Upcoming surgery.

[Ward]

I will be having my aortic valve replaced, and at age 41 have decided to get a St. Judes mechanical. The Coumadin idea bothers me some, but would rather not have another surgery like this in my lifetime. No surgery date yet, my cardiologist wants to do an angiogram first to look around in there. That is scheduled for July 17, 2001. I would like some input on Coumadin. Thanks.

 

[Christina]

Hello Ward,

I have been on Coumadin for almost 11 months, and it has given me no side effects so far. It takes a while to get "regulated" though, and it can get frustrating and scary at times especilly when the INR is either too low or too high. But like you I also opted for the mechanical as I don't ever want to do this again if I can help it.
I have my own Protime machine and check my INR often as anything and everything interferes with Coumadin.

Read the following. I hope it gives you the help you are looking for.

The only oral anticoagulant is coumadin. This is given for several months after a person has had a blood clot in a leg vein or the lung and sometimes after a heart attack as well. People with mechanical heart valves and many patients with atrial fibrillation or blood clots in their heart chambers must remain on coumadin chronically to prevent strokes. Some people have unusually thick blood due to abnormal coagulation proteins and also must remain on coumadin permanently.

Treatment with coumadin requires periodic monitoring with blood tests. Doctors used to measure something called the prothrombin time or "pro-time" but we now measure a more accurate indicator of blood thinning called the International Normalized Ratio (INR). The main side effect with coumadin is an increased risk of bleeding.

Many medications interact with coumadin. It is prudent to check the INR more frequently when other medications are added or withdrawn.

Coumadin works by interfering with the effect of vitamin K. Vitamin K is used by the liver to make some of the coagulation proteins. Excess vitamin K will offset the effect of coumadin. However, contrary to popular belief, people on coumadin do not have to avoid foods with vitamin K. The dose of coumadin can be adjusted for any level of dietary vitamin K intake. However, it is important to eat the same amount of vitamin K containing foods all the time so that the level of blood thinning remains stable. Vitamin K is found in vegetables, particularly the green leafy vegetables.


Christina

 

[Rain]

Coumadin

Coumadin

Coumadin is a royal pain in the butt!! But so is heart surgery!

It makes a big difference how 'consistent' your life style is. Some people have a lot less problems with it than others.

It really helps to have your own monitor.

Good luck!

Rain

 

[LeslieD]

Having Ross Procedure

Having Ross Procedure

Ward,
I understand about future surgeries. I'm 40 and scheduled for my 1st surgery on 7/25. I've chosen the Ross Procedure. If this is not a possible option once they get in I've had a hard time deciding on mechanical or tissue. I'm so afraid of Coumadin because my life style is not consistant. Mechanical valves have other problems and don't always mean no more surgery either.

What were your deciding factors to go mechanical other than future surgery?

Leslie

 

[Nancy]

Hi Ward

Hi Ward

My husband Joe has been on Coumadin for 24 years. It's not that difficult. You go and get tested about once a month plus or minus depending on how regulated you are. They will let you know your results and how much Coumadin to take. That's it until the next testing time.

Joe doesn't fuss too much about what he eats and drinks. He's tries to do everything in moderation. He's never had a major bleeding incident. His cuts do stop bleeding.

The most important thing is to take your Coumadin as told to take it and at the same time every day. Really, really, no biggie. A minor inconvenience. Also make sure that the facility giving you your dosage is going to be timely with the results. You should receive results the same day.

Joe is going for his third heart valve surgery on July 18.

I wish you the best with your surgery.

Nancy

 

[RobThatsMe]

Hi Ward,


Welcome to the site. Please ask all the questions you have on your mind. There are many fine people here that will help if they can.

I also had my Aortic Valve replaced, 3/23/00. I have a St Judes valve, and take Coumadin.

There are several site that you can use to obtain further information about this drug and other drug interactions. Please check these sites out and lookup your specific drugs that you are taking.

http://www.warfarinfo.com/

http://www.heartpoint.com/coumadin.html

http://neuro-oas.mgh.harvard.edu/stopstroke/coumadin_aspirin.html

http://www.coumadin.com/

The Drug interaction site is:

http://www.nlm.nih.gov/medlineplus/

I have not had any problems with taking Coumadin myself.

Hope you get all this behind you soon,

Rob

 

[martha]

Hi Ward,

I'm 50 and had my aortic valve replacment at 49. Choose the homograph, no coumadin. All I need to take it a baby asperin a day. No worry about bleeding either. Yes, it's true that in 15 years or so I will have to have a replacement. However, they will have come out with so many improvements by that time. Good luck with your decission. martha

 

[hensylee]

Welcome, Ward. My brother is newly on coumadin and is not yet adjusted. That part is a pain but you get used to it. In my brother's case, I am the one who has to get used to it as he is easily confused, so the nurse calls me to make sure he gets his dosage change right!

YOu will do just fine in the surgery. Look at all these members who have gone through heart surgery and we are doing very well (I had bypass, not valve).

God bless

 

[Gerry]

Hi Ward

Welcome to the site. Making the decision between tissue valve or mechanical valve is possibly the biggest decision you will have to make in your life. Unfortunately, there is no perfect solution or choice.

It really boils down to a mechanical valve + coumadin for the rest of your life or a tissue valve (including an allograft) with no lifestyle restrictions or drugs but a reasonable possibility of a re-op down the track.

All the coumadin people on this site will tell you that if they had their time over again, they would still make the same choice. I think the tissue people would say the same. That's because we have all learnt to live with our respective fates and so few of us have done both, so we can't compare.

Anyway, a few thoughts to consider :- We humans are very resilient and we get used to almost anything, no matter how daunting it might seem beforehand. (If you have never brushed your teeth before and were told you had to start this twice daily routine, you'd think what an imposition).

Modern cardiac surgery is pretty straightforward and routine. In my case, I was in hospital 1 week then 1 week feeling a bit sorry for myself and then I started getting back to normal. I was back at work 6 weeks after surgery. I have friends who have been inconvenience or "suffered" more due to broken limbs or torn muscles. So for me, the prospect of another surgery doesn't hold the fear that it does with some others.

Bottom line :- draw up a list of pros and cons for each option and decide which of those factors has the greatest impact (positive & negative) on YOU personally. Ask questions, read articles and you will know when you are ready to make a choice which you feel is RIGHT FOR YOU. It's a personal decision for every one of us and what was right for me may not be right for you.

Hope this helps

Regards

 

[Dan O'Brien]

Ward,

I concur with Gerry. I am 37 and had my aortic valve replaced 3/28/01 with a homograft. I spent 5.5 days in the hospital and was off work for 6 weeks. I know I will need another valve surgery in my lifetime -- hopefully only one more. Now, a little over three months after my surgery, I am playing baseball with my son, playing some of the best golf of my life (maybe it's the caffeine I cut out), holding my 20 month old daughter, etc... I feel almost as if I never even had surgery. My wife even has put me back to work in the backyard (it can't all be good). I find that my life has gotten back very close to normal in a very short timespan. I now just take one baby aspirin per day. For all of this normalcy, I believe I can handle another heart surgery, which was not nearly as bad as I expected.

As Gerry said, this is a very personal choice with no easy answer. I was fortunate to have a complication-free surgery, although I did have to go back into the hospital with concerns of an infection -- which turned out to be a false alarm. It may not be as straight forward next time around. If you have the time, I would recommend you research all of your options, talk to different surgeons about their recommendations, and then go with your heart --sorry, couldn't resist.

Best wishes to you as you search for the best answer for you.

 

[Jean]

Decisions!

Decisions!

Ward,

I echo what the others say here. I had a homograft at the Cleveland Clinic in Jan. '00. I feel great now and am just on a baby aspirin a day. I love my homograft and will do it again in need be...the surgery and recovery weren't that bad considering how sick I was beforehand (my family doctor let it go way too long. I'm just lucky there were no long term effects.)

Still I would never presume to tell anyone what to do. But I do think you need to do all the research you can find on all the options and then make a decision you feel at peace with. Talk to the Lord a lot...He will guide you. By the time I had my surgery, I was totally at peace, which is more than I can say about my husband who was a wreck. I think it is easier for the patient than the family.

Good luck and God bless. Keep us posted so we can keep you in our thoughts and answer any questions you may have...DO NOT HESITATE TO ASK...the only stupid question, is the one not asked.