StrokeSurvivorBlog

For the last 3 weeks Steve has been taking an anti-coagulant to thin his blood, either Warfarin or Apixaban. A blood thinner is necessary because the atrial fibrillation causes pooling of his blood in the left ventricle of his heart. This can result in blood clots, which in turn can cause another stroke. If the blood is thinned, the chance of another stroke is greatly reduced.

The FDA estimates that 2 million people start taking warfarin in the United States every year to prevent blood clots, heart attacks and stroke. Warfarin is a difficult drug to use because the optimal dose varies and depends on many risk factors including a person’s diet, age, and the use of other medications.

People who take a dose larger than they can tolerate are at risk of life-threatening bleeding. Those who receive too low a dose are at risk of equally dangerous blood clots. Dosing is particularly important at the beginning of therapy, when problems in adjusting the dose can lead to complications such as bleeding.

Warfarin is the second most common drug — after insulin — implicated in emergency room visits for adverse drug events.

Physicians and other health care professionals who prescribe warfarin regularly check to see if the drug is working properly by ordering a test called the PT or prothrombin time that evaluates the blood’s ability to clot properly. The results are measured in seconds and compared with the expected value in healthy people, known as the International Normalized Ratio or INR.

Since Steve started the anti-coagulant, he has gone in for blood draws twice a week. The optimal INR should be between 2 and 3. His last INR was 2.5, which was just perfect. If it’s higher than 3, it will be too thin and he’ll be subject to bleeds, or even a hemmorraghic (bleeding) stroke.

Now that we found the right dosing to make Steve therapeutic, the frequency of the blood draws can be reduced. Eventually they will be required only once a month.

Although he is being treated as if he’s taking warfarin, we’re not sure which anti-coagulant he’s on. It’s either warfarin (marketed as Coumadin) or the experimental drug Apixaban. Both are manufactured by Bristol-Myers Squibb. Steve takes them both, but only one of them is active. The other one is a placebo. The good news is that it’s working. The great news is that he’s had no side effects!

This is such an answer to prayer. Thank you for praying for us.