Why its probably hard to stay in range for some...

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pellicle

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It is helps many of us that have multiple meds to take, and the divider between the morning meds and evening meds.
now I'm down to three: warfarin, metoprolol and aspirin. As I take warfarin once a day, metoprolol twice a day and aspirin every second day I find the set, check and take process once a week helps simplify it all and reduce mistakes.
 

Superman

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It is helps many of us that have multiple meds to take, and the divider between the morning meds and evening meds.
All good. I’m not suggesting anyone else should do anything different than what works for them.

I take Warfarin, Metoprolol, and Aspirin in the AM. Metoprolol in the PM.

If missing doses ever becomes an issue as I get older, I’m sure I’ll change my approach.
 

Superman

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myself I think you got a leg up by starting much earlier than most of us.

🤔 I wonder if you had any errors in the first few years?

Have a good day
I have no idea. I was talking to my wife about this. I went out of the country for three weeks about seven months after my first surgery. I was still 18. I’m sure I brought my meds with me. But I couldn’t test back then in another country.

I know one of the first things I did was ignore my doctors and start taking my warfarin in the morning instead of “7:00PM”. I never knew where I’d be one evening to the next. But I generally woke up in the same place. Safer for me. I had deduced that the vast majority of people that were on warfarin at the time were pretty religious about finishing up the evening news with Tom Brokaw or Dan Rather, taking their meds, then watching Wheel of Fortune. That wasn’t me.

Either way, I don’t really remember going in to get tested nor do I have memories of taking my meds. I was just on mental auto pilot I guess.

I know I would sometimes go months between blood lab draws. Between full time work and college, getting to lab was the thing that got squeezed out. Back then I was super consistent at 4mg’s daily though and my “pro-time” was always in range when I got around to the lab. Lucky I guess.
 
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pellicle

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Back then I was super consistent at 4mg’s daily
I think being younger helps ... and perhaps being consistent.

As well the data shows that
1) the range of safety is wide
1674096000890.png

and 2) some people are just stroke resistant

Event free:
  • case 1 = 13 years
  • case 2 = 35 years
both cases had maintained antiplatelet therapy (such as aspirin is). Further it contains this table of others:
Table 1
A summary of cases with long event-free survival in patients with mechanical valve replacement.
CASESAGEPOSITIONTYPEYEARS
Kucukaksu et al.1956AorticB-S30
Uzun et al.2345AorticS-E2
Yildiz et al.2042AorticB-S22
Ozkokeli et al.2158AorticS-E37
Ikizler et al.2258AorticS-E34
Sharma et al.2368AorticSt Jude23
Björk et al.16Mitral
Perez-Zaldivar et al.1426MitralSt Jude10
Cicekcioglu et al.2421TricuspidB-S15
Iscan hz et al.2525PulmonarySt Jude15
Enes et al.546MitralSt Jude27
Present case 192Aortic23
Present case 266AorticB-S35
 

jeffp

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and 2) some people are just stroke resistant
Lest some think to play the odds; I imagine a chart of the longest run of Russian roulette survivors would look similar (especially with mitral valves).
Best way to win is not to play, regardless of your possible genetic predisposition against clot formation.
 

slipkid

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I would not be able to manage without my daily pillbox. Just too ez to 4get things without it, then later wondering if took something or not. But that doesn't always mean I remember...

2 years ago I had to transition from normal life where I took my warfarin after coming home from work (or after dinner on days off), to an upside down inside out 12 hour timeshifted backwards nightshift from hell. To keep the warfarin meds on roughly same daily time as b4 I did NOT shift 12 hours fwds or back I just started taking it when I got up which was then in the evening. Which was a very ez adjustment to make though, get up, take the pills.

Now I am back to "normal" lifestyle with dayshift again (HALLELUJAH! Can't believe I lasted 2 years in the godawful hell) and to keep warfarin on same 24 hour clock I have to go back to taking it after work/dinner again and finding it difficult to remember even with the pillbox since I got used to just taking the pills upon waking up. Have had to put up NOTES around the house to remind me to take it in the evening now despite the pills being in the PM part of my pillbox, until I do it enough such that that part of my brain associated with performing non-thinking automatic tasks gets trained for this schedule again.
 

slipkid

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Happy to read this
Thanks Pellicle. Last 2 years of 12 hour nightshifts has been hell, don't even know how I did it. Made 100X worse trying to get any medical tests or Dr appts while I am even awake.

Just try to imagine if all Dr office/labs/etc were only open about 9pm to 7am. And try to figure out how to handle that with 12 hour fasting tests to make it even more ridiculous. GOing 26 hours with no food or 27 hours with no sleep is not ez.
 
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