Good Morning (from OzTrayliYa)
Thanks for the detailed information. Can I ask please, where did you get the graph from?
most certainly the URL for study it came from is this:
Background Oral anticoagulant therapy is effective for the prevention of arterial thromboembolism in various patient groups. The increased risk of hemorrhage remains the major drawback to this therapy and is associated with the intensity of anticoagulation. Finding the optimal intensity at...
I'm sorry that I didn't include it in my first iteration of this discussion, sheer laziness (and probably the experience that few actually ask for reference sources), I'll reference my citations (which I normally do) with you from now on.
In terms of my activity and any other conditions. I guess I am a fairly normal 50+ year old. My work is office based, away from work I enjoy DIY, gardening, hill walking, tinkering with my old car and when the sun is out and there is a bit of a breeze, sailing a single handed dinghy on local lakes.
you sound a lot like me, although mostly I love my 1989 Mitsubishi Pajero because I never need to tinker with it. I do however need to tinker
with my 2006 Yamaha quite a lot due to its age
and some design flaws
. Sadly however I've not done any sailing since leaving my little coastal village many years ago to "go to the big smoke" and do my degree. There have been many compensations however.
I like a beer or glass of wine but would not describe my self as a 'binge drinker'!
this is definitely me (or was until just this year for reasons I can go into but will refrain from here), so warfarin therapy is no obstacle to that.
My medical history to date has two points of interest, a detatched retina 4 years ago followed by a bleed 2 years ago. My eye doctors are OK with me taking wafarin. I have also had 'friendly' polyps removed in 2 of the last 3 colonoscopies I have had in the last 15 years.
sorry to hear about the issue there but as you have identified, doctors do not suggest warfarin is contra indicated.
I'm seeing a second surgeon next week so will ask about St Judes also. Then it will be decision time.....which surgeon and ultimately which valve type.
Some good reading on why (not having one myself) I have come to recommend the St Jude
Nice to meet someone else with a unicuspid valve (well, I used to have one). Your surgery is a day before my AVR one year anniversary. My AVA was .9 at time of surgery. My results from stress echo made my surgeon opt for surgery (even though I was successfully able to run at top speed at the top...
and of course many other good threads. However (lets use sailing here for your convenience) there is always a difference between what a maker (interested in sales) will claim about their product and then there is what happens to that in the water, does it win competitions and more importantly if its your daily hack how well will it last.
As you know, new comers need to attract someone, and may make claims not actually lived up to.
On the warfarin topic, I have a couple of extra questions. #1 What happens if I need unrelated surgery that the warfarin may cause a problem with, can you come off warfarin for a few days?
Ok, well on my blog I have a lot written on this topic, it boils down to the idea of "management". Some people "couldn't manage to get wet sailing" but others can manage to win races. The choice of a mechanical valve come down to how you manage Warfarin, so lets address two procedures I've had.
Eventually one finds that some sort of small surgery is needed, for those of us on warfarin (perhaps after a large surgery such as a heart v...
I needed to have a little surgery to remove arthritis from my toe, so this being a peripheral surgery where bleeds were less likely (because...
this of course should imply something about the needs for measurement and ways to deal with that, which this artile of mine touches on:
A post on the management of Anti Coagulation Therapy (ACT) by Vitamin K Antagonist (VKA) - Warfarin I've decided to call this the rapid Du...
That was of course written up (by me) in conjunction with another member here (@Chuck C
) who took my management ideas to a higher level (because unlike me he had a more pressing need) of accuracy. I'm both indebted to his diligence and honestly flattered by his recognition.
Naturally you'll notice that a model of modelling has been built in those articles, but not clarified with precision because I yet hold hopes of selling the idea.
#2 Have you ever known of a case when the patient either reacts badly to warfarin or they cannot mantain the required theraputic range? Wondering what happens then.
In the (a little over ten) years of being here I can say
- Harriet was inappropriately advised to have a mechanical (in Canada iirc) and her medical condition was entirely and strongly a contraindication for warfarin therapy
not on this forum but one or two cases appear in the literature where people have apparently been allergic to warfarin and in each case its either been to the dye or the excipient, in all cases I've read this has been addressed with changing brand.
Thanks for taking the time to read and any replies.
you're welcome ... balls in your court, so feel free to digest all that and hit back with questions.
Lastly everyone who starts warfarin (and doesn't just sit around whinging about it) begins to develop a feel for managing it. Not least because of my background in biochem and data modelling I decided (back in about 2014) to develop a data based INR management decision making system to facilitate dose choice with a simple matrix. If you wish when you start managing INR reach out and I can set you up with that and can work with you to teach you how. Over the years here I've worked with quite a number of people and you can find a number of current members who know my model and work with it. Oh, I don't charge and I prefer to teach a man to fish, not become a supplier of fish; so the emphasis will be on making you self sufficient.
I'm sort of retired now and live out in the country to avoid large groups of people and enjoy my life
and ride my bike
as it happens at Mt Alford there is a great micro brewery too (which makes an unannounced appearance at the end.
Scenic Rim Brewery perfect family friendly day trip destination from Brisbane, the Gold Coast and surrounds. A complete craft brewery experience in a heritage listed 130 year old build. Dine at the cafe and try the beer brewed onsite. Scenic Rim Brewery has more than meets the eye!
which never fails to impress me after a nice ride through the mountains to get there.
(and that front disc still has that song bird caught in it