Should one worry about internal bleeding with coumadin after auto accident?

[heartlady2]

Hi everyone, I hope I'm doing this right as this is my first post here. I see the name of several friends form another heart forum--zipper actually encouraged me to post here. My husband, age 50 takes coumadin after aortic valve replacement last Jan. 2001 (a year ago). Yesterday he was in an auto accident where he was whacked from behind pretty severely. He refused to go in the ambulance called to the scene, but does think he might have blacked out for a minute--felt very disoriented. He did go to his regular doctor, a first time visit, after the accident as he was on the way to this doctor's office when the accident happened. The only think the doc found was blood in his urine. The doc said he suspected a UTI (urinary tract infection) although the blood was the only symptom.--apparently no leucosytes or anything. He gave him antibiotics for two weeks, sent him home to return in two weeks. The nurse however, said almost in passing, that she wondered if the impact of the accident caused the bleeding. I'm now a little worried about that? Wouldn't other things have been present if it had been infection? If it were internal bleeding would it stop on its own? What should we do to check it out? We've moved recently so don't know many medical personnel here right now. Working on it. Would appreciate any feedback. H.

 

[RobThatsMe]

Hi Heartlady,

Welcome to the site. I posted this response over on WebMD, didn't know if you saw it, so I am posting it again.

Sorry to hear about Max's accident, but glad to hear that he appears to be OK.

As for the blood in his urine, I have several concerns.

Did the doctor test his INR levels? If his level was too high, bllod in his urine is a symptom of internal bleeding. It may be that he needs his dosage adjusted.

My next concern is that the doctor gave him an antibiodic. Many antibiodics act as a blood thinner.
So, if his levels were already too high, this will thin it even higher. If he did have internal bleeding, than the antibiodic thinning of the blood could make it worse.

I really think that you should rule out an internal engery if possible. I would also make sure that his INR level is within his prescribed range, and have it checked within 1 week of taking the antibiodics to make sure his INR levels are still ok.

I have been on Coumadin for 2 years now, and have a home testing unit that sure helps provide peace of mind. When I read your post, I thought that I would alert you to the concerns that I had.

Hope Max is doing better,

Rob

 

[Johnny Stephens]

Loss of consciousness?

Loss of consciousness?

Hello Heartlady!

You mention "but does think he might have blacked out for a minute". Everything I have ever heard says that any suspected loss of consciousness needs to be evaluated to determine the cause.

 

[Nancy]

Hi Heartlady-

Welcome to the site. It's the greatest place for information, friendship and support for heart patients and their families.

I'm so sorry to hear that your husband had an accident. I have to agree with the others who have posted. If there's anything I've learned throughout my husband's long journey with heart problems, it's that nothing is ordinary and everything means something. So if he "blacked out" even for a few seconds, and also has blood in his urine, I would make sure that he's seen by a doctor who will keep a close eye on him. I would try to get a cardiologist to see him pronto. You should also be extremely observant for anything at all out of the ordinary. I don't want to alarm you, but it's much better to be safe than sorry.

Take care and please let us know how he's doing.

 

[Zipper]

The accident

The accident

Hi H,

Glad to see you here! As you can see, this group responds, and all are very active and caring. It's a great site for any questions and if you subscribe to a thread and request it, it will be sent to your e-mail.

Most here are on coumadin due to valve replacement and have lots of experience. Any time you are in doubt, just ask and you will get answers! Notice it's all printer friendly, also!!!

Salud,

Zipper *~*

 

[Mb]

Hi!

Sorry to hear about your husbands accident. Even small things that happen, never mind an accident can be cause for worry with these patients.

My husband, about four weeks ago now, experienced blood in his urine.
(He had gross hematuria - visible blood to the naked eye - ugh)

The first thing they checked out was the possibility if infection. No infection.

His INR was only 4.0 at the time....a bit high, but certainly not bad.

Well, a day stay at the hospital for IV antibiotics, and a cystoscope later,
with a highly qualified urologist, showed just some slight scarring in the
urethra. So, they think it was the coumaden.

It ALWAYS needs to be checked out. I echo others advice.....call his
cardio.

Lastly, is he absolutely certain he had a blackout after the accident? Is
it possible it was before? I know my husband has dizzy spells....they last
for around 10 minutes sometimes. A-fib is the cause, combined with the
beta blocker. Actually all of this we will know for sure after a stress/echo
scheduled for the 20th.

Best of luck to you. We assure you, that you are NOT too worried. Get
him checked out......and anymore "dizziness", to the ER pronto!

Marybeth

 

[Lorraine]

Hi Heartlady,

Wecome to our VR.com family! You have come to the right place. I'm sorry to here about your husbands accident. Find a cardio quickly. Blood in the urine is nothing to fool around with. I'm with Rob on taking antibiotics if it's possible his INR is too high. His regular doctor should have had an Protime test done to check his INR, before putting him on antibiotics. I think any kind of impact would cause bruising, which could cause bleeding, especially on Coumadin. Please keep us informed of his outcome! Take care!

 

[Marty]

Blood in urine after accident

Blood in urine after accident

All the above comments are appropriate. In my clinic we would follow Max with repeat urine tests looking for blood, INR's to make sure he's in therapeutic range, and not yet mentioned a renal sonogram which can show blood in and around the kidney.

 

[heartlady2]

Hi friends, Thank you all for your replies and input. I am trying to convince my husband to do as suggested and let the cardiologist check him out, and not to wait two weeks (!) to return to the internist to have the blood in his urine rechecked. I will call both doctors tomorrow myself to ask for advice--my husband thinks I worry too much, I think he is hard-headed (of course I'm thankful for that in some ways! LOL) This is Sunday, and we've calmed since Thursday afternoon when the accident occured--my husband is much calmer as well. I am watching him like a hawk however. Thanks for helping us think it through. It would help if we hadn't moved recently of course, so that we would have doctors that actually knew us. Oh well. Thank you all, H.

 

[Jessica_B.]

Hi heartlady!

Hi heartlady!

I'm another oldie from Webdmd as you know . I don't think you are over-worried here. Coumadin is a potent medication and being whacked from behind in an auto-accident could definately cause all sorts of problems. So call the doctors and have them advice you on what to do. Sometimes people are their own worst enemy (me included) when we play down the importance of various events. And if you have to yank him by the ear to take him before the two weeks has passed, you definately should!

I hope all is well with you!

/jessica

 

[Guest]

There are also some top-notch anticoagulation people in North Carolina. To find a clinic in your area look at www.carsgroup.org and click on clinic locations. They will also know cardiologisis in the area.

 

[heartlady2]

Hi Aunt Jess! Its so good to see so many "old" LOL friends here! You 26 year old baby with a transplant! I'm so glad you are doing so well! I greatly appreciated your comments here and on the other board. It helped me be bolder with Max, who definitely wanted to bury his head in the sand. Max had has his protime done just a couple days before the accident, then of course the accident was Thursday, and the doc cut his coumadin in half to compensate for the antibiotic. Having listened to everyone, I have convinced Max to return to the doc this week and not wait for the two week date! I am anxious to see if there is still any blood in his urine, as I've become convinced it was from the impact, not an infection, since they saw no signs of infection. I don't know what they'd do if he is still bleeding, but at least we can check it out. He seems okay--just angry, which is not like Max to begin with--he's mourning the loss of his baby truck! But I appredciate everyone's help and concern--helped me clear my thoughts and develop a plan. Love ya, Helen