2nd Mitral Valve Replacement Next Week

[Homeskillet]

Try checking the Anti-coagulation and home testing sites on this board. Anti-coagulants are not a villain. Warfarin has 50 fifty years of successful use. The recently introduced oral anti-coagulants are not suitable for replacement valves only for A-fib. I'm sorry the tissue valve needs replacing do soon.

Excellent. Will do...if I can find them on here.

Thank you.

 

[Homeskillet]

Also read last night that fiber supplementation affects Warfarin ranges.

This could be a huge problem for me since I have taken fiber capsules daily for years now for regularity.

Same thing w. Melatonin drops for sleep.

Just wondering if anyone has any ideas or knows if this is accurate?

Thank you again!

 

[pellicle]

Hi

Also read last night that fiber supplementation affects Warfarin ranges.

can you cite where you read that?
1) always question everything you read especially from fluff sites which promote alternative therapies
2) always seek verification from alternative sources
3) self testing allows you to "know" for yourself ... to my mind any other way of managing INR is like not having a fuel gauge in your car and just relying on knowing when you filled up last and it usually lasts the week to a tank

also, don't worry about INR over much ... its a statistical thing, not a hammer to belt your head in. You won't suddenly turn into a rigid clot or burst out bleeding even if your INR strays one way or the other.

The stroke dick0236 mentioned above in his history was due to a few circumstances which conspired:
* he has an old ball and cage generation valve which are more prone to trigger thrombosis
* he provoked the situation by not taking his pills for an extended period

I think he would be plenty happy to confirm further details about that. We all learn a lot from "accident analysis"

Best Wishes

 

[jwinter]

I do not know about fiber but do take Melatonin occasionally for sleep. The reason I feel safe in using it is because they offered it to me at bedtime when I had my surgery last November at Mayo.

I have ON-X and am on monthly INR testing. Be sure and get your scheduling from your doctor as there are clearly some of us on different schedules here.

 

[dick0236]

No insurance, just VA, which is horrid. Trying to look into a CoaguChek XS, but think a Dr. has to order it for me. I cannot seem to purchase one on-line in the US.

Definitely want to shoot for weekly - or 2x/week - checks.

A stroke is precisely what concerns us until we figure out my INR. My question is, do I just risk a stroke until they get it figured out?

Thank you again.

I am on Medicare. Self-testing was approved by Medicare several years ago and should also be covered by VA.
2x/week is overkill unless there is a serious INR problem.
Stroke risk is normally not that big of a problem while establishing your maintenance dose. INR range spreads allow for a reasonably significant allowance (1.5-2.5, 2-3, 2.5-3.5) depending on valve style and/or doc's preference. My range is 2.5-3.5 but I am not alarmed anywhere between 2-4. My stroke occurred after I had, knowingly, gone several days with NO warfarin....my fault, not the fault of warfarin.

 

[Homeskillet]

Hi

can you cite where you read that?
1) always question everything you read especially from fluff sites which promote alternative therapies
2) always seek verification from alternative sources
3) self testing allows you to "know" for yourself ... to my mind any other way of managing INR is like not having a fuel gauge in your car and just relying on knowing when you filled up last and it usually lasts the week to a tank

also, don't worry about INR over much ... its a statistical thing, not a hammer to belt your head in. You won't suddenly turn into a rigid clot or burst out bleeding even if your INR strays one way or the other.

The stroke dick0236 mentioned above in his history was due to a few circumstances which conspired:
* he has an old ball and cage generation valve which are more prone to trigger thrombosis
* he provoked the situation by not taking his pills for an extended period

I think he would be plenty happy to confirm further details about that. We all learn a lot from "accident analysis"

Best Wishes

Here is the link for regarding the interaction of fiber w. Warfarin:

https://health.ucsd.edu/specialties...s/warfarin/Pages/supplement-interactions.aspx


Again, thank you for all of the info. My mind is slowly starting to ease just a little w. the notion of being on this blood thinner (not like I really have any other option).

 

[Homeskillet]

I do not know about fiber but do take Melatonin occasionally for sleep. The reason I feel safe in using it is because they offered it to me at bedtime when I had my surgery last November at Mayo.

I have ON-X and am on monthly INR testing. Be sure and get your scheduling from your doctor as there are clearly some of us on different schedules here.

Gotcha'! Checking into what kind of mechanical valve they are putting in Wednesday afternoon.

 

[Homeskillet]

I am on Medicare. Self-testing was approved by Medicare several years ago and should also be covered by VA.
2x/week is overkill unless there is a serious INR problem.

Stroke risk is normally not that big of a problem while establishing your maintenance dose. INR range spreads allow for a reasonably significant allowance (1.5-2.5, 2-3, 2.5-3.5) depending on valve style and/or doc's preference. My range is 2.5-3.5 but I am not alarmed anywhere between 2-4. My stroke occurred after I had, knowingly, gone several days with NO warfarin....my fault, not the fault of warfarin.

Ok, just read where several have said they test 2x's/week. I think weekly sounds reasonable if I can just get a self-check machine (which could take a very long time w. the VA).

 

[Homeskillet]

This is precisely the kind of stories that scare us to death (see link below):

http://www.mechanicalheartvalve.co.uk/forum/topics/detached-retina-caused-by-haemovitreous

 

[pellicle]

Hi

This is precisely the kind of stories that scare us to death (see link below):

http://www.mechanicalheartvalve.co.u...-haemovitreous

well I thought that the answers were sober and intelligent. Life is not without risk. Part of the maturation of our lives is to realise that life is risk. There are risks everywhere. It is only in the mind of a child that "everything will be OK" and God will save us. One only has to have your partner die of cancer or be born in a place like Yemen to see that.

The risks are there, I'd be curious to know what the AC therapy was (Spain has funny ideas with which agent they use and my experience is that it has a short half life and is hart to manage (and yes I've had a request here from a Spanish woman to assist her daughter living in the UK with her INR management some years back, so actual experience).

Lastly she had not lost her eye ... just had bloodshot eyes as I read it. It is unclear if warfarin actually caused it (doubtful) or simply exacerbated it (likely) ... her INR checking frequency is not mentioned ... were it multiple weeks or months between checks her INR could well have been higher than she thought at the time of incident. Speculation because that's not detailed.

Its good to be informed, but always think about what you're reading, its not just a horror story ... conisder everything with a Sherlock Holmes eye.



Have a listen to this quote from a movie ... I think its applicable (from about 30 seconds to about 2 min). Marlin Brandos monologue on confronting and dealing with difficulty

[video=youtube;W-mgdUdOjhs]https://www.youtube.com/watch?v=W-mgdUdOjhs[/video]

 

[Homeskillet]

Hi



well I thought that the answers were sober and intelligent. Life is not without risk. Part of the maturation of our lives is to realise that life is risk. There are risks everywhere. It is only in the mind of a child that "everything will be OK" and God will save us. One only has to have your partner die of cancer or be born in a place like Yemen to see that.

The risks are there, I'd be curious to know what the AC therapy was (Spain has funny ideas with which agent they use and my experience is that it has a short half life and is hart to manage (and yes I've had a request here from a Spanish woman to assist her daughter living in the UK with her INR management some years back, so actual experience).

Lastly she had not lost her eye ... just had bloodshot eyes as I read it. It is unclear if warfarin actually caused it (doubtful) or simply exacerbated it (likely) ... her INR checking frequency is not mentioned ... were it multiple weeks or months between checks her INR could well have been higher than she thought at the time of incident. Speculation because that's not detailed.

Its good to be informed, but always think about what you're reading, its not just a horror story ... conisder everything with a Sherlock Holmes eye.



Have a listen to this quote from a movie ... I think its applicable (from about 30 seconds to about 2 min). Marlin Brandos monologue on confronting and dealing with difficulty

[video=youtube;W-mgdUdOjhs]https://www.youtube.com/watch?v=W-mgdUdOjhs[/video]

Gotcha'. Well, she claims her INR was in range, which was the alarming factor in her scenario.

Thanks for the insight though.

 

[Homeskillet]

Okay, I will try to let this be the last question gang (don't mean to be a nuisance):

Is there any particular shaving cream, razor or method that would help in not cutting myself while shaving? I almost always nick myself shaving, esp. around my upper lip area.

Also read that I should not use toothpicks since they can quickly cut the mouth. And, that I should make sure to use waxed floss?

Thanks so much!

 

[pellicle]

I'll try to answer both posts in one
firstly you are not being a nuisance ... if you feel a need to ask you should ask. I encourage you to write your questions (even after you've written them here) in a note of some sort and take that with you next you see your surgeon to ask and assist your decision making. Consider the various answers here and see which feels right for you.

Your surgery is soon yes?

Gotcha'. Well, she claims her INR was in range, which was the alarming factor in her scenario.

Her INR was in range as measured when?? Like if you are pulled over for speeding and the police man says you were speeding and you say you weren't. He then says to you, not while he was following you but the aircraft above measured your speed 20 minutes ago and he'd just caught up with you.

Next its not an alarming factor because we have no evidence that she would not have had exactly that problem without being on Warfarin. Sure she was but we have no knowledge if that was any cause or just a contributor. Warfarin does not cause bleeds, if you were not prone to them before you will not be prone to them now. Warfarin just exacerbates bleeds. Its as simple as that.

There was no mention of when the measurements were taken. She may have been in range at the time the bleed started, she may not. We just don't know.

As to tooth picks I never use them anyway. I do instead use waxed floss (which I've always used in my life) and "picksters". Nothing however beats a scale and clean from a good dental hygenist at least yearly. There is subginival plaque build up and that's like a coral reef for bacteria.

Small mouth cuts aren't really the issue. its the subgingival stuff.

See my post here: http://www.valvereplacement.org/foru...972#post867972

and Agians post just 2 down from that ...

 

[Warrick]

Okay, I will try to let this be the last question gang (don't mean to be a nuisance):

Is there any particular shaving cream, razor or method that would help in not cutting myself while shaving? I almost always nick myself shaving, esp. around my upper lip area.

Also read that I should not use toothpicks since they can quickly cut the mouth. And, that I should make sure to use waxed floss?

Thanks so much!

I use Gillette razors and think I might have nicked myself once in the last 18 months, I use Palmolive gell thats in a tube rather than foam in a can, I use a brush and I find it doesn't dry out (or is "wetter" on your face) as much

just before my op my Dad (he also has a mechanical valve) told me I would have to buy an electric razor now, I was like why?

I don't like shaving in general and dislike electric razors so have stuck with a blade, I prefer to go 4-5 days between shaves and then I find as it's longer it's easier and I don't get the irritation and I think it lessens the chance of nicks, but I guess you may need to shave everyday for work etc, maybe go electric

 

[Homeskillet]

I'll try to answer both posts in one
firstly you are not being a nuisance ... if you feel a need to ask you should ask. I encourage you to write your questions (even after you've written them here) in a note of some sort and take that with you next you see your surgeon to ask and assist your decision making. Consider the various answers here and see which feels right for you.

Your surgery is soon yes?




Her INR was in range as measured when?? Like if you are pulled over for speeding and the police man says you were speeding and you say you weren't. He then says to you, not while he was following you but the aircraft above measured your speed 20 minutes ago and he'd just caught up with you.

Next its not an alarming factor because we have no evidence that she would not have had exactly that problem without being on Warfarin. Sure she was but we have no knowledge if that was any cause or just a contributor. Warfarin does not cause bleeds, if you were not prone to them before you will not be prone to them now. Warfarin just exacerbates bleeds. Its as simple as that.

There was no mention of when the measurements were taken. She may have been in range at the time the bleed started, she may not. We just don't know.

As to tooth picks I never use them anyway. I do instead use waxed floss (which I've always used in my life) and "picksters". Nothing however beats a scale and clean from a good dental hygenist at least yearly. There is subginival plaque build up and that's like a coral reef for bacteria.

Small mouth cuts aren't really the issue. its the subgingival stuff.

See my post here: http://www.valvereplacement.org/foru...972#post867972

and Agians post just 2 down from that ...

Excellent points all around...esp. the point analogy about coral reef & plaque build-up. Personally, I plan on getting my teeth cleaned at least every 6 mos. Just dread the Lovenox shots.

Was also thinking tonight that I might do well to inform my barbers that I am on Coumadin after the surgery?

I have included several notes to ask the surgeon Wednesday. Surgery is Thursday morning. Little to no sleep between now & then.

Will have to be tomorrow night around same time before I can respond.

This site is simply a God-send to us right now.

 

[Homeskillet]

I use Gillette razors and think I might have nicked myself once in the last 18 months, I use Palmolive gell thats in a tube rather than foam in a can, I use a brush and I find it doesn't dry out (or is "wetter" on your face) as much

just before my op my Dad (he also has a mechanical valve) told me I would have to buy an electric razor now, I was like why?

I don't like shaving in general and dislike electric razors so have stuck with a blade, I prefer to go 4-5 days between shaves and then I find as it's longer it's easier and I don't get the irritation and I think it lessens the chance of nicks, but I guess you may need to shave everyday for work etc, maybe go electric

Got it. Funny thing is, personally, the electric razors cut me worse than a hand-held razor! And yes, I do have to shave every day.

I would surmise that the key is to keep the face as wet as possible & get in the habit of going as gentle as possible. I sure wish there was a specific razor known to not nick as much.

Back tomorrow night gang. Thanks again!

 

[pellicle]

I would surmise that the key is to keep the face as wet as possible & get in the habit of going as gentle as possible. I sure wish there was a specific razor known to not nick as much.

myself I've gone through a few razors to find one that works. I am now sworn to the Shick Exacta 2 disposable.

I found that any of the pivot head ones "juddered" at some point resulting in a nick. I prefer to countour as I shave manually.

I also adjusted my style so that I (carefuly) go slightly sideways as I am going down. DO NOT start going sideways (of course) or you'll get a nick.

I usually wet the lube strip first (to allow it time to soak up some water and start lubing) and use plain unscented soap not any of the Gels or creams.

These days I don't shave from the chin up, so tend to look like this:
[IMG2=JSON]{"data-align":"none","data-size":"full","src":"https:\/\/c1.staticflickr.com\/3\/2013\/32944036156_6c9bb6b348_z.jpg"}[/IMG2]

but the neck was always where I'd nick the most anyway ... which bled on my collar (when I used to need a collared shirt when I was going to work)

I noted zero difference before and after warfarin.

"Norman Gunsten" can provide clues on how to stop the bleeds with his famous dunny paper trick:
[IMG2=JSON]{"data-align":"none","data-size":"full","src":"https:\/\/i.ytimg.com\/vi\/3ZiacKbOAqw\/hqdefault.jpg"}[/IMG2]

 

[dick0236]

Excellent points all around...esp. the point analogy about coral reef & plaque build-up. Personally, I plan on getting my teeth cleaned at least every 6 mos. Just dread the Lovenox shots.

lso thinking tonight that I might do well to inform my barbers that I am on Coumadin after the surgery?


Why will you need Lovenox shots for a dental cleaning? I get my teeth cleaned twice per year and have never had a need for anything like Lovenox. In fact, after 50 years on warfarin, I have never found it necessary to inject myself with Lovenox......for any reason. The only med I use prior to invasive dental work is 2000mg Amoxicillin, an anti-biotic.

Why tell your barber?......unless he/she gives you a shave with a straight razor.....and he/she is very old and shaky... If you tell him/her I guarantee they will scared to death and will surely cut you....LOL

Me thinks you are giving warfarin way too much credit for causing uncontrolled bleeding. BTW, I used to use a little toilet paper to help clot the shaving cuts. Now that I'm retired I use an electric shaver......completely solved the "nic" problem.

 

[pellicle]

Dick

Why will you need Lovenox shots for a dental cleaning?
...
Why tell your barber?..

I read these sorts of things here from time to time and wonder what the hell medical people tell people (patients) ...
dunno (shakes head) ... so much misinformation out there

 

[Homeskillet]

myself I've gone through a few razors to find one that works. I am now sworn to the Shick Exacta 2 disposable.

I found that any of the pivot head ones "juddered" at some point resulting in a nick. I prefer to countour as I shave manually.

I also adjusted my style so that I (carefuly) go slightly sideways as I am going down. DO NOT start going sideways (of course) or you'll get a nick.

I usually wet the lube strip first (to allow it time to soak up some water and start lubing) and use plain unscented soap not any of the Gels or creams.

These days I don't shave from the chin up, so tend to look like this: [IMG2=JSON]{"data-align":"none","data-size":"full","src":"https:\/\/c1.staticflickr.com\/3\/2013\/32944036156_6c9bb6b348_z.jpg"}[/IMG2]



but the neck was always where I'd nick the most anyway ... which bled on my collar (when I used to need a collared shirt when I was going to work)

I noted zero difference before and after warfarin.

"Norman Gunsten" can provide clues on how to stop the bleeds with his famous dunny paper trick: [IMG2=JSON]{"data-align":"none","data-size":"full","src":"https:\/\/i.ytimg.com\/vi\/3ZiacKbOAqw\/hqdefault.jpg"}[/IMG2]

Got some Schick razors today, along w. a special lubricating cream designed to avoid nicks.

Also just purchased $200 worth of bandages & wound sealant designed specifically for anti-coagulant users here:

https://www.amazon.com/Biolife-LLC-WoundSeal-Powder-ea/dp/B006FZ5IQK?th=1


May be a bunch of hooey, but, I suppose it can't hurt?

I have read where some warfarin users have stated that they noticed no differences in small scrapes, etc. Have also read where many others have stated that they could definitely see a diff. after on warfarin. I'm thinking it's all according to the individual?

Surgery in less than 48 hrs. Meeting w. surgeon tomorrow to grill him w. some hard questions before surgery. Thank you again!