Lumps and bruises

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dick0236

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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 .
A couple nites ago I watered a garden and was driven indoors by biting insects on my legs. Put some anti-itch creme on my legs.......next day I noticed 4-5 "pea" size bruizes in the bite area. My INR was 3.4 yesterday. Can't ever remember getting "bite" bruises ever before.......bugs are really vicious this year. Maybe yours are also insect bites.
 

Duffey

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A couple nites ago I watered a garden and was driven indoors by biting insects on my legs. Put some anti-itch creme on my legs.......next day I noticed 4-5 "pea" size bruizes in the bite area. My INR was 3.4 yesterday. Can't ever remember getting "bite" bruises ever before.......bugs are really vicious this year. Maybe yours are also insect bites.
We have something called buffalo gnats that are prevalent in areas of flooding. I live along the Mississippi River and this year the gnats have been particularly vicious. I also have swelling at the site of the bites, enough so that until I realize what it’s from, my mind races wondering what new medical malady has struck. I seem to react much more strongly to the bites than other family members. I second Dick’s suggestion that you consider your lumps are a reaction to insect bites.
 

Protimenow

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Actually, you'll be 'thirding' the suggestion. I asked if this could be insect bites in one of the first posts on this thread.
 

Gail in Ca

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After I had a melanoma removed from my calf (this was major, on warfarin),
I was referred to see an oncologist, who saw my many bruises, some kind of large, and he said to me," You should try not to bruise yourself"!! On warfarin, one will just have bruising all the time, really. Some of the worst ones are caused by my dog or cat running into me, or jumping on me. Also, doorways and doorknobs are my enemy!
 

Protimenow

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'You should try not to bruise yourself.' Damn, why didn't YOU think of that? I assume he was joking.

Yes, bruises come with the territory. I haven't learned yet how to gauge your INR by the size of a bruise - I have a meter for that.

Yes, bumping into things, or things bumping into you are common causes (for me, at least) of bruising. Sometimes, of course, I haven't got a clue to what caused my latest bruise.

A bit more bruising than people not on an anticoagulant is, however, a rather cheap price to pay for better heart functioning - perhaps for extra years of life - for stroke avoidance - and for the other benefits that a mechanical valve provide. After almost 28 years on coumadin, I've kind of gotten used to taking it.
 
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tom in MO

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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.


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....
This thread was started by Paul and his valve is in the Aortic position not mitral.

I did read the paper and I find in the literature information that supports the recommended ranges. Note that size is not the only judge of statistical significance...

I don't need any papers to keep me in my recommended range. I can look at my body and how it reacts to cuts and bruises, this is enough for me to keep in my 2-2.5. You routinely counsel people to keep their INRs high and that being over range is not a problem. My experience is different, and my advice to those that care to hear it is different than yours..."stay in range, it's not hard to do for most of us."
 
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pellicle

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This thread was started by Paul and his valve is in the Aortic position not mitral.
I guess that this then is the first thread here that's gone "off topic" due to subsequent questions.

My experience is different, and my advice to those that care to hear it is different than yours..."stay in range, it's not hard to do for most of us."
Tom, in all seriousness do you have a reading comprehension impediment? You continue to miss the bits where I also say its best to stay in range but add the bits that "don't panic if you get out of range a bit and here is why" ... Let me quote that to you again:

"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."​


Unless of course you don't have a comprehension issue but just enjoy picking a fight with me (which you picked from pretty much my very first post here when I was in hospital and totally ****, having my first debridement operation and was trying to assist a young lad confused about why so many told him warfarin was dangerous. You knew where I was and why and still gave me 5h1t like you are doing now ... I don't forget stuff like that.

So which is it? comprehension impaired or lover of picking a fight with?
 
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Protimenow

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Ooo. I hope this doesn't escalate.

Tom -- it's interesting that you know when you're in range.

From 2006-2009, I also thought that I knew when I was in range. I had no money for doctors or for blood tests. I knew that I could 'feel' when I was in range, just by monitoring my bruising, or other signs (I don't remember what those signs were). I mentioned this on a different site, and was almost booted off because I was giving bad 'advice.' (It wasn't advice, just a personal history). My dosage was always the same during those years, and I may have actually stayed in range - my diet was pretty consistent, activity was pretty consistent, and my dosing was consistent.

But I wouldn't try that again. I realize how lucky I was to not have negative consequences, and how fortunate I am to be able to test my INR with my own meter. I don't advise ANYONE to conclude that their INR is in or out of range, just based on physical signs (if you bruise, but not too badly, you're in range, if you're peeing blood, or get some monster bruising, you're out of range, and if you drop dead from a stroke, I guess it doesn't matter any more, does it?).

Although I'm in range whenever I test my INR, I'm not quite cavalier enough to conclude that, as long as my dose is consistent, I won't fall out of range. It happens.

Weekly testing is the best way to confirm that you're feeling as if you're in range. You can give yourself a few extra points if you're always right (and testing weekly to prove it).
 

Superman

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I typically suspect I’m on the high side, not by bruising, but by the little red color around small cuts. Almost like a bleeding (no pun intended) marker.

Still test weekly though.
 

tom in MO

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I guess that this then is the first thread here that's gone "off topic" due to subsequent questions.


Tom, in all seriousness do you have a reading comprehension impediment? You continue to miss the bits where I also say its best to stay in range but add the bits that "don't panic if you get out of range a bit and here is why" ... Let me quote that to you again:

"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."​


Unless of course you don't have a comprehension issue but just enjoy picking a fight with me (which you picked from pretty much my very first post here when I was in hospital and totally ****, having my first debridement operation and was trying to assist a young lad confused about why so many told him warfarin was dangerous. You knew where I was and why and still gave me 5h1t like you are doing now ... I don't forget stuff like that.

So which is it? comprehension impaired or lover of picking a fight with?
So I have either a reading impediment or am an internet troll. Thanks. You're a class act.
 

tom in MO

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Ooo. I hope this doesn't escalate.

Tom -- it's interesting that you know when you're in range.

From 2006-2009, I also thought that I knew when I was in range. I had no money for doctors or for blood tests. I knew that I could 'feel' when I was in range, just by monitoring my bruising, or other signs (I don't remember what those signs were). I mentioned this on a different site, and was almost booted off because I was giving bad 'advice.' (It wasn't advice, just a personal history). My dosage was always the same during those years, and I may have actually stayed in range - my diet was pretty consistent, activity was pretty consistent, and my dosing was consistent.

But I wouldn't try that again. I realize how lucky I was to not have negative consequences, and how fortunate I am to be able to test my INR with my own meter. I don't advise ANYONE to conclude that their INR is in or out of range, just based on physical signs (if you bruise, but not too badly, you're in range, if you're peeing blood, or get some monster bruising, you're out of range, and if you drop dead from a stroke, I guess it doesn't matter any more, does it?).

Although I'm in range whenever I test my INR, I'm not quite cavalier enough to conclude that, as long as my dose is consistent, I won't fall out of range. It happens.

Weekly testing is the best way to confirm that you're feeling as if you're in range. You can give yourself a few extra points if you're always right (and testing weekly to prove it).
I can't tell if I'm in range w/o the meter. Sorry if I implied that. I do see the effects of warfarin and for me this is enough to keep me within range. As a boy scout, the motto "Be prepared" was part of my upbringing. I agree, with warfarin, being prepared is to be in-range.
 

Protimenow

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My father uses a pendulum to check his INR...😀🌈
You can even find your lost car keys with them
🤪🤪
Pendulum wouldn't check INR - just heart rate.

And, after the surgery, it was not possible to play hide and seek with my daughter - I would be standing behind a door, and she'd say 'Hi dad.' That's the last time I tried to get away with THAT game.
 

pellicle

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So I have either a reading impediment or am an internet troll. Thanks. You're a class act.
well I gave reasons, demonstrating my assertion clearly. If there is some other explanation as to why for so many years now you've consistently made similar references to misquoting and then correcting me then I'm always interested to hear what that is. I just proposed two options. As they say, "if the cap fits ...". So you can either just read my posts and correct any actual misinformation I provide (rather than just mis-read and then correct what I didn't say, maybe even properly and courteously engage with me in discussion) or you can continue with your Punch and Judy show ... its your call.

I wouldn't call you a troll, as it seems your just in it for trolling me. Because I don't believe you have a reading impediment, I see sufficient evidence to make it clear you just like harrasing me. I don't mind, just don't expect me to not reply in kind. This goes back to 2012 and I believe there is sufficient evidence to make my case.

Additionally I see plenty of other substantial mis information here which would be the more low hanging fruit to go for if correcting misinformation was indeed your goal.

Or (gosh) you could take the time to provide practical and useful information to question askers rather than just say "maintaining your INR is not hard".
hatTip.jpg
 
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Warrick

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@Protimenow he believes he can read his INR with the pendulum...
 

Protimenow

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Hey, Warrick: I commented on your post about your grandfather.

I said that a pendulum may be useful for checking heartrate, but NOT for INR.

Thinking about it, though, if a pendulum was set to click at one click per second, and you had a good reagent, you may be able to time how many pendulum clicks it takes before blood clots. You'll then know how many full seconds (it'll be hard to determine fractions of a second) it takes to clot. If you have a good reagent, with a known value, you can divide the clotting time by the reagent value and get an approximate value for INR. So, although I didn't say, and didn't think, that, like your grandfather, you can use a pendulum to determine INR, it's actually possible if you have a reliable time source and can count quickly enough.
 

Agian

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Hey, Warrick: I commented on your post about your grandfather.

I said that a pendulum may be useful for checking heartrate, but NOT for INR.

Thinking about it, though, if a pendulum was set to click at one click per second, and you had a good reagent, you may be able to time how many pendulum clicks it takes before blood clots. You'll then know how many full seconds (it'll be hard to determine fractions of a second) it takes to clot. If you have a good reagent, with a known value, you can divide the clotting time by the reagent value and get an approximate value for INR. So, although I didn't say, and didn't think, that, like your grandfather, you can use a pendulum to determine INR, it's actually possible if you have a reliable time source and can count quickly enough.
LOL. I haven't read horse **** like that in a while.
 

tom in MO

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well I gave reasons, demonstrating my assertion clearly. If there is some other explanation as to why for so many years now you've consistently made similar references to misquoting and then correcting me then I'm always interested to hear what that is. I just proposed two options. As they say, "if the cap fits ...". So you can either just read my posts and correct any actual misinformation I provide (rather than just mis-read and then correct what I didn't say, maybe even properly and courteously engage with me in discussion) or you can continue with your Punch and Judy show ... its your call.

I wouldn't call you a troll, as it seems your just in it for trolling me. Because I don't believe you have a reading impediment, I see sufficient evidence to make it clear you just like harrasing me. I don't mind, just don't expect me to not reply in kind. This goes back to 2012 and I believe there is sufficient evidence to make my case.

Additionally I see plenty of other substantial mis information here which would be the more low hanging fruit to go for if correcting misinformation was indeed your goal.

Or (gosh) you could take the time to provide practical and useful information to question askers rather than just say "maintaining your INR is not hard".
View attachment 887166
Thanks again. You're a class act.
 

Protimenow

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Hey, Agian. YOU'RE the one who said your grandfather uses a pendulum to test his INR -- NOT ME.

My theorizing about how a pendulum can be used to test INR is NOT HORSESHIT. The pendulum on a clock moves as one swing per second.

The gold standard for INR measurement is called Tilt Table. It measures the time that it takes to form a clot, and is the method used by labs. Sure, they're using better timers, but this comes down to timing the clot.

An electronic timer would definitely be more accurate, but if we used your father's clock, if it has a pendulum that swings a long distance, it may be possible to guess at tenths or quarters of a second, while you're busily trying to detect when the blood stops moving and a clot has formed.

They've been testing INR for at least 50 years, long before meters were available, and tilt table is the method used. So - even though your joke about dad's INR being measured using a pendulum looked ridiculous on the face of it, the principal behind actuallly timing the prothrombin time using a stable source is solid. Check out Tilt table, or look up the gold standard method for detecting INR, and you'll see that this method uses timing to detect a clot - and a pendulum may actually be adequate.

Not horseshit.

Not a joke like the one that you made about your father.
 
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