Warfarin first timer needs advice

[steve119]

Hi I had heart valve replacement surgery and was fitted with a mechanical valve, six weeks ago. I'm 24 yrs of age. I have a few questions i was hoping that could get answered.

1) My INR is currently at 3.6, i'm getting checked every two weeks, i have been told it needs to be on 2.5. I'm currently taking 4/5mg on alternate days. How long does it usually take for the INR to become stable? Also what are the risks of the INR level being too high?

2) I am quite a sporty person, and like to play contact sports. I have been given differing advice on whether it is stilll possible to play contact sports, for example soccer, which i play a lot of. What are peoples thoughts on this, and what are the risks ok playing?

3) Finally I used to get my chest waxed quite frequently, will this still be possible to do being on warfarin. obviously once the scar has fully healed?

Many thanks, look forward to the replies.

 

[Rich]

Steve,
I think the first question regarding your warfarin, is the most inportant issue here.
You should not have a target to shoot for, but rather a range.
With a mechanical valve(like mine) it probably should be 2.5 to 3.5.
That is a pretty common range.
Trying to hit a specific number is next to impossible.
Perhaps you may have mis-understood what they told you?

Regarding contact sports, I would say you would have a LOT of bruises at the least. Personally I would advise against it.
Rich

 

[Ross]

Yes, your range should be 2.5 to 3.5 and not a set number. It is, in my opinion, impossible to hit. While 3.6 my be our of your range, it would not require changing the dose you are on. Most of us like to be at the higher end so we can indulge in extra greens and things. At six weeks to eight weeks, your INR should be stable. If it's not, someone isn't doing something right.

Contact sports is going to produce a lot of bruising. If that's what you do for fun, protect your head as much as possible and go have fun.

Last time I checked, waxing has nothing to do with bleeding, so I wouldn't know why not.

 

[PamO]

Ross - have you ever waxed? YIKES And you can bleed a little from it, but not a lot.

 

[Georgia]

Rich, you need to visit www.warfarinfo.com - an invaluable website run by our invaluable Al Lodwick (hear the fanfare?).

3.6 isn't going to hurt anyone; if you'd had another check immediately after this one, it might have been 3.4. The inr is a tricky thing, which is why you're given a range rather than a single value.

Please continue to ask any questions you have; you might want to read threads on this site, and you'll find out what an accomplishment it is to have an inr of 3.6. Many people on this site would be thrilled with that!

 

[Gemma]

Hi Steve, nice to see another Brit here

Now, to answer your questions:

1) which valve did you have replaced? If it was your aortic valve, the range you should be aiming for is probably 2.0-3.0 (which would make 2.5 bang in the middle). If it's mitral, it'll be a bit higher (2.5-3.5 or 3.0-4.0, I forget which). As everybody's already said, 3.6 isn't really horrifically high. Below 2 or above 5 are generally where you have a problem. Also, at 6 weeks out it's very possible your INR may start to creep down again gradually, as you recover more and get back to your usual lifestyle. My boyfriend Jim's INR range of 2-3 (aortic valve replaced) was maintained on a dose of 6mg daily at first, now 2 years later he takes 9mg. Just a side-effect of getting your life back!

2) Jim's surgeon and cardio both said he could do whatever he wants. He rides a motorbike (on the road and recently started trials riding), mountain bike, works in an engineering job... However, head injuries are best avoided whilst on warfarin, so no more heading the ball maybe!

3) OUCH! Probably no reason not to wax your chest from a warfarin point of view, but if I was a guy, I think I'd pass thank you very much!

 

[sue943]

Hi Steve

Did they give you a yellow book with your range marked? I have mitral and aortic and my range is 3 to 4, so for me 3.6 would be perfect.

You are obviously very brave, waxing, aaaagh!

 

[William]

If you're like me, it'll be up and down with your INR for some time till it gets stable. About sports, contact sports will be a problem. Other sports, no problem except for getting cut. I jog, lift weights, and rock and ice climb since my replacement 13 months ago. Special attention is given with the climbing to avoid getting a cut, plus I carry a "patch kit" in my backpack, which is a mega bandage kit. As for waxing, it's gotta be safer then shaving. I'd wait a few months though to let your chest heal, you don't want to stretch the skin for a while. Talk to your Doctor about that one. Will

 

[ALCapshaw2]

Contact sports are generally discouraged, primarily because of the probability of bruising and internal bleeding.

HEAD injuries are especially dangerous and a Brain Bleed can be FATAL so headgear is always advised whenever there is a risk of head injuries.

It's up to you how much risk you are willing to take.

'Al Capshaw'

 

[Rich]

Georgia,
I don't understand your comment to me.
I have been 'talking' to Al for years, and I have been on Coumadin for almost ten years.
I do have a fair idea of what I'm talking about.

 

[Guest]

Rich, I think that Georgia put the wrong name in her post.

Steve, I think that it would be best to wear a helmet. I was a consultant in a murder trial where a man died after falling down into a pile of wood chips. You would certainly be at risk if you went down at full speed. Headers would also be a risk for a brain bleed (probably reduced greatly with a helmet). You are probably the first person on this site who openly admitted to waxing his chest. I'm sure that you will not bleed to death from it. Let us know how it turns out. I'm not sure exactly why somebody would want to do that, but at your age, I assume that it is considered a "chick magnet". Please consider coming to the next reunion and entering the prettiest scar contest. Rain would probably want to be a judge instead of a contestant!!!

 

[Georgia]

Mea culpa, Rich - of course I meant Steve - a bit of pumphead and I'm sorry. I even reread it and missed that I had the wrong name. Duh. I certainly didn't mean to offend you. BAD FINGERS.

Thanks, Al.

 

[Rich]

Georgia,
No offense taken, I just didn't understand.
I'm sure Iv'e done similar things.

Al,
Thanks for that response yesterday, I hope my brother-in-law contacts you.

Steve,
I don't know how you can stand a waxing, sounds very painful.
On the lighter side, I threw my back out about a month ago, a problem with the sciatic nerve. It is of course located partially on one's butt.
My doctor suggested using those stick on icey hot pads, instead of a heating pad. Well I did and it felt pretty good. Then that night I wanted to soak in a hot tub of water but couldn't get that pad off. SO my wife offered to remove it. Well talk about a wax job, I almost went through the roof while she of course almost died laughing.

 

[steve119]

Hi thanks for all the replies guys. Much appreciated. From what has been said I think it would be wise of me to give up contact sports, may have to take up golf. Checked my warfain booklet, and my INR range should be 2.5-3.5, so you were right. As for the waxing, the pain isn't that bad after you have had it done about 10 times. The first time was more painfull than the the actual surgery. Thanks once again.

 

[archkre]

Forget about football, even more in G.Britain with the brutality you are having this days!
First foul against you the ref. shows yellow card you are history!
You have beautiful sports like tennis you can practice!

 

[Rain]

Al... are you picking on me again? lol

Al... are you picking on me again? lol

Al, sweetie... I'm from the old school where men were proud to have hair on their chest. Ya know I was in Cancun about this time last year.... not a hairy chest down there, not one. I thought it was a little wierd.

But Steve..... what ever floats your boat. If you are determined to wax your chest, may I recommend a Mohawk? At least for a year or so. And please be careful, enjoy life, but please be careful. Your body is not the same as the body standing next to it that isn?t on coumadin. You?re here asking questions, so I know you?re a smart guy. I?d love to see you take up golf.