Coumadin a no-no??

[PMP]

Anybody have experience with a cardiologist telling you you need Coumadin but the nephrologist saying "no way"?

My father is on hemo.  He's 83 years old.  Has a graft.  Started with a slow heart rate about three weeks ago.  His cardiologist wanted him to start on Coumadin and a drug to try and regulate the heart rate (which didn't work...made him feel like he'd been hit by a truck).  Until they get that worked out, though, the cardiologist wants him on Coumadin, to help prevent a stroke.

Well, the nephrologist won't hear of it.  We understand why, but I was wondering if anybody else has faced this kind of situation...one doc saying one thing, another doc saying another...and the patient getting nowhere.  And does anybody know if Coumadin can really cause a bleeding problem that can get out of control or something??

Thanks!

Pat

[flip]

Coumadin (sodium warfarin) is also found in rat poisons. In larger doses it causes internal bleeding. That's how it kills rats.

[thegrammalady]

i'm on coumadin because i had a pulmonary embolism. the neurologist is aware of it. they take a blood level every monday at dialysis (they fax the results to my primary care doc and have adjusted the heparin i get during dialysis. i'd ask the neph what his problem is. it kind of sounds like he doesn't want to deal with the adjustmenst that will have to be made for dialysis.

[PMP]

"it kind of sounds like he doesn't want to deal with the adjustmenst that will have to be made for dialysis."


Grammalady, I think you hit the nail on the head.  A cardiologist friend (not my dad's doctor) said the same thing.  Do you mind me asking if you've had any out-of-the-ordinary problems with bleeding after dialysis since you started on the Coumadin? 

Pat

[cambonesegirl]

I was on Coumadin a couple times while I was on dialysis because I had blood clots from previous cathaters in me, I really didn't have any problems with excess bleeding after dialysis treatments, but everyone is different. Maybe your Dad can ask the nephrologist if he can take some baby aspirin, it helps thin the blood out some.

[boxman55]

I am allergic to heparin so I take coumadin to prevent clotting the machine...Boxman

[thegrammalady]

"it kind of sounds like he doesn't want to deal with the adjustments that will have to be made for dialysis."


Grammalady, I think you hit the nail on the head.  A cardiologist friend (not my dad's doctor) said the same thing.  Do you mind me asking if you've had any out-of-the-ordinary problems with bleeding after dialysis since you started on the Coumadin? 

Pat

i had a bit of trouble clotting when they changed to coumadin dose, i went from 2mg daily to 2mg 5 days a week and 3 mg twice a day. i take the extra on wed and fri nights. the second week of the change i had a little trouble clotting after friday's treatment. the nurse just adjusted the amount of heparin i get, no problem with doing it.

[PMP]

I am allergic to heparin so I take coumadin to prevent clotting the machine...Boxman

Boxman, you're back home??  Nice!  Hope you're doing okay.  And thanks for responding. 

Also, I've never tried this website's option to "quote" in my reply, so no telling what this is going to look like!!  Sorry if I've screwed up.  Guess we'll see.

Pat

[PMP]

I was on Coumadin a couple times while I was on dialysis because I had blood clots from previous cathaters in me, I really didn't have any problems with excess bleeding after dialysis treatments, but everyone is different. Maybe your Dad can ask the nephrologist if he can take some baby aspirin, it helps thin the blood out some.

Hi Cambonesegirl,

My father is taking baby aspirin currently.  I was thinking maybe they could take him off of that on the days of dialysis or something.  Well, thank you for your comments.  I love hearing about other people's experiences and opinions.

Pat

[PMP]

i had a bit of trouble clotting when they changed to coumadin dose, i went from 2mg daily to 2mg 5 days a week and 3 mg twice a day. i take the extra on wed and fri nights. the second week of the change i had a little trouble clotting after friday's treatment. the nurse just adjusted the amount of heparin i get, no problem with doing it.

You know, one of the nurses at the dialysis center told my dad that if he did go on Coumadin, they would probably need to adjust the heparin he gets.

Pat

[stauffenberg]

I was on Coumadin for all eight years I was on dialysis, since my renal failure had been caused by Wegener's disease, which had produced various clots in my veins.  I never had any problem with the combination of Coumadin and dialysis, although the INR value (internal normalization ratio -- a measure of the slowing of blood clotting capacity by Coumadin), had to be monitored closely.  Some patients, especially those with fistulas, will experience difficulty with prolonged bleeding from taking Coumadin on dialysis.

[PMP]

Stuaffenberg, eight years?  Wow.  My dad already occasionally has problems with stopping the bleeding.  I've wondered if those Sure Seal bandages would help, but his clinic doesn't (and won't) use them. 

He knows Coumadin will probably make the bleeding worse, so we (his children) think he's not too upset that the neph isn't allowing it.  So we're just waiting for him to have a stroke.  Not a comfortable feeling. 

I hate dialysis!!! 

Pat

[boxman55]

Yuo can order the sure-seals on line for about 16.00 per hundred if you want to try them...Boxman

[PMP]

Yuo can order the sure-seals on line for about 16.00 per hundred if you want to try them...Boxman



I wish I could get the real scoop on those things.  They sound like a great solution to me, but my father has been told that if he uses them, he's pretty much asking for trouble with his graft...trouble as in a trip to the hospital.    

Pat