Iron, coumadin, mechanical valve

[mooha34]

OK, I'm about a year out from having my aortic valve replaced with a St. Jude mechanical. I also had to have an aortic aneurysm corrected. I have been on Comadin since that time and get my levels checked bi-weekly. Just recently I have been diagnosed with a mild case of Anemia. I am pretty sick of all this, but I realize I have to take care of myself. I am now 33 and just seems like I am way too young for all this. Here are a few questions:

1) Will the iron interfere with the coumadin?
2) How long will the mechanical valve last?
3) Is there any advancement on a drug to replace coumadin?

Thanks

 

[Rich]

I can't address the iron question.
I was told my St. Jude should last thirty to thrty five years.
After this much time why are you having blood tests bi-weekly?
Most including myself usually test once a month unless there is a problem.
As far as Comadin we keep hearing stories of studies on new drugs, but I wouldn't hold my breath. Once you get in a consistent routine, Coumadin really is no big deal. It has not stopped me from doing anything, just have to be a little more cautious.
Rich

 

[Freddie]

One question answered:

One question answered:

I was put on iron for the first three months of post-op, then later I was told by my surgeon that Iron will not interfere with coumadine/warfarin.

 

[Karlynn]

I have a 16 year-old St. Jude mitral valve and do get anemic from time to time because the valve can chew up blood cells a bit. It's my understanding that the newer models do not do this as much.

But anyway, I take iron from time to time and do not notice a change in my INR - but I sure feel less tired!

Basically - no one knows how long your valve will last. We have a member who's had his for 40 years and is going strong. As long as you don't have scar tissue encroachment on the valve (the biggest reason a mechanical needs to be replaced) you should feel comfortable in not being surprised if it lasts you a lifetime.

Do you home test your INR? And by bi-weekly - do you mean every other week or two times a week? I hope it's not 2 times a week or I can see why you're tired of it all. Look into home testing - it will allow you more control over you schedule and it is being shown that those that home test are much more stable and safe.

I was 32 when I had my valve replaced. It take a bit of getting used to the whole "I have a heart issue" thought, but eventually you won't give it much thought.

 

[yankeeman]

Re: iron and coumadin

Re: iron and coumadin

I also got a St. Jude's mechanical valve (last July) and had some anemia problems after the surgery.

They put me on an iron supplement for a month and when it ran out they didn't really do anything after that.

My surgeon said the valve will last "forever" which is why I got a mechanical valve in the first place. The risks of reoperations with bovine or porcine valves are undeniable.

The coumadin (actually, warfarin) is a pain in the ass. I had some precancerous moles removed and bled from the incisions for a month -- once bled through my shirt at work in the office and was sent home.

But it's the price of admission for mechanical valves. I have heard nothing about a replacement and doubt there ever will be one because the physics will never change...the idea is to stop the blood from clotting and causing a stroke and putting me in a nursing home (or lower)

Good luck.

 

[mooha34]

Thanks

Thanks

Thanks for all your responses.

I was getting tested once every 3 weeks for a few months but then got a high reading once and took a few times to get it straight. Then, they lowered my INR goal to 2-3 instead of 2.5-3.5. That took a while to get straight. I am still young and went through divorce last year, so I tend to go out and have some drinks on the weekends. I think that messes with my readings as well. I only drink on weekends, and have heard a different answer regarding alcohol from every doctor and nurse. I guess some are more conservative than others?

Oh, when I say bi-weekly, I mean every other week.

Thanks again,
Marty

 

[dick0236]

I can't help with the "iron" question since I have never been treated for anemia.
Mechanical valves are designed to last a long time. Reasons for replacing mechanical valves are most likely due to issues other than a valve "wearing out".
I also wish there was an alternative to warfarin but, alas, so far no such luck. Once you accept ACT, it is no more difficult than any other "maintenance" therapy to live with.

To answer the question in your second post about the effect of alcohol...try testing on Friday before the weekend. The alcohol from the previous weekend should be out of your system by then. Drinking in moderation should pose little INR problems. Drinking to excess will cause problems....been there, done that.

 

[Karlynn]

Alcohol is dehydrating to the system. A dehydrated system will increase the concentration of warfarin in your body causing your INR to rise. Same thing goes for getting the flu and/or fever.

I have no issues with INR when having a glass or two of wine or beer, or one martini. And don't give much thought to having a beer or wine when out to dinner with family or friends. I'm a "cheap date" as it doesn't take much for me to start feeling silly. If I go for a 3rd glass..... well I just don't because I don't like the way it makes me feel after. If you are drinking on weekends to the point of moderate inebriation or beyond, you are probably dehydrating yourself causing the INR to rise. If you're waking up hung-over, chances are your INR is up too.

Dick makes a good point. If you feel your drinking isn't outrageous and when you've tested your INR after and it's high, but not horribly high, then test on Fridays, figure you'll have a few high days a week due to the alcohol and just live your life.

The other issue with alcohol is that it can be very irritating to ulcers and the warfarin will cause the ulcer to bleed sooner when irritated by alcohol. So people with ulcers need to avoid over-consumption. The problem arises when you don't know you have a bleeding ulcer. Then you need to rely on how your stool looks after your weekend activities. Black isn't good.

 

[catwoman]

I have some anemia, too. It was diagnosed lasts spring when I had my annual physical & bloodwork. When I saw my cardio in July, he wanted to find the exact cause, so I had a TEE and more bloodwork, including blood cultures. I have some paravalvular (perivalvular??) leakage, which seems to be causing the anemia.

I take B-12 for it.

Unless you have scar tissue impinging on the leaflets, blood clots or bacteria on the valve, your valve should last a long time, if not your entire lifetime.

 

[briansmom]

My son has anemia due to his heart failure, he was on IV iron therapy 1x/week for 10 weeks. Iron does not affect INR, but it may make you feel a whole lot better!
IMHO, alcohol is only a problem because of dehydration, hard on the stomach and the stupidity that goes along with it. If you can control those factors, then I wouldn't worry about it. You still have to live and have fun, just be aware of the risks that you are taking and minimize them to whatever level you are comfortable with.