Rat Poison

Let's talk about Atrial Fibrillation. 

I don't work for a pharmaceutical company, but I am a big fan of warfarin sodium, the drug commonly referred to as, "Coumadin".

Coumadin is frequently prescribed for a condition called,  "atrial fibrillation".  For all you non-medical folks out there, atrial fibrillation--afib--is a disease where the electrical impulses controlling the upper chambers of the heart are erratic.  As a result, the heart's upper chambers--the atria--quiver ineffectively.   Blood isn't pumped well; clots form in the heart.  These clots can break loose and be ejected into the body.

All blood pumped from the heart goes into the aorta.  The aorta is like a SUPERHIGHWAY from the heart; every other artery branches off of it.  

Aortic Superhighway

There are two little arteries immediately off the aorta that feed the heart itself, like back roads that only the maintenance workers can use. 

The next TWO arteries branching off of the aorta go to the brain.  That is where clots being shot out of your heart by its own pumping action are most likely to go.  Your brain.

A clot that travels to your brain and clogs an artery shut there is called a, "stroke".


For those of you who need numbers to be convinced, some statistics:

Afib makes you 6 times more likely to have a stroke.

35% of people with afib will suffer a stroke unless treated.

Afib is responsible for 25% of all strokes

Afib strokes are more major and disabling

23%  afib strokes die (compared with 8% of other stroke etiologies)

44% suffer significant neurologic damage

Strokes in women are more disabling than strokes in men

Coumadin reduces the risk by 60-70%

My sister-in-law has been diagnosed with atrial fibrillation. She is refusing to take coumadin.

Her physician had her sign a waiver saying she understands the risks of not taking coumadin and she is releasing him from all liability.

Nurse's Note: If your physician asks you sign a waiver saying you won't sue him if a bad outcome occurs because you won't take a medication he's prescribed--RIGHT THEN a pulsing neon light and a 57,800 decibel siren should go off in your head. The Solid Gold Dancers should bust out dancing in your living room. 

Take a few minutes and re-think your actions.

Are there risks in taking Coumadin?  Sure!

Are there risks in driving a car?  In cooking spaghetti?   In petting Whimsy?

Every drug carries a risk.  That is what that encyclopedic-length disclaimer inside drug packages are all about.   But, it is a calculated risk.   The risk-to-benefit ratio has been carefully weighed.

Here's a test to see if you should take coumadin if your physician prescribes it.  Rate on a scale of 1 to 5 how valuable these skills are:

1=I hate that!
5=Gotta have it!

Your ability to:

1.  Feed yourself

2.  Get your pants on

3.  Wipe your own ass

4.  Walk to your mailbox

5.  Recognize your family (who IS that ugly old woman?)

6.  Live independently

7.  See

8.  Hear

9.  Bathe yourself

10.  Speak intelligibly 

If your test score was more than 0.3, take the drug your doctor prescribes.

If not--would you consider leaving me your car in your will?

(c) copyright 2012 by the author of this blog. All rights reserved.