Have to go back on coumadin...
Well, I saw another neurologist, my previous one is moving so he referred me and this one has almost a totally different opinion on my status. Of course though he has more knowledge and experience with PFOs (Amy B. see below 
).
Here is your Sally Struther's Learn from Home - Medical Degree lesson for the day:
Patent Foramen Ovale (PFO)
"The foramen ovale is a small hole located in atrial septum that is used during fetal circulation to speed up the travel of blood through the heart. When in the womb,a baby does not use it's own lungs for oxygen-rich blood, it relies on the mother to provide oxygen rich blood from the placenta through the umbilical cord to the fetus. Therefore, blood can travel from the veins to the right side of the baby's heart and cross to the left side of the heart through the foramen ovale and skip the trip to the baby's lungs.
Normally the foramen ovale closes at birth when increased blood pressure on the left side of the heart forces the opening to close.
If the atrial septum does not close properly, it is called a patent foramen ovale. This type of defect generally works like a flap valve, only opening during certain conditions when there is more pressure inside the chest. This increased pressure, called the Valvsalva maneuver, occurs when people strain while having a bowel movement, cough, or sneeze.
If the pressure is great enough, blood may travel from the right atrium to the left atrium. If there is a clot or particles in the blood traveling in the right side of the heart, it can cross the PFO, enter the left atrium, and travel out of the heart and to the brain (causing a stroke) or into a coronary artery (causing a heart attack)."
Since I have a history of DVT (deep vein thrombosis) he wants me to go back on Coumadin and talk to my cardiologist about having surgery to close the PFO...it's a minor surgery. I asked him about just getting a filter and he said they have too many complications for this. I guess if I was going to go through a minor procedure might as well close the PFO. He has ordered several more tests and will determine the actual course of action after he gets those results.
Well, at least I got about 10 days with no coumadin, and will get a few more since I can't be on it for some of the tests he ordered. Bad news is I finally got my period and it wasn't fun, and I had been off the coumadin so not looking forward to next month.
~Sarah Margaret
).
Here is your Sally Struther's Learn from Home - Medical Degree lesson for the day:
Patent Foramen Ovale (PFO)
"The foramen ovale is a small hole located in atrial septum that is used during fetal circulation to speed up the travel of blood through the heart. When in the womb,a baby does not use it's own lungs for oxygen-rich blood, it relies on the mother to provide oxygen rich blood from the placenta through the umbilical cord to the fetus. Therefore, blood can travel from the veins to the right side of the baby's heart and cross to the left side of the heart through the foramen ovale and skip the trip to the baby's lungs.
Normally the foramen ovale closes at birth when increased blood pressure on the left side of the heart forces the opening to close.
If the atrial septum does not close properly, it is called a patent foramen ovale. This type of defect generally works like a flap valve, only opening during certain conditions when there is more pressure inside the chest. This increased pressure, called the Valvsalva maneuver, occurs when people strain while having a bowel movement, cough, or sneeze.
If the pressure is great enough, blood may travel from the right atrium to the left atrium. If there is a clot or particles in the blood traveling in the right side of the heart, it can cross the PFO, enter the left atrium, and travel out of the heart and to the brain (causing a stroke) or into a coronary artery (causing a heart attack)."
Since I have a history of DVT (deep vein thrombosis) he wants me to go back on Coumadin and talk to my cardiologist about having surgery to close the PFO...it's a minor surgery. I asked him about just getting a filter and he said they have too many complications for this. I guess if I was going to go through a minor procedure might as well close the PFO. He has ordered several more tests and will determine the actual course of action after he gets those results.
Well, at least I got about 10 days with no coumadin, and will get a few more since I can't be on it for some of the tests he ordered. Bad news is I finally got my period and it wasn't fun, and I had been off the coumadin so not looking forward to next month.
~Sarah Margaret 
Sarah,
Sorry to hear that you've got to go back on the coumadin. If you have the "repair" surgery, will you be able to go off the coumadin afterwards? If so, it might be worth it just for that.
You've made so much progress despite the bumps in the road. Hopefully, this is just another little "bump"! Hang in there!
Vickie J. 
From what I've read, and what he explained...if I get it repaired I would stop coumadin, it's an either or thing. He is actually doing a study comparing the 2 options...closing the PFO vs. coumadin. But those results will not be in for a couple more years before they know which is the better treatment. Given the risks of being on coumidin I will probably opt for the closure...but I know I have a lot more questions before I make a final decision. I also want to get my PCPs input on the matter.
Sorry Sarah to hear that you have to go back on coumadin. I know how you was looking forward to not having the dreaded monthly thing 
.
Do you know if by having the operation, if it will help with the DVT and the monthly??? Keep us posted on how things go and I will keep you in my thoughts and prayers. 
God Bless,
~Roiann 
Sorry you have to do the coumadin thing but hopefully the doctor knows best. My surgeon knew right away I had to have my gallbladder out despite me having 2 ultrasounds and endoscopy to rule it out. sometimes it'**** or miss with the docs but I pray that this will hope you be on the road to recovery!! Keeping my fingers crossed for you.
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