A major problem for people with AF is that they are not put on anticoagulants when they should be. But the study we’re looking at today shows it is even worse for women: Women are 1.8 times as likely to be undertreated for AF as men. Where’s the study from? It's a recently published study (May 2016) from the Journal of the American Geriatrics Society by Mark … [Read more...]
Tragic case leads coroner to recommend our service
What happened? An elderly man was on warfarin for atrial fibrillation and had not had an INR test for sometime. He unfortunately developed gastro-intestinal bleeding and became very unwell. When he arrived at hospital his INR was 8.1. In spite of multiple blood transfusions he died the next day. This tragic story reinforces the importance of two areas we have covered in … [Read more...]
Frivolous Friday – Feeling cold? Winter or warfarin?
"Of course I feel cold; I've got thin blood!" New Zealand is at its coldest right now which may seem odd to those of you sweltering in the mid-summer temperatures of the Northern Hemisphere, but we have snow low on our mountains. I fly to work for one of my clinics and the view on the right was taken from my plane yesterday. Not a bad commute, but a little cold. New … [Read more...]
“Am I being silly doctor?” – 5 life-threatening concerns
When you’re on anticoagulants, you may have concerns that you’re not quite sure if you should be bothering your doctor with. My patients often bring up these concerns towards the end of a visit and start by saying, “Am I being silly doctor?” I feel that even though my work as a haematologist can be very busy, answering a patient’s questions is a core part of my job, so I’d … [Read more...]
The twelfth of never? How long do I need anticoagulants?
How long you need anticoagulants depends on the balance of risks between having a blood clot and bleeding and these will be different for each individual. Your specialist will decide the length of time anticoagulants are needed in your particular case. This is just a guide. But it includes song titles. And the links to the songs on YouTube. We’re kind that … [Read more...]
Happy 100th Birthday Heparin!
It is one hundred years since the discovery of the blood thinning drug heparin, which is still used today. Jay McClean, who was a medical student at the time, presented a paper at the Society of the Normal and Pathological Physiology at the University of Pensylvania reporting his discovery of an anticoagulant extracted from liver, hence the name Heparin (Hepa meaning … [Read more...]
Quiz – Old or New – What’s best for you?
If you’re taking anti-coagulant pills, you have a choice between warfarin or one of the New Oral Anti-Coagulants (NOAC) such as Pradaxa/dabigatran, Xarelto/rivaroxaban or Eliquis/apixaban. We’ve chosen Pradaxa/dabigatran as the representative of the NOACs for this quiz. How much do you know about their differences? Completing this quiz may help you realise why either one is … [Read more...]
Stopping anticoagulants – 5 life-threatening excuses
Around 30% of people started on a long-term anticoagulant have stopped taking it by three months. This is not merely missing a few tablets or reaching the end of the time you needed anticoagulants for, but deliberately stopping while you’re meant to be taking them. And of course once people are no longer anticoagulated they’re at risk of a life-threatening stroke (if they have … [Read more...]
Frivolous Friday – Urine uses: Have you used this?
You might wonder, what is the link between urine, blood clotting, and my trip to Sweden? All will be revealed as we take a closer look at our urine. Surprisingly urine contains an important chemical called urokinase, that breaks down blood clots. While researching this post I was surprised to find out that urine has been used for medicinal purposes for centuries. In an … [Read more...]