This is just a hypothetical question but since being on Coumadin I often think of what ifs? Say I slice my finger off when my INR is about 3 and I am not near a healthcare facility. Would I be able to stop the bleeding before I passed out from the blood loss and died? An inquiring mind wants to know.
What happens if I sever my finger?
- Thread starter QuincyRunner
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almost_hectic
Well-known member
Apply and hold direct pressure. As with and major cut. You wouldn’t bleed to death.
pellicle
Professional Dingbat, Guru and Merkintologist
almost_hectic is on the money there ... just apply usual first aid and on such major injuries being on warfarin or not being on warfarin is not going to be the critical. You should apply a tight (no kidding, really TIGHT) bandage right at the end of the joint too. If possible wrap glad-wrap over the end to minimise ingress of any new foreign matter. Get to a hospital quickly.
... also, its really gonna hurt when the shock wears off
... also, its really gonna hurt when the shock wears off
I agree with the above posts.......you will not bleed out if you get to a medical ER ASAP. I haven't cut anything off......but I've tried
....
....got hit in the back of skull by a running ceiling fan. Stitches at a hospital about 15 miles from accident. Went back and finished putting ceiling tiles in place.
....fell off ladder in garage on elbow. Stitches required at an Immediate Care Center.
....deep cut, 1-1/2" long, in fatty part of palm with box cutter. Stitches required at Immediate Care Center.
The positive note is you learn not to do stupid things while on warfarin.........unfortunately I am a slow learner, especially when I get impatient. God knows what stunts I may have pulled had warfarin not reined me in before I did real damage.
.... ....got hit in the back of skull by a running ceiling fan. Stitches at a hospital about 15 miles from accident. Went back and finished putting ceiling tiles in place.
....fell off ladder in garage on elbow. Stitches required at an Immediate Care Center.
....deep cut, 1-1/2" long, in fatty part of palm with box cutter. Stitches required at Immediate Care Center.
The positive note is you learn not to do stupid things while on warfarin
.........unfortunately I am a slow learner, especially when I get impatient. God knows what stunts I may have pulled had warfarin not reined me in before I did real damage.I am not greatly worried by bleeding risks, but I do now keep a well stocked first aid box, with a variety of plasters and bandages etc. just in case
pellicle
Professional Dingbat, Guru and Merkintologist
ever since "that thread" I keep a well stocked cellar with red wines, tons of Aspirin and crucumin tablets for the SHTF Zombie Apocalypse ... and of course naturally a bunch of these so that I can get out of town with the Zombies blocking my way
Superman
Well-known member
Depends which one. A thumb would be the worst. Fortunately we have nine others. You’ll adapt. Could affect your job though, if you’re a professional pianist or something.
AlaJim
Member
AlaJim
Member
You might consider a .45-70 in place of the 30-30. It's got a lot more punch. LOL
pellicle
Professional Dingbat, Guru and Merkintologist
I don't need the range ... :-D For punch I'd go solids in 12G something classic like a Mossberg (if they were legal in Australia ;-)
Agian
Well-known member
No such things as zombies. I looked it up. Stop spreading anti-British propaganda.
pellicle
Professional Dingbat, Guru and Merkintologist
Brexit
Agian
Well-known member
You're going to get thousands of EU bureaucrats coming after you, looking for money. May as well be zombies, but they aren't. Zombies are more intelligent.
If you cut off a finger, blood will flow. It'll probably flow a lot until you put a lot of pressure on it. I'm thinking about wrapping it tightly with thread, dental floss, or maybe even a rubber band, to stop the flow of the blood. Pellicle's suggestion to put a plastic bag over it is a great one - it'll block stuff from getting into the wound, and catch the blood.
Warfarin slows clotting. It's good for small cuts and scratches. It reduces the possibility of a clot forming on the heart valve -- the blood cells that may try to attach to the heart valve or the materials that connect it to your vessels may clot without warfarin - add warfarin, and these clots don't happen.
So - warfarin won't increase the blood flow for cuts where a lot of blood will flow.
But -- for things like impacts with other things, you can get some large, and often very colorful, bruises. (The blood escaping from damaged capillaries and vessels takes longer to clot, so more blood gets into the tissues. I dropped a marble block on my foot a few years ago, and, boy, was that attractive for a few weeks). If you get a hard hit to the head, there's increased bleeding risk - and it probably should be checked out.
OTOH -- if you take way too much warfarin, or you take or eat something that makes the anti-clotting effects of warfarin even worse (cranberry, grapefruit, and other things), you may wind up like a rat poisoned with warfarin and all the lovely critters who eat the rat - working its way up the food chain to birds, wolves, coyotes, and many other carnivores -- by having massive internal bleeding and, in extreme cases, even death.
This is the reason that we (speaking for myself and others who self-test weekly) test weekly, manage (or take advice from 'professionals' who know what the hell they're doing) - so that our INRs stay in range.
Personally, I don't worry about the big cuts - I'm pretty careful, just like the others here are. I don't want my INR below 2 for more than a week or so (preferably never, but low for a few days), but I'm more concerned about it being way too high.
Warfarin slows clotting. It's good for small cuts and scratches. It reduces the possibility of a clot forming on the heart valve -- the blood cells that may try to attach to the heart valve or the materials that connect it to your vessels may clot without warfarin - add warfarin, and these clots don't happen.
So - warfarin won't increase the blood flow for cuts where a lot of blood will flow.
But -- for things like impacts with other things, you can get some large, and often very colorful, bruises. (The blood escaping from damaged capillaries and vessels takes longer to clot, so more blood gets into the tissues. I dropped a marble block on my foot a few years ago, and, boy, was that attractive for a few weeks). If you get a hard hit to the head, there's increased bleeding risk - and it probably should be checked out.
OTOH -- if you take way too much warfarin, or you take or eat something that makes the anti-clotting effects of warfarin even worse (cranberry, grapefruit, and other things), you may wind up like a rat poisoned with warfarin and all the lovely critters who eat the rat - working its way up the food chain to birds, wolves, coyotes, and many other carnivores -- by having massive internal bleeding and, in extreme cases, even death.
This is the reason that we (speaking for myself and others who self-test weekly) test weekly, manage (or take advice from 'professionals' who know what the hell they're doing) - so that our INRs stay in range.
Personally, I don't worry about the big cuts - I'm pretty careful, just like the others here are. I don't want my INR below 2 for more than a week or so (preferably never, but low for a few days), but I'm more concerned about it being way too high.
Drinking cranberry and grapefruit juice or enjoying cranberries and grapefruit will not result in any problems. Many of us do it all the time, and we have test results to prove no INR impact. "All things in moderation."
If you cut off anything, use a tourniquet. They are back in style again.
Superman
Well-known member
Saying it, “will not result in any problems” is false. Cranberry juice does affect INR. Back before home testing and monthly (or less) lab work, I started enjoying cranberry juice quite frequently. After very dark urine tested positive for blood in my urine, my INR came back approaching 10, with no other change than my daily glass of cranberry juice.
I cut that out of my diet and my INR came back down with no other changes.
I haven’t had much cranberry juice since. I also started home testing weekly. A glass here or there isn’t a huge deal, with weekly testing and adjustments to the dose as appropriate. But to say no INR impact is just wrong.
Superman
Well-known member
Kind of funny. When I google for studies, most medical publications will say there are cases demonstrating a link. Warfarin has added it to their labeled list of possible interactions. But there is one organization that says, “nothing to see here!” Something called, “The Cranberry Institute”. 
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pellicle
Professional Dingbat, Guru and Merkintologist
Oh ...
https://www.valvereplacement.org/threads/my-monty-python-moment.42094/
then there's this https://en.wikipedia.org/wiki/Grapefruit–drug_interactions
The effects are caused by furanocoumarins (and, to a lesser extent, flavonoids).[citation needed] These chemicals inhibit key drug metabolizing enzymes, such as cytochrome P450 3A4 (CYP3A4).
and this: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1873672/Subsequent investigations showed that grapefruit juice acted by reducing presystemic felodipine metabolism through selective post-translational down regulation of cytochrome P450 3A4 (CYP3A4) expression in the intestinal wall.
but youre probably right ... fake news
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Thanks, Pellicle, for bringing up that 7 year old thread.
Re: INR ranges --- Tom in MO claimed that, according to IINR, the maximum value for INR is 5, is ridiculous. (Of course, that was 7 years ago)
Most meters advertise a range of sensitive up to at least 8. They probably wouldn't advertise this if it wasn't so.
Years ago, a doctor told me that my INR was 7.1. In November 2018, a hospital lab (probably incorrectly, because it didn't match my meter) said my INR was 6.something.
I had another ridiculously high result from a clinic that apparently didn't know how to handle the blood after it was taken.
Early last year, a lab said my INR was 5.7 (it wasn't - I verified this with two other labs, an immediate test on my meter, and comparison to earlier tests), and the doctor who sent out the blood thanked me when I told him that the lab was wrong because another of his patients, whose INR was always stable, had an INR of 7.1. Clearly, INRs DO go above 5.
Re: INR ranges --- Tom in MO claimed that, according to IINR, the maximum value for INR is 5, is ridiculous. (Of course, that was 7 years ago)
Most meters advertise a range of sensitive up to at least 8. They probably wouldn't advertise this if it wasn't so.
Years ago, a doctor told me that my INR was 7.1. In November 2018, a hospital lab (probably incorrectly, because it didn't match my meter) said my INR was 6.something.
I had another ridiculously high result from a clinic that apparently didn't know how to handle the blood after it was taken.
Early last year, a lab said my INR was 5.7 (it wasn't - I verified this with two other labs, an immediate test on my meter, and comparison to earlier tests), and the doctor who sent out the blood thanked me when I told him that the lab was wrong because another of his patients, whose INR was always stable, had an INR of 7.1. Clearly, INRs DO go above 5.
pellicle
Professional Dingbat, Guru and Merkintologist
no worries, its what I do ...
but please, I'd appreciate it if you didn't directly and in an inflammatory way provoke Tom (its like a punch and judy show). Subtle mentioning of facts is sufficient IMO. After all Tom is a reasonable man.
Also I think you are misreading toms remark: "IIRC the quantitative range of most INR tests is about 0.5 to 5, so any INR level over about 5 is not "real", but certainly over 5. "
I believe this is entirely consistent with understandings of the Roche XS system
which suggests that when a Coagucheck is showing 4.5 it maybe that a lab is showing a little less and that this trend exaggerates if you look at the linear they've (probably the computer has) chosen for that.
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