NOAC ANTI COAGULENT
I am post opp from 2005 I weighed in at 30st prior to surgery.
Presently I am a few lb's over 16.
My Question is this, until recently I have been on warfarin but in the last few months it has become extremely difficult to control.
I recently had a heart ablation for atrial Fibrillation I a being very closely monitored Warfarin wise this is what has shown that its not being very effective it keeps dropping dramatically from 3.5 to 1.3 in.
The cardiologist has suggested one of the new anticoagulant (N.o.a.c.) like riveraxoban dagibatran etc.
The problem is the BPD DS and malabsorption, apparently they can not be very effective.
Does anyone here on the forum take one of these new types of medication and doors they actually work effectively/ how do they know that they do as there does not seem to be any tests to ensure that you receive therapeutic effects ie anti coagulation.
If again you do have testing to ensure everything is as it should be, what are the tests carried out thus enabling me to present a possible answer to my cardiologist.
Thanks
Alun135,
here in the states there is no reversal for any of these other drugs...there are no testing done on those other meds here to make sure they maintain in effective limits. Any weak blood vessels could burst with no stopping of the bleeding possible.....for instance if you had macular degeneration, could/would bust and make permanent blindness a real possibility.. a stroke would extend and not be able to be stopped ,...ditto for a gastric bleed. Here the only way gastric bleeds is handled for people on these drugs is to stop the drug and give blood transfusions ... My Uncle had 6 units of packed red bllood cells post a gastric bleed when on one of the thinners with no monitoring.
I understand this problem. My hubby just had ablation in 8 spots on his heart and is on coumadin.in addition,He has a heriditary clotting disorder and will have to be on warfarin for life, there is no other drug that can be safely used because of other health issues he has..
They may need to adjust your dose to be different on one or more days of the week and keep a diet diary ..to record which foods you are eating and track your high K1 foods and your INR 's on the same page... Coumadin has a record for requiring readjustment of doses as the body re adjusts the amounts of Vitamin **** produces. 2x a week may be necessary until is stable 2 x then once weekl then 2x mo, then monthly. If INR drops may need to readjust dose up. one or two days a week by half a tab( what they did for my hubby) and recheck in a week for a few times if stable. that would be new dose.
Part of the problem may be the foods you are eating, that give the variance in the effectivelness of your warfarin. All things green have some K1 in them..okra, sweet peas,green salads, wild greens, turnip greens , kale, spinach,. things that are free in amounts are string beans, summer and zucchini squash,onions, garrlic, roasted peppers,carrots, potatoes and white potatoes. Some of these you would want to extremely limit portions, but I had wls i***** an eat some of those.a still very close to goal.
The body makes K1 in the intestine from some of the foods you eat. There are long lists of foods that you must eat routinely in set amounts to keep your levels consistent. ex. my hubby can only eat 3 servings of 4 oz of broccoli or other foods high in vit K1.a week.they must be spaced apart on the same day each week.All the foods that are supposed to be good for you, gotta throw those lists out the window to maintain warfarin. unless you do a rigid diet. This was our solution he likes broccoli and gets 4 ounces on sunday wed and friday...for a night meal. the one day his dose is lower is thursday.and that dose comes at 4-6 pm.
After most WLS all anticoagulants can only be used with extreme care because of the increased risk of intestinal bleeding. There are natural products like cod liver oil, vitamin E, ginko biloba, ginger, hawthorn and ginseng tahta can affect teh thinness fo your blood all of these thin it and make meds more effective. also grapefruit slows excretion of warfarin. If you had grapefruit that would account for a high spike... Hope this has given you more perspective and helps you take care.
