Failure of Onx valve and problems with lowering INR

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DDT77

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I think that you must have completely misread the statement that you responded to. This was NOT about INRs of 6 or 7 - it was of INRs that were .5 BELOW the target INR up to .7 ABOVE the target INR - NOT INRs between 5 and 7. This is above and below the RANGe - not absolute values.

This 'Rat Poison' thing should end here.
My apologies, I was trying to be somewhat sarcastic with the rat poison comment. I did not realize there was sensitivity on the term. I now understand that some in the community are sensitive to the term.

On the range comment: I copied and pasted from the link referenced. Top of page 7. INR values below 6, but 0.7 or more above target.

I will reinforce my previous comments.
This study indicates slight reduction in daily intake of Coumadin until back in range. My caretaker promotes a more aggressive 'hold' type response to INR values that are slightly higher than target + 0.7. For instance, my target is 2.5. If I test at INR=3.3, my care team takes hold approach as 3.3>(2.5+0.7). This study would create a damped 1st order response with the slight change in dosage, while my care team uses a technique that tends to create a 2nd order response with low damping, as next test I tend to be lower (out of range), and thus need maybe 2x normal dosage...
 

pellicle

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My apologies, I was trying to be somewhat sarcastic with the rat poison comment.
none needed ... it "is" rat posion ... anyone who gets angsty about it needs to get their humor gland massaged

My Finnish friends sent me this postcard after surgery


it says "why feed rats when you can kill them dead with rat poision (commonly warfarin)

In Australia we commonly sell this one:

887245


yep ... that says warfarin right there on the pack. So evidence suggests that:

887246


A valuable skill is to be able laugh at the 5hit one is in :)
 

Warrick

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So that ratsaks 500mg per kg, so probably at best 2-4 weeks worth of doses in a box,
Not worth stocking up with for either a nuclear or zombie apocolypse... and we might be looking to eat rat kebabs by then
 

Protimenow

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Hey, Warrick: what a great idea. Feed the right dose to the rats, then, aftter they die, you can take your daily dose by eating the rat. This solves two problems - gets rid of rats and serves as nutrition for you.

As far as lack of humor about the 'rat poison (not poision)' comment -- I've heard it too often, from too many people, to treat it as a benign topic.

People avoid warfarin because the material is used to kill rats -- they seem to exclude the possibility of a mechanical valve BECAUSE they're deathly scared of taking 'rat poison' and what it will do to them.

I'd be more comfortable in a world where warfarin is seen as a compound that can help those with mechanical valves, clotting disorders, or other reasons for taking it, to stay alive -- and not to avoid it, or fear it, because it's used to kill rats.
I'd be more comfortable in a world where the stuff isn't referrred to as 'blood thinner' - but this term is so deeply engrained (or is it ingrained?) into modern vocabulary that this isn't going to happen.

When a day comes when 'rat poison' isn't a reason to avoid surgery to install a device that will probably last a lifetime, I won't mind seeing the words 'rat poison.'

As with most, if not all of us, it would be nice if, someday in the future, a new, affordable, easily reversible anticoagulant that doesn't require INR testing comes along.

The heavily advertised anticoagulants that many people with AFib are taking (I've heard that these cost up to $8 a dose) was probably also intended for patients with mechanical valves - but testing probably didn't provide data demonstrating its safety or positive results in people with mechanical valves. I'm pretty sure that these weren't developed only for treating AFib or deep vein thrombosis.

For me, even if an oral anticoagulant that would make weekly testing no longer necessary comes along, it may still take some convincing to get me to give up the easily manageable, easily reversed, extremely inexpensive warfarin. (Come to think of it, maybe this argument makes it difficult for drug companies to justify the costs of developing and testing a more expensive alternative to warfarin).
 

pellicle

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As far as lack of humor about the 'rat poison (not poision)' comment -- I've heard it too often, from too many people, to treat it as a benign topic.
I don't see you changing the world by berating all of us in here mate. Roll with the punches, bend like the reed in the wind ... But good luck finding peace or happiness by getting agro at the world and championing a lost cause.

 

pellicle

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So that ratsaks 500mg per kg, so probably at best 2-4 weeks worth of doses in a box,
5hit, I'd never thought of looking at the dose ... this makes me think that some of my 1mg tablets and a bit of Deb (instant mashed potato) could make a "killer" concoction for the rats (who are unable to puke, so when they eat stuff are stuck with what happens ;-)

Cool!
 

Protimenow

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I didn't think that I was berating anyone -- just pointing out my personal issues with the 'rat poison' comment.

BTW - I took my 'rat poison' a few hours ago.

For the last 40 years, my life has been about words - and after my TIA, words - and usage - have somehow become even more important.

SO - forgive me if it feels like I was berating someone for using that term.

And, I guess it's an Australian term, but what is 'getting agro with the world'?
 

nobog

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I've tried to change the world by getting people to say "center of mass" instead of "center of gravity" - in like "that motorcycle has a low center of gravity..." The center of gravity is the middle of the earth - or the sun - or something - but it is not a chunk of the engine or frame on the cycle.

So... center of gravity it is !! :D
 

Protimenow

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Nobog - I have to disagree with you. The 'center of gravity' for that motorcycle, or car, or anything, is a point where the gravitational forces of the motorcycle even out - it's a point of balance. Center of gravity is, basically, the center of gravitational pull for that particular object. A motorcycle, or car, or whatever, with a low center of gravity is more stable than one with a higher center of gravity -- a motorcycle with a low center of gravity will be less likely to tip over than one with a higher center of gravity.

If you climb on a ladder, the higher you climb, the higher your center of gravity becomes - and the less stable (and more likely the ladder, with you on it, is likely to fall) you become. (Your center of mass is also higher, because most of the mass is coming up the ladder - but center of mass and center of gravitational forces aren't the same thing).

The gravitational center of the earth is an entirely different thing - and, to me, can't be confused with a thing's center of gravity.

I'm not entirely sure what center of mass means -- it sounds to me as if this is something WITHIN the item, rather than a force that occurs outside of the item. Take that same motorcycle, I would guess that, because there's probably more metal in the engine than in the frame, the center of mass for that motorcycle would be somewhere around, or inside of, the engine, while the center of gravity would be, one would hope, a few feet UNDER the bike.

I look forward to your posts more than many others because I usually learn something from them, but I don't agree that the center of gravity is the gravitational center of the earth (it applies to any item that you're evaluating - not the gravitational center of the earth), or that center of mass relates to a spot that is probably below the motorcycle that you mention.

And - one more thing - I suspect that the center of mass for this planet is probably at the same spot as the center of gravity - but the further out from this center you go, the more variance will exist between center of mass and center of gravity.

Hey, administrator - this isn't politics; it's off the original subject of this thread; and it's been friendly all the way through.

Perhaps Nobog and I will discuss this further, before you close this thread.
 
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nobog

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Hey protimenow its all good - its how we learn :)

but coming from an engineering background:

In physics, the center of mass is the arithmetic mean of all points weighted by the local density or specific weight. If a physical object has uniform density, its center of mass is the same as the centroid of its shape (from a quick Google search).

This has nothing to do with gravity. Sorry for deviating from the original thread.
 

Protimenow

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Hey protimenow its all good - its how we learn :)

but coming from an engineering background:

In physics, the center of mass is the arithmetic mean of all points weighted by the local density or specific weight. If a physical object has uniform density, its center of mass is the same as the centroid of its shape (from a quick Google search).

This has nothing to do with gravity. Sorry for deviating from the original thread.
I understand your definition of center of mass. But, when they say center of gravity, they're referring to a spot, usually below the object, where the gravitational forces focus. Take, for example, a bicycle -- it may be accidental, but it's designed so that the center of gravity is at a point that is slightly below the wheels. Put a person on the bike, and there's more weight below the person's trunk than there is on the top half of the body - the center of gravity becomes a point a foot or two BELOW the wheels - and this gives the bike its stability. Objects with a low center of gravity are more stable than objects having a center or gravity that's above the 'ground.' More weight at the bottom than at the top keeps things from tipping over (that's why I wear heavy shoes).

Center of mass is a different thing.

And, as we all know, Agian is either the center (or centre) of gravity - or, perhaps, the center of the universe.
 

Protimenow

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Well, yeah, gyrostability. Perhaps I was thinking of tightwire walkers - with the really wide poles that shift the center of gravity far below the poor soul's feet. I knew that riding the bike made it much more stable - but didn't get to gyrostability. My High School Physics only went so far...
 
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