *from what I understand only the warfarin will affect an INR because Lovenox works on the bloods clotting in a different way
            just found this old post that should answer this http://www.valvereplacement.org/foru...x-shots-on-inr

            My question is, I have read that an INR below 2.0 is asking for a stroke, but am wondering if this is still considered the case w. the ON-X mitral valve?

            *if you can find Pellicles blog he has some very neat stuff on the considered danger sides of too low and too high INRs, sorry I don't know much on the on-x

            From what I understand the coag XS does not need calibrated, someone can correct me if I'm wrong but each strip self calibrates everytime the machine is used,

            if you read the stuff on the coag website it mentions on board calibration etc, I think there is the odd crook strip but the machine gives you an error code and the strip is wasted which can be frustrating

            Thank you again for taking the time to educate me on these topics. Tremendous information on here!
            [/SIZE][/COLOR][/B][/QUOTE]
            27mm St Jude mechanical AVR, mitral valve repaired.Surgery 4th Nov15 at 39 yrs old. Bicuspid Aorta.40 yrs old.Sternal wires removed 28th Oct 16.

            Comment


            • #7
              well done sir!

              if I may (as you've done a great job with this) I'll just add some thoughts of my own (for out of the frying pan into the skillet's benefit)

              So Homeskillet keep in mind you are getting warfarin, not ebola ... millions of americans are on this daily and you don't read of blood baths occuring.


              Originally posted by Warrick View Post

              1. How critical is it that I take the Coumadin at the same time each night (when I take mine personally). ay? 1, 2, 3 hours...or 30 min.?

              *I've been told that its simply better to take at the same time everyday so you remember, I guess you could carry your days dose with you? Sometimes I might go 4-5 hours past my normal time of 6.30pm and I've never noticed an apreciable difference
              agreed ... but if you start to shift 12 hours to and fro expect a few minor fluctuations but its something I do from time to time (like when I fly places)


              2. As I asked on another thread, let's say I go for 2 weeks w. no cookies, cokes, chocolate, etc. Then, one night I get a hunkering for some & go all out. Is this going to throw my INR way out of whack? Or, are they only worried about leafy greens rich in vitamin K?

              *I think it's only vit K that you will notice, if I haven't had any substanial veges for several days I certainly see a change in my INR going up, but generally its like 0.2-0.6 up, it's not like it's going to sky rocket over 4.0 or more I don't think
              agreed, although stuff like grapefruit juice can have an effect not because its vitamin K but because its one of the very few foods which interfere with the P450 pathway for disposal of warfarin from the system. If you think about it like pouring warfarin (pretend its water) into a bucket with a hole, you want to maintain a similar level in the bucket so you need to tip in water to get that level and then adjust the rate so that additions balance leaking out the hole. Grapefruit juice essentially plugs the hole in the bucket

              3. I have read that it is important to remain hydrated on Coumadin. Fact or myth?
              never heard that one before ... never experienced any difference before or after ... as its not a dieruetic I can't see any basis in biology for that. Water has to go somewhere if its going to dehydrate you ... which means if you don't sweat more, piss more of breath steam its not gone anywhere.


              4. Though some may laugh at this, I have spent a total of approx. $500 on blood sealant powders, nose plugs, coban wrap & sterile gauze. I have put them in zip-lock bags & put them in both vehicles, my gym bag, our bathroom & kitchen. But, what do I do if I start rectal bleeding? I have read no tips on how to stop that?
              I'm one of the people who can't believe it, and as to rectal bleeding is this common for you now? Warfarin does not "cause" bleeds, it just makes bleeds last longer. If you've never had blood coming out of your arse before you probably won't now. If you (on the other hand) do regularly have rectal bleeds you should mention this to your doctor. I was just talking to someone else about anal sex and INR the other day as it happens. (sorry about the keyboard Steve).


              5. Will fasting for religious purposes affect my INR? To illustrate, I usually eat no food at all for 24 hours, then resume my regular eating habits. If I did this once or twice per week will this cause problems, or is this a no-no altogether?
              no


              6. I have never been one to eat greens anyway & actually despise salads personally. So, the vitamin K issue is really a non-issue for my anyway. But, what other foods are rich in vitamin K that we might not usually consider to be so?
              essentially if its not green ... it doesn't have it.


              Finally, my surgeon stated to me that because of the ON-X valve, in a few months he hopes to shoot for a lower target INR range. My range is currently at 2.5-3.5. I am anticipating it to be much higher tomorrow since I've been bridging w. Lovonox & taking a Coumadin dosage of 11.25 for the last 3 nights (I have been stalled at 2.1 for several days).

              *from what I understand only the warfarin will affect an INR because Lovenox works on the bloods clotting in a different way
              correct ...


              My question is, I have read that an INR below 2.0 is asking for a stroke, but am wondering if this is still considered the case w. the ON-X mitral valve?
              its a statistical thing ... there are many cases of people who have gone to an ER with heart problems to find that 1) its caused by a blockage in the valve 2) they have not had any anticoagulants for over a year 3) they had no symptoms except for build up of blood clots gradually obstructing the valve. Indeed it was this evidence which formed a view that AC therapy can be reduced.

              So while having an INR below (say) 1.5 increases your chances of a clot you won't have one straight away ... depending on a number of factors. Consider "walking across the street without looking" ... depending on traffic density you may not get hit, you may just get the horn blown at you (which would be a TIA) or have nothing happen at all


              From what I understand the coag XS does not need calibrated, someone can correct me if I'm wrong but each strip self calibrates everytime the machine is used,
              that is correct

              if you read the stuff on the coag website it mentions on board calibration etc, I think there is the odd crook strip but the machine gives you an error code and the strip is wasted which can be frustrating
              never heard of that

              Best Wishes

              Comment


              • #8
                Originally posted by Guest View Post
                ... I've been bridging w. Lovonox & taking a Coumadin dosage of 11.25 for the last 3 nights (I have been stalled at 2.1 for several days).
                I think I may have mentioned this earlier, but why are they not simply increasing your dose of warfarin with respect to the lack of increase. The most basic rule is to adjust dose to achieve the INR desired. If the INR isn't going up, after a few days, it means you need to adjust the dose up.

                Also, with respect to the rectal bleeds, some Google searching has suggested that first aid approach would be to use a tampon to control the bleeding before getting to hospital. Don't leave it in too long (it is first aid after all) as you may get toxic shock syndrome.

                epstns (WARNING: coffee spurt alert) I found this link on Google Books referring to procedures to control rectal bleeds post prostate ultrasound (so, not like Yahoo.Gay.Life.Arse.Bleeds, something with an ounce of veracity)

                Comment


                • #9
                  Originally posted by Guest View Post
                  4. Though some may laugh at this, I have spent a total of approx. $500 on blood sealant powders, nose plugs, coban wrap & sterile gauze. I have put them in zip-lock bags & put them in both vehicles, my gym bag, our bathroom & kitchen. But, what do I do if I start rectal bleeding? I have read no tips on how to stop that?
                  I won't take the whole thing on, because others have done a fine job. Forgive me, but I'm taking this as permission to laugh at this one! Bright side is, as long as the expiration dates are far out, you should be well stocked for a long, long time! Geez, I don't think I've used $500 worth of supplies stopping bleeds since I started this drug over 26 years ago! I don't even have a styptic pencil anymore, and I shave manually.

                  If they won't last, I would go through and see what you can return. Probably $450 worth, if you didn't already have a normal first aid kit at home.

                  If I ever get a nose bleed (which is no more or less frequent than anyone else in the house), I use that great blood stopper called Kleenex. Can't remember the last time I cut myself shaving, but if a small nick, Kleenex till it stops! In the event of an injury, maybe a little bigger bandage since it might bleed a little longer? If it needs stitches, it needs stitches. That wouldn't change whether or not warfarin was involved.

                  You keep saying "ER". Don't you have "urgent care" facilities in your area? A lot cheaper, and can deal with most minor things. Only time I go to ER is if A.) patient is not responsive (not necessarily me), B.) urgent care sends me there, or C) urgent care is closed.

                  10/15/2009 - St. Jude Medical Valve / Conduit Graft 25mm. Dr. Robert Hooker Jr at Meijer Heart Center, Spectrum Health Butterworth Hospital, Grand Rapids, MI.

                  September 2009 - diagnosed with 4.9 cm ascending aorta with two aneurysm bulges.

                  11/21/1990 - St. Jude Medical Valve 23A-101. Dr. Seong Chi at Ingham Regional Medical Center, Lansing, MI.

                  Aortic Stenosis and BAV diagnosed in infancy.

                  Comment


                  • #10
                    I agree with everything Warricl and Pellicle posted above. I'll only add:

                    1. Self-test if you can.....if not, go to a lab that is dedicated to INR testing, such as in a cardiologist office. General labs have limited and often questionable info.

                    2. Remember that you are in the minority when it come to using warfarin. 80-85% of warfarin patients are on it for a-fib or other blood disorders....that means they are generally elderly, poorly educated on using warfarin and are on a ton of other medications (prescribed by several different MDs), making INR management more difficult.

                    3. Millions live successfully with diabetes by adjusting some personal habits and testing (finger sticks) frequently.......mechanical valve patients can too.
                    Starr-Edwards mechanical AVR 1967 at age 31.....University of Kentucky Med. Ctr., Drs. Richard Wood & Gordon Danielson surgeons. No surgery (heart or otherwise) since. On Warfarin ACT since surgery with no diet, lifestyle, or activity restrictions....and I live one day at a time.

                    Comment


                    • #11
                      Originally posted by Superman View Post

                      Can't remember the last time I cut myself shaving, but if a small nick, Kleenex till it stops! In the event of an injury, maybe a little bigger bandage since it might bleed a little longer?
                      T​​​​'is but a scratch...

                      Comment


                      • #12
                        Originally posted by pellicle View Post

                        T​​​​'is but a scratch...

                        "No worries! Just a flesh wound!"
                        10/15/2009 - St. Jude Medical Valve / Conduit Graft 25mm. Dr. Robert Hooker Jr at Meijer Heart Center, Spectrum Health Butterworth Hospital, Grand Rapids, MI.

                        September 2009 - diagnosed with 4.9 cm ascending aorta with two aneurysm bulges.

                        11/21/1990 - St. Jude Medical Valve 23A-101. Dr. Seong Chi at Ingham Regional Medical Center, Lansing, MI.

                        Aortic Stenosis and BAV diagnosed in infancy.

                        Comment


                        • #13
                          Someone mentioned using their HSA for strips. If you buy them off of Amazon and EBay? Will your HSA admin accept those receipts?

                          Comment


                          • #14
                            Originally posted by Warrick View Post
                            [

                            1. How critical is it that I take the Coumadin at the same time each night (when I take mine personally). I pastor a church & am very frequently out late at night after meetings, counseling, etc. It is really going to be hard to take it at the exact same time each night. However, if I take it when I wake up, I will have the same problem since I may wake up at 9:00 a.m. or 11:00 a.m. (I am an extreme night owl). I guess my question is, how much "grace" time do I have from day to day? 1, 2, 3 hours...or 30 min.?

                            *I've been told that its simply better to take at the same time everyday so you remember, I guess you could carry your days dose with you? Sometimes I might go 4-5 hours past my normal time of 6.30pm and I've never noticed an apreciable difference

                            2. As I asked on another thread, let's say I go for 2 weeks w. no cookies, cokes, chocolate, etc. Then, one night I get a hunkering for some & go all out. Is this going to throw my INR way out of whack? Or, are they only worried about leafy greens rich in vitamin K?

                            *I think it's only vit K that you will notice, if I haven't had any substanial veges for several days I certainly see a change in my INR going up, but generally its like 0.2-0.6 up, it's not like it's going to sky rocket over 4.0 or more I don't think

                            3. I have read that it is important to remain hydrated on Coumadin. Fact or myth?

                            *Don't know whether warfarin makes a difference but dehydration headaches aren't nice so I can't see how warfarin would change that, warfarin is affecting clotting time remember not actually blood "thinner" where as dehydration headaches is actually from thicker blood from what I understand

                            4. Though some may laugh at this, I have spent a total of approx. $500 on blood sealant powders, nose plugs, coban wrap & sterile gauze. I have put them in zip-lock bags & put them in both vehicles, my gym bag, our bathroom & kitchen. But, what do I do if I start rectal bleeding? I have read no tips on how to stop that?

                            *I haven't read tips on that either and I hope to never need them, from what I understand you have to have a massively high INR for this to happen unless you have other problems internally, I have had an INR of 7.7 and had no bleeding anywhere, I remember reading an article from a doctor that said he had picked up early cancers in some of his patients on warfarin because of bleeding, so perhaps a blessing in disguise in some cases.

                            5. Will fasting for religious purposes affect my INR? To illustrate, I usually eat no food at all for 24 hours, then resume my regular eating habits. If I did this once or twice per week will this cause problems, or is this a no-no altogether?

                            * My guess is fasting could have an affect as theres no vit K intake, others may know more, thats where regular testing would tell you how your body would react to it, it's like alcohol affects some INRs greatly and others it doesn't , so everyones different

                            6. I have never been one to eat greens anyway & actually despise salads personally. So, the vitamin K issue is really a non-issue for my anyway. But, what other foods are rich in vitamin K that we might not usually consider to be so?

                            * not sure on this , I think it's in most fruit and veges but google will tell you, I think cranberry juice and grapefruit juice can be big influences
                            all I can advise is eat your normall diet, thats all I ever do

                            Finally, my surgeon stated to me that because of the ON-X valve, in a few months he hopes to shoot for a lower target INR range. My range is currently at 2.5-3.5. I am anticipating it to be much higher tomorrow since I've been bridging w. Lovonox & taking a Coumadin dosage of 11.25 for the last 3 nights (I have been stalled at 2.1 for several days).

                            *from what I understand only the warfarin will affect an INR because Lovenox works on the bloods clotting in a different way
                            just found this old post that should answer this http://www.valvereplacement.org/foru...x-shots-on-inr

                            My question is, I have read that an INR below 2.0 is asking for a stroke, but am wondering if this is still considered the case w. the ON-X mitral valve?

                            *if you can find Pellicles blog he has some very neat stuff on the considered danger sides of too low and too high INRs, sorry I don't know much on the on-x

                            From what I understand the coag XS does not need calibrated, someone can correct me if I'm wrong but each strip self calibrates everytime the machine is used,

                            if you read the stuff on the coag website it mentions on board calibration etc, I think there is the odd crook strip but the machine gives you an error code and the strip is wasted which can be frustrating

                            Thank you again for taking the time to educate me on these topics. Tremendous information on here!
                            [/SIZE][/COLOR][/B]
                            [/QUOTE]

                            Exactly what I was looking for Warrick! Felt better after reading this.

                            Thank you much!

                            Comment


                            • #15
                              Originally posted by pellicle View Post
                              well done sir!

                              if I may (as you've done a great job with this) I'll just add some thoughts of my own (for out of the frying pan into the skillet's benefit)

                              So Homeskillet keep in mind you are getting warfarin, not ebola ... millions of americans are on this daily and you don't read of blood baths occuring.




                              agreed ... but if you start to shift 12 hours to and fro expect a few minor fluctuations but its something I do from time to time (like when I fly places)




                              agreed, although stuff like grapefruit juice can have an effect not because its vitamin K but because its one of the very few foods which interfere with the P450 pathway for disposal of warfarin from the system. If you think about it like pouring warfarin (pretend its water) into a bucket with a hole, you want to maintain a similar level in the bucket so you need to tip in water to get that level and then adjust the rate so that additions balance leaking out the hole. Grapefruit juice essentially plugs the hole in the bucket



                              never heard that one before ... never experienced any difference before or after ... as its not a dieruetic I can't see any basis in biology for that. Water has to go somewhere if its going to dehydrate you ... which means if you don't sweat more, piss more of breath steam its not gone anywhere.




                              I'm one of the people who can't believe it, and as to rectal bleeding is this common for you now? Warfarin does not "cause" bleeds, it just makes bleeds last longer. If you've never had blood coming out of your arse before you probably won't now. If you (on the other hand) do regularly have rectal bleeds you should mention this to your doctor. I was just talking to someone else about anal sex and INR the other day as it happens. (sorry about the keyboard Steve).




                              no




                              essentially if its not green ... it doesn't have it.




                              correct ...




                              its a statistical thing ... there are many cases of people who have gone to an ER with heart problems to find that 1) its caused by a blockage in the valve 2) they have not had any anticoagulants for over a year 3) they had no symptoms except for build up of blood clots gradually obstructing the valve. Indeed it was this evidence which formed a view that AC therapy can be reduced.

                              So while having an INR below (say) 1.5 increases your chances of a clot you won't have one straight away ... depending on a number of factors. Consider "walking across the street without looking" ... depending on traffic density you may not get hit, you may just get the horn blown at you (which would be a TIA) or have nothing happen at all




                              that is correct



                              never heard of that

                              Best Wishes
                              Okay, now I feel like I'm getting some real time answers w. all of these posts. Have already read this several times.

                              Comment

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