Meat valve & warfarin
- Thread starter ChouDoufu
- Start date
Help Support Valve Replacement Forums:
K
Karlynn
Your feelings about large doses don't bother me. I think what bothers me is the fact that your fear has probably been initiated, in part, by a general medical community that still speaks about warfarin like it's a drug of last resort because you can bleed to death on it. What they don't tell people is that it is also in the top 5 most prescribed drugs in the US. So if it were as dangerous as our behind-the-times medical community would have us all think, it would be prescribed only in rare circumstances.
I think if we found out that it also helps people lose weight (and I'm exhibit A that it doesn't
) I think we'd see a real shift in attitude.But now on to Ross' sex topic....
Ross
Well-known member
K
Karlynn
This falls under the "tell me something I don't know" catagory.
Jkm7
Well-known member
Your feelings about large doses don't bother me. I think what bothers me is the fact that your fear has probably been initiated, in part, by a general medical community that still speaks about warfarin like it's a drug of last resort because you can bleed to death on it. What they don't tell people is that it is also in the top 5 most prescribed drugs in the US. So if it were as dangerous as our behind-the-times medical community would have us all think, it would be prescribed only in rare circumstances.
I think if we found out that it also helps people lose weight (and I'm exhibit A that it doesn't
But now on to Ross' sex topic....
It's fine my feelings don't bother you.
They don't have to, of course.
Please don't assume where my feelings come from. You make the wrong assumption. All PA's, nurses, doctors, caregivers at Mass. General who started me on coumadin were informed, current and competent in their accurate knowledge about the drug. as was my coumadin Manager. All of you would approve of their approach and suggestions to me. NO ONE, I repeat, NO ONE told me anything that any of you would consider bogus info......
Wherever my feelings of stress and distress about such a very large dosage come from, they are very real and my problem.
Can't say how very sorry I am to have made my honest comment in what I thought was a supportive atmosphere. It's wonderful that I am the only one who had to take such a large dose and felt uneasy about it. Hope no one else ever has to cope with the feelings I endured and well may have to again.
No worries: My problem and I'm exhausted trying to forthrightly get my message through. I seem unable to competently do so. I regret I didn't do as I told a VR member last night I was going to do and that was to walk away from this thread.
Thank you.
M
Mary
Here's an abstract found for DK Wysowski's article, and I can't find the 1 person's death to 10 million prescriptions statistic that is quoted in the previous post.
However, this statement is worrisome. She states, "From US death certificates, anticoagulants ranked first in 2003 and 2004 in the number of total mentions of deaths for drugs causing "adverse effects in therapeutic use."
Bleeding complications with warfarin use: a prevalent adverse effect resulting in regulatory action.Wysowski DK, Nourjah P, Swartz L.
Division of Drug Risk Evaluation, Food and Drug Administration, White Oak, Bldg 22, Room 3424, 10903 New Hampshire Ave, Silver Spring, MD 20993, USA. [email protected]
BACKGROUND: Warfarin sodium is widely used and causes bleeding; a review might suggest the need for regulatory action by the US Food and Drug Administration (FDA). METHODS: We accessed warfarin prescriptions from the National Prescription Audit Plus database of IMS Health (Plymouth Meeting, Pennsylvania), adverse event reports submitted to the FDA, deaths due to therapeutic use of anticoagulants from vital statistics data, and warfarin bleeding complications from national hospital emergency department data. RESULTS: The number of dispensed outpatient prescriptions for warfarin increased 45%, from 21 million in 1998 to nearly 31 million in 2004. The FDA's Adverse Event Reporting System indicated that warfarin is among the top 10 drugs with the largest number of serious adverse event reports submitted during the 1990 and 2000 decades. From US death certificates, anticoagulants ranked first in 2003 and 2004 in the number of total mentions of deaths for drugs causing "adverse effects in therapeutic use." Data from hospital emergency departments for 1999 through 2003 indicated that warfarin was associated with about 29 000 visits for bleeding complications per year, and it was among the drugs with the most visits. These data are consistent with literature reports of major bleeding frequencies for warfarin as high as 10% to 16%. CONCLUSIONS: Use of warfarin has increased, and bleeding from warfarin use is a prevalent reaction and an important cause of mortality. Consequently, a "black box" warning about warfarin's bleeding risk was added to the US product labeling in 2006. Physicians and nurses should tell patients to immediately report signs and symptoms of bleeding. A Medication Guide, which is required to be provided with each prescription, reinforces this message.
PMID: 17620536 [PubMed - indexed for MEDLINE]
(Weighted) LinksEST LinksEST (RefSeq) LinksGSS LinksGSS (RefSeq) LinksOMIA LinksOMIM (calculated) LinksOMIM (
I'm a little experienced w/warfarin - 9 yrs now - and my answer to you is that I was not seeing better results upping the dosage on alternate days. Tried that route and it didn't work since my INR vacillated all over the place. I take 10mg daily.
As a sidenote to Jkm7 - I hate warfarin, hate that I have to take it the rest of my life, hate when it's low, hate when it's too high and I do believe it's one of the most dangerous drugs out there. There are many people on this website who feel the same as I do, but they don't express their views because our beliefs/feelings are frequently refuted and jeez, who wants to argue.. Have I made myself perfectly clear...
K
Karlynn
If y'all really want to get scared - Google Tylenol.
Ross
Well-known member
I took the quote from Al's site with the reference.
Dear, what they don't tell you in those reports are, were these patients compliant and were they followed and dosed properly, amongst a whole host of possible causes? I'm willing to bet the farm that most were not compliant or followed up closely with PROPER dosing technique. I guess I shouldn't post references because no matter what, it can be twisted into something entirely different then it's true meaning.
BETWEEN 1998 AND 2004 AN AVERAGE OF HOW MANY PEOPLE PER YEAR
IN THE UNITED STATES BLED TO DEATH FROM ANTICOAGULATION?
32
1998 = 12
1999 = 17
2000 = 39
2001 = 39
2002 = 27
2003 = 44
2004 = 46
Total = 224 over 7 years for an average of 32 per year.
This is data from death certificates listing this as the cause of death.
There were an estimated 30,600,000 prescriptions filled for warfarin in 2004. This is an estimated increase of 45% from 1998.
So for every 10 million prescriptions filled for warfarin, approximately 1 person died with the primary cause of death being anticoagulation.
Reference: Wysowski DK et al. Bleeding Complications with Warfarin Use. Arch Intern Med. 2007;167:1414-9
http://www.warfarinfo.com/anticoagulation-deaths.htm
Do the math and see what you come up with.
M
Mary
I guess it's just how you read the abstract. It seemed pretty clear to me.
The quote from Al's is misleading. What it refers to is cases where bleeding to death because of anticoagulation was listed as the "primary cause" of death.
That has more to do with how death certificates are filled out than anything else. Examples: the primary cause was a bleeding ulcer, the primary cause was an intracranial bleed, the primary cause was an error in surgery, the primary cause was trauma causing internal hemorrhage. Not: the primary cause was warfarin use. It doesn't actually exonerate warfarin from causing deaths. There are an overwhelming number of studies that show warfarin use to have occasionally dangerous and even fatal consequences, and those are the ones that caused the FDA to put the black box warning on warfarin.
If it weren't so, the statistics would overwhelmingly favor mechanical valves at all ages. They don't.
The numbers shown from Al's site had nothing to do with whether people were in their proper range or not, nor even what their range was.
Basically, the numbers from Al's might be used to make a logically weak case that not many people actually exsanguinate from flesh wounds on Coumadin. That's something that I can readily believe anyway. (However, I will note that every once in a while, someone here gets a big scare. Those involved can see how it could happen.) It usually takes a while to bleed out, so thankfully, people usually get help first.
But stretching that to mean that coumadin is nearly without risk would be neither appropriate nor accurate. It's a drug that keeps many people alive and stroke-free who would not otherwise be. In so doing, it also takes a relatively small, documented human toll among its users. In the balance, it is a very worthwhile drug. Just don't fall into the wrong percentage group.
It's called the benefit-to-risk ratio, and all drugs are run through that equation by the FDA before (and now even after) they are approved for sale.
That describes more drugs than not. Similar: Celebrex and similar antiarthritic drugs, that offered much superior quality of life than pain relievers, like narcotics, Tylenol or over-the-counter NSAIDS (such as aspirin, ibuprofen, naproxen sodium [Aleve]), but hasten the departure of a few of their users along the way. You will see these drugs come slowly back. If patients accept the risk, these drugs can do more for patients' day-to-day lives than what else is available.
Any drug that can do much good also has a dark side.
Amiodorone is a prime example of a drug that can work almost instant wonders for arrhythmias, then has the poor manners to subject many of its users to unpleasant and even dangerous side effects over time, then refuses to completely leave the body for up to six months or more after the patient stops taking it.
Best wishes,
That has more to do with how death certificates are filled out than anything else. Examples: the primary cause was a bleeding ulcer, the primary cause was an intracranial bleed, the primary cause was an error in surgery, the primary cause was trauma causing internal hemorrhage. Not: the primary cause was warfarin use. It doesn't actually exonerate warfarin from causing deaths. There are an overwhelming number of studies that show warfarin use to have occasionally dangerous and even fatal consequences, and those are the ones that caused the FDA to put the black box warning on warfarin.
If it weren't so, the statistics would overwhelmingly favor mechanical valves at all ages. They don't.
The numbers shown from Al's site had nothing to do with whether people were in their proper range or not, nor even what their range was.
Basically, the numbers from Al's might be used to make a logically weak case that not many people actually exsanguinate from flesh wounds on Coumadin. That's something that I can readily believe anyway. (However, I will note that every once in a while, someone here gets a big scare. Those involved can see how it could happen.) It usually takes a while to bleed out, so thankfully, people usually get help first.
But stretching that to mean that coumadin is nearly without risk would be neither appropriate nor accurate. It's a drug that keeps many people alive and stroke-free who would not otherwise be. In so doing, it also takes a relatively small, documented human toll among its users. In the balance, it is a very worthwhile drug. Just don't fall into the wrong percentage group.
It's called the benefit-to-risk ratio, and all drugs are run through that equation by the FDA before (and now even after) they are approved for sale.
That describes more drugs than not. Similar: Celebrex and similar antiarthritic drugs, that offered much superior quality of life than pain relievers, like narcotics, Tylenol or over-the-counter NSAIDS (such as aspirin, ibuprofen, naproxen sodium [Aleve]), but hasten the departure of a few of their users along the way. You will see these drugs come slowly back. If patients accept the risk, these drugs can do more for patients' day-to-day lives than what else is available.
Any drug that can do much good also has a dark side.
Amiodorone is a prime example of a drug that can work almost instant wonders for arrhythmias, then has the poor manners to subject many of its users to unpleasant and even dangerous side effects over time, then refuses to completely leave the body for up to six months or more after the patient stops taking it.
Best wishes,
Ross
Well-known member
Well we can always eat peanuts.
And God forbid if the entire medical community would get on the same page and manage people correctly instead of blaming the patients all the time, you'd see a very large decrease in poor case turnout.
The point is, someone managed properly, compliant with care etc, is not very likely to experience any major problem. I didn't say impossible, I said NOT LIKELY. I'm sure if I search all day for a few days, I can come back and post a boat load of studies to support what I'm saying. I'm also sure that some of you will spend the same amount of time accumulating counter arguements nonetheless. It's pointless.
Guess it's easier to say Coumadin will kill you. Surgery won't. It's a shame that this point is so overlooked being that I just added another person to the In Loving Memory forum that never made it out of the hospital. But, I'm wrong. Those things don't happen.
As for Al's statement being misleading. He started a thread/poll here awhile back and even in it he said that it was a culmination of death certificates nonspecific in causes. It doesn't make it misleading to do the math and arrive at a conclusion however.
http://www.valvereplacement.com/forums/showthread.php?t=25652
http://www.valvereplacement.com/forums/showpost.php?p=305382&postcount=12
And God forbid if the entire medical community would get on the same page and manage people correctly instead of blaming the patients all the time, you'd see a very large decrease in poor case turnout.
The point is, someone managed properly, compliant with care etc, is not very likely to experience any major problem. I didn't say impossible, I said NOT LIKELY. I'm sure if I search all day for a few days, I can come back and post a boat load of studies to support what I'm saying. I'm also sure that some of you will spend the same amount of time accumulating counter arguements nonetheless. It's pointless.
Guess it's easier to say Coumadin will kill you. Surgery won't. It's a shame that this point is so overlooked being that I just added another person to the In Loving Memory forum that never made it out of the hospital. But, I'm wrong. Those things don't happen.
As for Al's statement being misleading. He started a thread/poll here awhile back and even in it he said that it was a culmination of death certificates nonspecific in causes. It doesn't make it misleading to do the math and arrive at a conclusion however.
http://www.valvereplacement.com/forums/showthread.php?t=25652
http://www.valvereplacement.com/forums/showpost.php?p=305382&postcount=12
and now back to sex....
i found these in the local drugstore. mmmm, green tea flavor! but wait,
green tea is a good source of vitamin K. excessive use may lead to a
lowering of PT values for those on warfarin (but for the wearer or wearee?),
so opening another foil packet could cause a cut, and you could bleed to
death! what would be listed as the primary cause of death? terminal
prophylaxis?
i found these in the local drugstore. mmmm, green tea flavor! but wait,
green tea is a good source of vitamin K. excessive use may lead to a
lowering of PT values for those on warfarin (but for the wearer or wearee?),
so opening another foil packet could cause a cut, and you could bleed to
death! what would be listed as the primary cause of death? terminal
prophylaxis?
B
Bridgette
LOL!! That is too funny!
Ross
Well-known member
Your diet may be wild, but at some point, you'll find the sweet spot. Best of all for you, at least it's temporary, so you don't have to sweat it too much. Heck some of the Docs here don't even start patients on it, though it's recommended protocol.
I came here to say the same thing..'meat' valve(?) You must have anI just had to say that every time I read the title of this thread "Meat Valve...." I laugh out loud.
interesting sense of humor.
JKM7- I also had to take large doses to hit target post op. My docs on the
floor were becoming frustrated since they wouldn't let me go until I was
close to target. It seems I have a high tolerance for most drugs.Well atleast
I shouldn't be easily poisoned!
Well we can always eat peanuts.
And God forbid if the entire medical community would get on the same page and manage people correctly instead of blaming the patients all the time, you'd see a very large decrease in poor case turnout.
The point is, someone managed properly, compliant with care etc, is not very likely to experience any major problem. I didn't say impossible, I said NOT LIKELY. I'm sure if I search all day for a few days, I can come back and post a boat load of studies to support what I'm saying. I'm also sure that some of you will spend the same amount of time accumulating counter arguements nonetheless. It's pointless.
Guess it's easier to say Coumadin will kill you. Surgery won't. It's a shame that this point is so overlooked being that I just added another person to the In Loving Memory forum that never made it out of the hospital. But, I'm wrong. Those things don't happen.
As for Al's statement being misleading. He started a thread/poll here awhile back and even in it he said that it was a culmination of death certificates nonspecific in causes. It doesn't make it misleading to do the math and arrive at a conclusion however.
http://www.valvereplacement.com/forums/showthread.php?t=25652
http://www.valvereplacement.com/forums/showpost.php?p=305382&postcount=12
See that's the thing NO body says coumadin will kill you and surgery won't, that is NOT what most people say, I at least say that the chances of having an adverse event are close to the same wether you chose to choose tissue and surgery or mechanical and take coumadin. I've never read one person say there is no risk to surgery, but the risk of coumadin is often dowplayed. ALL we should do is give equal weight to the statistics, instead of saying the small percentage of risk having surgery (especially in an other wise healthy person) is something to be the most concerned about, but don't worry about the equally small percentage of people that die or have major problems because of taking coumadin.
As for if people were in range there wouldn't be as many problems, MOST if not all studies I have read, don't show that, they usually have something close to this for a results
RESULTS: A total of 225 trauma patients were studied, including 40 warfarin users (17.3%), of whom 22 (55.0%) were in the therapeutic group. Age, gender, and mechanism of injury were similar among groups. Likelihood of Glasgow Coma Scale score </=13 (odds ratio [OR] = 5.13, 95% confidence interval [CI] 1.97-13.39, p = 0.001), ICH (OR = 2.59, 95% CI 0.92-7.32, p = 0.07), overall mortality (OR = 4.48, 95% CI 1.60-12.50, p = 0.004), and mortality after ICH (OR = 3.42, 95% CI 1.09-10.76, p = 0.03) was increased in the therapeutic as compared with the nonuser group. There was no difference in any measured outcome between the nonuser and nontherapeutic groups. CONCLUSIONS: Therapeutic anticoagulation with warfarin, rather than warfarin use itself, is associated with adverse outcomes after traumatic brain injury in elderly patients.
http://www.ncbi.nlm.nih.gov/pubmed/...nel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
that is just one but most tend to show the simular data.
What I will never understand is why if anyone tries to point out there are risks to coumadin, especially in people in their 60s or up, people get mad or say we are saying coumadin is awful and surgery is risk free, because that is NOT what anyone says. I personally believe alot in fate and think when it is your time to go it is your time to go and wether you have tissue and a reop or mech and coumadin, it doesn't matter. BUT IF you worry about new people not knowing there ARE risks to surgery and worry about them hearing things that are NOT true about coumadin, (like shaving, eating ect) then it is only fair to be honest and admit there ARE people that do die or have major problems because of coumadin. THAT is how people make informed choices, which I thought was part of the purpose of this board.
Chou, could you ship over some of those Green Tea flavoured Balloons?
I'm thinking about stocking stuffers for next Christmas!
Or, what a great hostess gift.....
I'm thinking about stocking stuffers for next Christmas!
Or, what a great hostess gift.....
Chou, could you ship over some of those Green Tea flavoured Balloons?
I'm thinking about stocking stuffers for next Christmas!
Or, what a great hostess gift.....
I guess it is too late to order for Valentines day...darn
Hmmmmm, Express Post from China?
Let's ask Freddie, I hear she's got great "connections" with UPS.....
Let's ask Freddie, I hear she's got great "connections" with UPS.....
