New To Coumadin? It's Not To Be Feared. Please Read First

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Well-known member
Dec 15, 2001
On The Hot Seat
Dose the diet, don’t diet the dose - Eat what you like. If you are fairly consistent in what you consume on a weekly basis (such as green salads and vegetables) you can enjoy the food you love and the dose is adjusted according to your eating habits. Bottom line – live the life you would normally live and let the dose be adjusted to that.

My doctor says I'm taking too much Coumadin
If your INR is in-range, the amount of Coumadin taken to get you there is never "too much". Do not try to control the amount of Coumadin you take by what you choose to eat.

Adult beverages – You do not have to give up that glass of wine, or ice-cold beer that tastes so good on a hot summer evening. Responsible, moderate consumption of alcohol is not something you have to stop. However, over-indulging is not something you would want to do. More than the risk to your INR** level, over consumption of alcohol may exacerbate stomach lesions or ulcers and cause bleeding that you may not become aware of immediately. But a glass or two of red wine in the evening or with friends is perfectly acceptable.

Blood thinner- Contrary to the oft heard term referring to what type of drug Coumadin is, it DOES NOT "thin" your blood. Your blood's viscosity (thickness) does not change. The drug blocks the action of vitamin K within the liver. The drug effectively competes for the same absorption sites within the liver needed for vitamin K uptake. Thus the levels of vitamin K within the liver decrease. Reduced amounts of clotting factors VII, IX, X, and II are produced, and the clotting action of the blood is progressively impaired. The term "blood thinner" leads people to think that their blood will run out of them if they are cut. If your blood is a bottle of ketchup, adding Coumadin to it is not like adding water to it. The ketchup does not "thin out" with the addition of Coumadin. It's consistency is still the same, it just won't stick to your hamburger as easily.

It’s easier to replace blood cells than brain cells – Some doctors and other professionals in the medical field fear bleeding more than they fear stroke. Because of this, sometimes they will make adjustments in your Coumadin (warfarin) management in order to prevent bleeding by lowering or skipping doses when they see a high INR. The danger of this is that it puts the patient in greater jeopardy of forming a clot, which can result in a stroke by bringing their INR below therapeutic level. Damaged brain cells cannot be replaced, blood cells can be. The best approach is a cautious approach. An INR of 5 may look scary to the newer Coumadin user, but if you are an otherwise healthy person your chance of having a bleeding event (think of a quart of milk) at that number is extremely tiny. Most Coumadin users would much prefer to have an INR above their therapeutic range than an INR below their therapeutic range. For most, it is much easier to lower a high INR than to raise a low INR.

If you are faced with a medical or dental procedure, look to the official organization of the particular field for official protocol. Because of the fear of bleeding, not all doctors, dentist or oral surgeons choose to follow protocol.

My active lifestyle prohibits me from taking Coumadin. – The term “active lifestyle” is very subjective. Many warfarin users lead extremely active lives. has marathon runners, tri-athletes, swimmers, bikers, motorcyclists, boaters, world travelers, scuba divers, skiers and various other kinds of activities represented in our membership. Contact sports and other activities that present regular risk for serious injury may need to be reconsidered. Ski diving was always given as a sport you may need to give up. That has been rethought when one member commented that if your chute doesn’t open, being on Coumadin or not isn’t going to make much of a difference. Always follow the prescribed safety precautions called for in the sport you choose.

Don’t run with scissors! – There are many myths about what you shouldn’t do while on Coumadin in order to keep from bleeding to death. Things such as never sharpening your kitchen knives and only using an electric razor are a few of many that are just plain laughable. If you knick or cut yourself, you apply pressure as you would if you weren’t on warfarin. The only difference is that it may take a little longer for the bleeding to stop. Many Coumadin-taking members here have had some pretty good cuts and gashes. You can lose 2 pints of blood without getting into trouble. Picture what a spilled quart of milk on the floor looks like. Chances are anyone, regardless of whether they take warfarin, will have headed to the ER well before seeing 2 pints of blood come out of their body.

Home testing – Fortunately for warfarin users, the home testing field is growing rapidly. If one of your reasons for not wanting to take Coumadin is having to get tested regularly, then consider home testing. Many insurance companies will cover all or part of the cost of the machine and supplies. If your doctor tells you that home testing is not accurate, then you may want to consider what other old, incorrect information your doctor relies on. Home testing is just as reliable as going to a lab and may sometimes be more reliable depending on how long the lab lets your blood sit before testing it. If your doctor says he/she will not let you home test, ask them if they would make a diabetic patient go to a lab 2 or 3 times a day to test their blood glucose. The physical act of testing your blood to get an INR is basically the same as testing it for blood glucose. You stick your finger and put a drop of blood on a test strip in a little machine and wait for a number to “pop up”. The big difference is that you don't test more than once a week and sometimes only once a month if you are on Coumadin.

**INR – the number that tells how quickly or slowly your blood coagulates. A healthy person not on Coumadin will have an INR of around 1.0. Therapeutic INR range for aortic valve replacement is usually 2.0 – 3.0, for mitral valve replacement 2.5 – 3.5. Individuals may have particular circumstances that would call for their range to be different from these.

+++The members who put this list together are not medical professionals and the information here should not be taken as medical advice. It is information that has been gathered through years of our own personal warfarin usage. There is much more information about Coumadin, but we wanted to address the most often asked questions and the most often heard misconceptions.+++

For surely I know the plans I have for you, plans for your welfare and not for harm, to give you a future with hope. Jeremiah 29:11
Non-rheumatic Mitral Valve Prolaps,
10/91 Mitral Valve Replacement, St. Jude Mechanical 33mm
Home testing INR since 2002
DOB 12/6/58
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