3 Years on Mechanical Valve and Acending Aorta Replacement

I do not have a mechanical heart valve and am not on warfarin. However, I did a quick google search and came across this Q and A from Harvard. Hope this helps. Others with more experience in this area will, hopefully chime in.
All the best,
https://www.health.harvard.edu/hear...r-arthritis-pain-relief-while-taking-warfarin

chilly56 said:

Had an ascending aorta replaced along with a St Jude mechanical heart valve three years ago. I'm 62 and in pretty good health. I have quite a lot of arthritis in my hands, feet neck and back. Question; does anyone know of a safe pain medication I can use while on Warfarin? Meloxicam works wonders on my arthritis but my primary physician says I shouldn't take it because of the blood thinner. Any suggestions?

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chilly56 said:

Had an ascending aorta replaced along with a St Jude mechanical heart valve three years ago. I'm 62 and in pretty good health. I have quite a lot of arthritis in my hands, feet neck and back. Question; does anyone know of a safe pain medication I can use while othe fulln Warfarin? Meloxicam works wonders on my arthritis but my primary physician says I shouldn't take it because of the blood thinner. Any suggestions?

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I have a st Jude mechanical aorta valve done when I was 60 years of age and have had it now 26 years, and of course I have been on blood thinners the full 26 years, I am now 86 years old, and I too have arthritis in most of my joints, especially my hands, I am unable to take the correct medication used for arthritis, but have b be content with paracetamol and codeine by the name of SOLPADOL. I have to monitor my INR blood clotting time on a weekly basis but with my own monitor that is not a problem. I am just so grateful that my life was saved all those years ago. I wish you well, St Jude has served me well.

I have just told CHILLY 56 that my St Jude aortic mechanical valve was fitted 26 years ago, I do hope good health, no problems in the heart dept, just age related arthritis, for which I cannot have the correct medication, because of the lifetime blood thinners. I hope my answer helped the member.

@maggiemay

Firstly, welcome and secondly, brilliant , 26 year with the st Jude & age 86
i love hearing stuff like this

I am a medical professional (Retinal surgeon) but not a cardiologist. I had my first valve at age 29. Congenital bicuspid Aortic valve. It was a tissue valve that lasted 5 1/2 years placed in 1977. Then a St. Jude in 1983 and started on Warfarin. Then an ascending Aortic aneurysm repair (6.5 cm) with replacement of valve with another St. Jude 2006. Third degree block s/p surgery leading to pacemaker. Mitral clip 2016 for decompensated mitral insufficency. Worked like a charm. Also 8 stents due to problems with the right coronary artery kinking with saphenous extension after aortic surgery. Normal coronaries otherwise. Along with several pacemaker replacements (4) due to preference for a biventricular pacer which is more physiologic than a right sided "standard" pacer. Still bicycle around 100 miles/week. Age 70.
Have been on Warfarin since 1983. I have used NSAIDs many times over the years and have not seen any issues. Not sure where this warning has come from . There are some reports of altering the INR but in general these drugs don't affect the INR much. There may be some anti platelet activity but less than aspirin. So if you have a good INR monitoring system I don't see much problem with using these drugs. MANY things in medicine are just repeated without evidence. Ask your cardiologist why NSAIDs are contraindicted. Find the evidence. If there is, so be it. I have not seen it so far.

Have you tried special compounded local creams!? Ask your physician for one. Medicare covers this. My sister is 86 (not on warfarin) and the cream is very helpful.

vitdoc said:

I am a medical professional (Retinal surgeon) but not a cardiologist. I had my first valve at age 29. Congenital bicuspid Aortic valve. It was a tissue valve that lasted 5 1/2 years placed in 1977. Then a St. Jude in 1983 and started on Warfarin. Then an ascending Aortic aneurysm repair (6.5 cm) with replacement of valve with another St. Jude 2006. Third degree block s/p surgery leading to pacemaker. Mitral clip 2016 for decompensated mitral insufficency. Worked like a charm. Also 8 stents due to problems with the right coronary artery kinking with saphenous extension after aortic surgery. Normal coronaries otherwise. Along with several pacemaker replacements (4) due to preference for a biventricular pacer which is more physiologic than a right sided "standard" pacer. Still bicycle around 100 miles/week. Age 70.
Have been on Warfarin since 1983. I have used NSAIDs many times over the years and have not seen any issues. Not sure where this warning has come from . There are some reports of altering the INR but in general these drugs don't affect the INR much. There may be some anti platelet activity but less than aspirin. So if you have a good INR monitoring system I don't see much problem with using these drugs. MANY things in medicine are just repeated without evidence. Ask your cardiologist why NSAIDs are contraindicted. Find the evidence. If there is, so be it. I have not seen it so far.

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Vitdoc, Welcome to this forum. You certainly have a wealth of experience as both patient and medical professional. Thanks for the reminder about information being evidence based. I was also thinking that consulting with a seasoned pharmacist might also be an avenue to get some answers. Wishing you the very best with your health moving forward. Amazing....you bike 100 miles/ week! keep it up.

vitdoc said:

I am a medical professional (Retinal surgeon) but not a cardiologist. I had my first valve at age 29. Congenital bicuspid Aortic valve. It was a tissue valve that lasted 5 1/2 years placed in 1977. Then a St. Jude in 1983 and started on Warfarin. Then an ascending Aortic aneurysm repair (6.5 cm) with replacement of valve with another St. Jude 2006. Third degree block s/p surgery leading to pacemaker. Mitral clip 2016 for decompensated mitral insufficency. Worked like a charm. Also 8 stents due to problems with the right coronary artery kinking with saphenous extension after aortic surgery. Normal coronaries otherwise. Along with several pacemaker replacements (4) due to preference for a biventricular pacer which is more physiologic than a right sided "standard" pacer. Still bicycle around 100 miles/week. Age 70.
Have been on Warfarin since 1983. I have used NSAIDs many times over the years and have not seen any issues. Not sure where this warning has come from . There are some reports of altering the INR but in general these drugs don't affect the INR much. There may be some anti platelet activity but less than aspirin. So if you have a good INR monitoring system I don't see much problem with using these drugs. MANY things in medicine are just repeated without evidence. Ask your cardiologist why NSAIDs are contraindicted. Find the evidence. If there is, so be it. I have not seen it so far.

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What I have been told by two cardiologists is that most NSAIDs can lead to stomach bleeds in some people. This in concert with your higher INR can lead to difficulties in controlling the stomach bleeds. They both allowed me to take over the counter NSAIDs (e.g. ibuprofen) up to the maximum dose but for no longer than 2-months.

Had an ascending aorta replaced along with a St Jude mechanical heart valve three years ago. I'm 62 and in pretty good health. I have quite a lot of arthritis in my hands, feet neck and back. Question; does anyone know of a safe pain medication I can use while on Warfarin? Meloxicam works wonders on my arthritis but my primary physician says I shouldn't take it because of the blood thinner. Any suggestions?

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From what I've been told, NSAIDs are not pain relievers but anti-inflammatory drugs. My orthopedist tells me to take acetaminophen (e.g. Tylenol) up to the maximum dose for pain. You can also take both acetaminophen and ibuprofen together since one is for inflammation and the other for pain.

When I have a really bad problem (e.g. arthritis pinches a nerve in the neck giving crippling pain) he prescribes the over the counter NSAID and Oxycodone-Acetaminophen pills (e.g. Percoset.) There are other treatments (e.g. cortisone shots) that work for some, I tried them once or twice but not in a few years.

When it comes to meloxicam, he told me he won't prescribe it, but he knows my primary care physician and he told me that he won't prescribe it either. He was correct. My primary care physician told me there are a variety of reasons that he doesn't like meloxicam for routine use. I didn't delve into the reasons, but he does prescribe it for only occasional use to my wife.

I find stretching excercises, regular movement and walking 4 times a day (2 with the dog and 2 to the bus stop to get to work) helps keep me moving and helps control the pain. At work I get up every hour and every two hours I take a 5-min walk. I was eating acetaminophen for a year or so but since I upped my exercise have been free of them for about 6 months.

Hello, I am 58 and have a tissue AVR and an ascending stem. I have arthritis that has misshapen some fingers. I cannot tolerate
Any opiates . I don’t do well with more than a tiny bit of Tylenol and react to Motrin and Alleve, so I manage pain with
acupuncture from a highly trained LAC -which means not from a 1-2 year school in the USA. This matters.
A few bad sessions and people say it doesn’t work not realizing it requires a real specialized education (like 7 years.)
I also like an Arnica topical cream. I have a set of hand exercises I do daily from an OT . I use heated pads and ice for swelling.
It works! I am a fiber artist and need my hands I also work out very hard at a cardio rehab center 3 times a week - stair master,
Free weights , race walking on the treadmill, airdyne bike, sit-ups , balancing ..what ever I can think of and I go to Zumba classes.
I forgot about this site! Glad you are here. I also attend webinars from the Adult Congenital Heart Association and had a weekly
Call after surgery for a few weeks from their volunteers. Check it out. I don’t do a forum there. Don’t think they have one.

Glad this site has found me, as I forgot about it. AVR carbomedics valve with some ascending arch work in Sep 2006 at the Cleveland Clinic. As time marches on and older age issues like arthritis creep in, this site is very helpful to stay in tune with our possible remedies.