aortic aneurysm and coumadin

[SueInBoston]

Hi All,
My brother was recently diagnosed with aortic aneurysm and will need surgery. Once the doctors open up his chest, there may be a possibility that his aortic valve will need to be replaced. He is trying to make the decision between a mechanic valve vs. pig's valve. One of the deciding factor is coumadin. Any Disser take coumadin and can share their experience? Good or bad? My brother is 57, in good health and exercises.

Thank you for any advice

 

[The Mystery Machine]

Wow, I don't have a clue. I didn't know you could make a choice like that. My oldest may need a aortic valve replacement in her future. She has a repaired heart defect.

What does the surgeon say?

 

[Acklander]

I've taken coumadin for about 6 months after having a blood clot in my arm. It wasn't bad. You can't eat any of the deep leafy green veggies with it (i.e. spinach, dark salads etc...) because it nullifies the effects of it. If you get a bloody nose or something else where you bleed it's hard to stop. I had to wear a medical bracelet while on it in case of accident so that the medical people would know why I was bleeding like a stuck pig.

 

[PRINCESS VIJA]

Couple of things to add to the list to think about... How long does the surgeon say a pig valve will last? that would be something I would consider

My dad ended up with a mechanical valve, because he did not want a redo surgery, but was unhappy when he heard he had to really limit the alcohol intake because it messes up the coumadin levels.

 

[clhcpaca]

My mother had a pig's valve put in and it lasted about 7 years. She was told that the average was 6-9 years (this was around 20 years ago). With the pig valve she did not have to take coumadin.

I don't know what they are saying now about the lifespain of a pig valve, but if he uses the pig valve at age 57 he will probably end up with having another valve surgery. My Mom ended up having the artificial valve put in and taking coumadin. She had horrible experiences with it---she had to be one of the exceptions that the doctors could not get her levels regulated. It does react to foods and other medicines and the dose has to be watched.

Cindy

 

[SueInBoston]

The doctor said the pig valve will last approx. 15 years and no need to take coumadin. The mechanic valve will last forever but will need coumadin. Part of his concern with coumadin is diet restriction (he likes his wine with dinner and an occasional bourbon). Also he is still very active, rides motorcycle (leisure only), plays sports, so he's also concern that if he suffers any cuts, the coumadin will have a serious affect to his bleeding.

 

[Halloweenqueen]

I am on coumadin for life. I get checked every two weeks to make sure my INR (clotting time) is within a certain range. Most people go in once a month, but my blood is very reactive, so I go more often.

I've had two DVTs and three PEs. I have a clotting disorder.

The inconvenience of going to the doctor can be frustrating. Luckily when I moved to WA I found a coumadin clinic near my home. Appointments go much faster than a typical doctor's visit.

I have to watch my diet. Things that contain vitamin K, like dark greens can lower your clotting time. Things like alcohol and cranberry juice and increase it.

Side effects vary. I am very sensitive to cold. My hands will burn just getting a carton of ice cream from the freezer. I also experience hair loss. Many people complain of fatigue and weight gain.

Of course I have to watch my activity. I wouldn't ski or sky jump, etc. It's good to wear a medical bracelet and remind friends and family of your medication in case of an accident.

It takes some adjustment, like treating diabetes, but I fell into a routine and it's quite manageable. Good luck!

 

[SueInBoston]

bump...

anyone else have experience with coumadin?

TIA

 

[kacaju]

My dh has an artificial valve. He had surgery 5 years ago to repair his defective (born with it) aortic valve. My dh was 44 when he had his surgery. We were told, just as your brother was, the differences in the valves. One Dr. told dh that he would go with the pig valve so he didn't have to be put on the coumadin. You would just need surgery in about 10 years again.
The other Dr. looked my dh right in the eye and said... you are a young man, you don't EVER want to have this surgery again.
We went with that Dr. and DH had many complications after his surgery, that Dr was SO RIGHT. I think dh would rather die then go through that again. (he had complications due to his crohn's, he is not a *normal* heart patient)
Dh has, in these 5 years only once had an issue with his blood levels being off. He started having a nose bleed one morning and it didn't stop, turns out his levels were so off they almost had to transfuse him. He goes monthly to the lab to have his blood drawn. He has had minor issues but nothing bad other then that one time. the Dr.'s office calls him and they adjust his coumadin over the phone and then he goes back in a few weeks and checks his blood again. It has become routine to him and for him it is not a big deal.
The diet is notbad, what we were told you can go ahead and eat green leafy veggies, just #1 don't over do it and if you eat them on a regular basis your body adjusts. You get into trouble when you don't ever eat that stuff and then you over do it all at once.

 

[SueInBoston]

another bump..

Thank you...

 

[winnapooh]

My dad was on Coumadin after a heart attack. About a year later he developed an abdominal aortic aneurysm, and had surgery for that. Then last Easter, he woke up in the middle of the night thinking he was having a stroke. After being life-flighted to a larger hospital, they determined he didn't have a stroke, but that the Coumadin had weakened the blood vessels in his brain, and he had bleeding through the vessel walls and pooled on his brain, causing intense pain and seizures. It looked like he had hit his head, but he hadn't...it was the Coumadin. Two weeks in intensive care and two brain surgeries later, he had finally stopped having seizures, and luckily, is back to normal.

Ironically, while he was in ICU, there was another woman there visiting her husband who had the identical situation, also caused by Coumadin. Unfortunately, I don't think his outcome was as good as my dads.

To be honest, I would never take Coumadin, nor would any member of my family. However, I'm not a doctor, and I'm sure it helps people....but with the experience my family went through, it's not worth it.

 

[SueInBoston]

another bump for the weekend crowd..

thank you

 

[lucas]

My dad was on Coumadin after a heart attack. About a year later he developed an abdominal aortic aneurysm, and had surgery for that. Then last Easter, he woke up in the middle of the night thinking he was having a stroke. After being life-flighted to a larger hospital, they determined he didn't have a stroke, but that the Coumadin had weakened the blood vessels in his brain, and he had bleeding through the vessel walls and pooled on his brain, causing intense pain and seizures. It looked like he had hit his head, but he hadn't...it was the Coumadin. Two weeks in intensive care and two brain surgeries later, he had finally stopped having seizures, and luckily, is back to normal.

Ironically, while he was in ICU, there was another woman there visiting her husband who had the identical situation, also caused by Coumadin. Unfortunately, I don't think his outcome was as good as my dads.

To be honest, I would never take Coumadin, nor would any member of my family. However, I'm not a doctor, and I'm sure it helps people....but with the experience my family went through, it's not worth it.

I don't think anybody would choose to be on Coumadin. But those with atrial fibrillation have no choice. It's better than risking a stroke from not being on it.

 

[jbthi]

My husband has been on coumadin for a few years and will be on it the rest of his life. He loves salads, brocolli, etc. I just make sure he eats approx. the same amount foods with Vit. K each day. The only thing I have difficulty with is meds. Some meds will affect the reading and they don't show it on the info sheet. I don't know about it until his reading is off. They will ask him about anything new he is taking or using. The last thing that did it was a cortisone cream.

 

[joliesmom]

WIth coumadin you have to eat a consistent amount of dark green leafy vegetables because they are high in vitamin K (which is the antidote to coumadin). Coumadin thins your blood, vitamin K thickens your blood. They are giving you an estimate of 10-15 years with the pig valve, who knows where we will be medically in 10-15 years. I recently had a patient that had a trial valve replacement via her groin. I would say avoid the coumadin if you can, it really does impact your life with monitoring and risk of bleeding.

 

[Shelby5514]

I don't think anybody would choose to be on Coumadin. But those with atrial fibrillation have no choice. It's better than risking a stroke from not being on it.

My mother has A-fib, she was put on Coumadin in 2007 and had her blood tested faithfully. One night in Feb 2008 she woke up out of a sound sleep with a horrible headache, when she tried to get out of bed to take something for it she passed out. Luckily my sister was living with her at the time and called 911. She was rushed to the hospital where we found that she indeed had a severe hemorrhagic stroke and they told us to contact the family as she only had 24 hours to live. On her CT scan you can clearly see her brain had shifted due to all the bleeding. It was determined that the coumadin she was on caused the bleed and therefore the stroke. Thank God she had a wonderful team of neurologists that didn't give up on her and she is still with us. All of her doctors have vowed to never put her on the rat posion they call Coumadin again. I know it works for a lot of people but we're just not willing to take that chance again.

 

[lucas]

My mother has A-fib, she was put on Coumadin in 2007 and had her blood tested faithfully. One night in Feb 2008 she woke up out of a sound sleep with a horrible headache, when she tried to get out of bed to take something for it she passed out. Luckily my sister was living with her at the time and called 911. She was rushed to the hospital where we found that she indeed had a severe hemorrhagic stroke and they told us to contact the family as she only had 24 hours to live. On her CT scan you can clearly see her brain had shifted due to all the bleeding. It was determined that the coumadin she was on caused the bleed and therefore the stroke. Thank God she had a wonderful team of neurologists that didn't give up on her and she is still with us. All of her doctors have vowed to never put her on the rat posion they call Coumadin again. I know it works for a lot of people but we're just not willing to take that chance again.

It is scary. Too much Coumadin can cause a stroke.

On the other hand, I know someone who had 2 strokes due to A-fib and not being on Coumadin.

Seems you can't win!

 

[Shelby5514]

You're right Lucas, damned if you do and damned if you don't.

Since her A-fib is under control now, they felt that the Coumadin was just too much of a risk for her to continue taking it.

 

[lucas]

Also you have to be very careful of any supplements and over the counter meds you are taking while on Coumadin. I have heard even vitamin E and fish oil supplements can alter blood results while on Coumadin.