This could be a story we must attend.

I love that very line, and I thought I was the only one. I feel better now, and I thank you all for that.

/that is all

dofus: museisluse: Coumadin [Warfarin] Black Box warning:

WARNING: BLEEDING RISK

Warfarin sodium can cause major or fatal bleeding. [...]

Yep. And it's a pain in the arse to monitor properly. But it works for its intended purpose.

The alternative (for people too lazy/stupid to deal with Warfarin) is $100/$200/$300 a month - most of which goes into advertising and/or the drug company pockets. Which _we all_ pay for of course.

I suppose, of course, you're talking about Plavix, right? Plavix is one of the greatest anticoagulant drugs ever made, honestly. It works in a different manner than Coumadin, and is much easier to therapeutically regulate. Coumadin is also non-patient at this time, and able to be sold in a generic form which is why it's so cheap. It's a very well demonstrated fact that abruptly stopping plavix may result in death from a repeat CVA or AMI.

HoratioGates: I had an INR of 5.4 once on coumadin. I bumped my shin and 5 minutes later I had a lump the size of a golf ball on my leg. I suppose it's better than blood clots, but it is a real pain, especially since my insurance won't pay for one of those little tester units for me. It would be a lot easier to adjust my levels (and I could eat all those healthy green things that effect the levels) if they gave us home testers like they give diabetics.

The only "home" testers for INR I am aware of is the I-Stat module for Bedside Blood Labs. I doubt your insurance is going to drop the 15 grand for one, though.

SpaceMoose: Theodoric of York: Well, I'll do everything humanly possible. Unfortunately, we barbers aren't gods. You know, medicine is not an exact science, but we are learning all the time. Why, just fifty years ago, they thought a disease like your daughter's was caused by demonic possession or witchcraft. But nowadays we know that Isabelle is suffering from an imbalance of bodily humors, perhaps caused by a toad or a small dwarf living in her stomach.

full transcript (new window)

I always wonder why Steve Martin can't do stuff like this anymore, instead of making retreads of Peter Sellers movies which just make you want to watch Peter Sellers.

The other day i found a copy of "Cruel Shoes" in my basement. he was so funny and now he's coasting.

I guess that's what happens when you become rich and famous and older.

HoratioGates: I had an INR of 5.4 once on coumadin. I bumped my shin and 5 minutes later I had a lump the size of a golf ball on my leg. I suppose it's better than blood clots, but it is a real pain, especially since my insurance won't pay for one of those little tester units for me. It would be a lot easier to adjust my levels (and I could eat all those healthy green things that effect the levels) if they gave us home testers like they give diabetics.

I once got a 18 INR. When they ran my test the Intern on duty called me at home. It fun picking up the phone at 2am and hearing "hello, this is doctor Jones from Shock Trauma, we just got your test results back they are well outside the safe values. We are dispatching an ambulance to bring you in, but first I have some questions for you.....Are you bleeding from the ears, eyes, nose or gums?"

They don't have an automated test for INR, at least they didn't when I was on blood thinners. From what the technician explained to me they just put a drop of blood on a slide, look at it and time how long it takes to start clotting. If it takes normal blood 1 minute to clot and it takes yours 2 minutes your INR is 2. Blood thinners are a royal pain, I was very happy to get off them.

I've got the Leiden V genes which sucks. I ended up on warfarin for 6 months. If I knicked myself while shaving my legs, I bled and bled and bled. If I started eating green vegetables, I had to eat the same amount every day, because it messed with medicine and my PT/INRs. I was lucky I didn't get into any accidents.

However, if I ever get pregnant or whenever I travel overseas, I have to use Lovenox injections every day. Let me tell you, that shiat is expensive and painful. When I didn't have insurance, it was over $1000 for 10 days worth. The last time I went to Europe, I needed 6 injections and they were about $100 with my insurance. They really should come up with something better, since I couldn't afford them every day for almost a year. Plus, I get these huge bruises at the injection sites.

Beats the hell out of dying suddenly from a blood clot or suffering through the pain of another one in my leg.

Had a patient on heparin and integrilin today so I'm getting a kick...

Sitting here RTFA and responses from a Pharmacy, so I'm getting a kick...

/blocking the clotting action of platelets in the blood is not technically a "blood thinner".

St Andrew: Sitting here RTFA and responses from a Pharmacy, so I'm getting a kick...

/blocking the clotting action of platelets in the blood is not technically a "blood thinner".

But is death from internal bleeding technically DEAD?

Double plus good brothers on all the Theodoric of York references. Thanks!

I've been on Sodium Warfarin for 24 years. Eff Plavix, Eff Heparin (had to do self-injections at various times and reasons for a total of about 30 days over my lifetime). Eff Effient too.

me texan: Hello love, hows about a shave?

Came here for Mr. Todd.

/leaving slightly nervous
//that stare is just unsettling

Gyrfalcon: Generally speaking, unless you've been decapitated or dismembered, fatal bleeding from taking blood thinners is not usually a high risk. If you're bleeding to death from a shaving nick, you've got more problems than just blood thinners.

Not true. My mom took Coumadin for years with no problems until she reached her eighties. For reasons that were never determined, her reaction to the drug changed and suddenly she would get nose bleeds that couldn't be stopped, even with cauterization. We're talking enormous amounts of blood - enough to completely soak a big towel and make her pass out from blood loss. Her diet had been the same for years so it was most likely some sort of metabolic change, but the docs had to reduce the dosage significantly.

The bottom line is that some drugs really do have potentially fatal side effects that can't always be predicted -- even if you have taken the drug without incident for years. This is why HMO's like Kaiser require patients on blood thinners to be regularly monitored to see that the levels of the drugs in the blood don't go beyond the recommended norms, a situation that can happen without warning.

museisluse: Coumadin [Warfarin] Black Box warning:

WARNING: BLEEDING RISK

Warfarin sodium can cause major or fatal bleeding. Bleeding is more likely to occur during the starting period and with a higher dose (resulting in a higher INR). Risk factors for bleeding include high intensity of anticoagulation (INR > 4.0), age ≥ 65, highly variable INRs, history of gastrointestinal bleeding, hypertension, cerebrovascular disease, serious heart disease, anemia, malignancy, trauma, renal insufficiency, concomitant drugs (see PRECAUTIONS), and long duration of warfarin therapy. Regular monitoring of INR should be performed on all treated patients. Those at high risk of bleeding may benefit from more frequent INR monitoring, careful dose adjustment to desired INR, and a shorter duration of therapy. Patients should be instructed about prevention measures to minimize risk of bleeding and to report immediately to physicians signs and symptoms of bleeding (see PRECAUTIONS: Information for Patients).

PSSSST......Coumadin is a common rodent poison as well.