Lumps and bruises

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Paul1972

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I seem to be getting every now and then hard pea size lumps with a lots of bruising around it which takes weeks to disperse. I don’t feel like I’ve took a knock of any sort they just appear. They are mostly on my arm and legs,Just wondered if anyone else gets them.My inr is very rarely above 4 .
 

dick0236

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LOL.......it happens to me on a fairly often basis. Sometimes I can figure out why I got the bruise and sometimes I can't. I'm nursing one right now that I got banging into the edge of a door........and I didn't think it was hard enough to get the bruise I got. Almost always my bruises are in the soft tissue of my arms and legs.
 

Protimenow

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I rarely laugh.

Paul1972 - this sounds like popped capillaries. I rarely get those, but I DO get some amazing bruises. My INR is usually around 2.9-3.1.

I don't always remember where or when I did something that caused the bruising. I sometimes do things that, in retrospect, may seem a bit less than smart, in light of my use of an anticoagulant - for example, pulling a muscle at the gym, or overstressing an already stressed muscle, or just banging into something harder than expected.

These things happen -- but if you get a lot of those pea size lumps, this may indicate capillary issues - so you may want to talk to a doctor about them.
 

Paul1972

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Thanks for the replies guys, glad I made you laugh😊. I will have a word with docs got about 15 of them on arms and legs at min all with big dark bruises that have appeared in last 72 hours
 

Thomas

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I'm in the same boat with multiple bruises for no reason that I can think of, though not to that extent. That's a big number.
I just finally had one heal on my forearm; swelled up so big I looked like Popeye for a week!
 

CThrock

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I think things jump out at me when I'm not looking to give me bruises that unexplainable. Sometimes I get alot sometimes not. Sometimes big or small. Sometimes bruise is just a bruise other times it's got a hard bump in the middle. I've talked to my Cardiologist about it and he said there's not much they can do about it. Happens being on Warfarin. So I just deal with them. They are just annoying. 😲🤪
 

tom in MO

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I seem to be getting every now and then hard pea size lumps with a lots of bruising around it which takes weeks to disperse. I don’t feel like I’ve took a knock of any sort they just appear. They are mostly on my arm and legs,Just wondered if anyone else gets them.My inr is very rarely above 4 .
An INR of 4 is pretty high, in 7 years, I've never gotten that high and only be over 3 a few times. Usually for a mechanical valve in the aortic position, the range is 2-2.5 or 2-3. If your intended range is lower, you may want to adjust your dose.

I get small red marks due to capillaries, but these go away in a day. My cardiologist said to ignore them.
 

carolinemc

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I seem to be getting every now and then hard pea size lumps with a lots of bruising around it which takes weeks to disperse. I don’t feel like I’ve took a knock of any sort they just appear. They are mostly on my arm and legs,Just wondered if anyone else gets them.My inr is very rarely above 4 .
If you are on Coumadin(warafarin) and asprin, you will have these more easily. You will not always feel a bump into a door or your leg hit a chair leg. It happens. I have been dealing with this since OHS in 2001. Goes with the territory. And the INR does not need to be up to 4, needs to be a lower range, and you still have bruising. Doubt about 15 bruises in 72 hours unless you are quite active and bumping into chairs and walls. But do talk to the doctor and have the doctor explain the bruising. Just have to live with them unless you have a quite a large size bruise, or a bruise that takes forever to heal, then get worried.
 

pellicle

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An INR of 4 is pretty high, in 7 years,
although if you were a mitral valver it would be just out of range and probably not likely to cause harm or alarm
My old favorite chart showing relative risks of INR


which suggests that all the way to INR 4.4 is no significantly greater incidence of bleeds than 2.5~2.9
 

tom in MO

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although if you were a mitral valver it would be just out of range and probably not likely to cause harm or alarm
My old favorite chart showing relative risks of INR


which suggests that all the way to INR 4.4 is no significantly greater incidence of bleeds than 2.5~2.9
You put a lot of faith in that one paper. I think of it a wee bit differently. At an INR of 2-2.5, I notice the non-therapeutic or "side" effects of warfarin. At an INR of 4 the effects would be 2x more. A risk you don't mind taking, but it's a risk I don't want to take and it's a risk not recommended by cardiologists.
 

pellicle

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You put a lot of faith in that one paper
Well firstly it's not just that one paper, but that paper presents it well. Secondly that paper presents data from thousands of patients and happens to present it in a graph that I find well done and good at communicating the issues.

You should read it, it is the results of a study of 4,202 patients, so quite statistically sound in size.

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/415179

you will note that its not alone, and in the literature you'll find reasonably good accord with their findings.

I think of it a wee bit differently...
So you have any research which supports more than your concern , which actually shows significantly more bleed events in the range we are talking?

You are implying that it's my recommendation that remaining at INR = 4 is the goal, when the reality is I write that you should target your INR according to your valve type and mention this graph to provide reassurance to those who are concerned about what their INR is (when our of range) that the situation is really n it dangerous and to not great and to steer back to their target.

But you seem unable to grasp that subtle difference.

You ignore my point that for a mitral valver 4 is just outside their normal range....
 
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