Life DOES go on after DVT
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This site is for people with DVT, seeking comfort and information from others who understand from personal experience.
 
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dero
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dero


Posts : 904
Join date : 2007-12-09
Age : 64
Location : Near Ottawa, Ontario Canada.

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PostSubject: Re: My story...   My story... - Page 6 Icon_minitimeSat Jul 16, 2011 3:18 pm

I am presently on Tanzaparin injections until we (my Hemo and myself) what cocktail du jour I will serve. One thing for sure, warfarin is ruled out as an option, I, warfarin, are not compatible, I have way too many side effects from it, have to remember this is for the rest of my life, I still have to live. (lol)
I did the usual 8 vile of blood for the vampire crew, asked them to leave me some, and did a chest x-ray to rule out any traces of PE. I still have to do another Doppler, my hemo wants a good one for the records, she was not happy with the one that was done for Emerg.

She (my Hemo ) is pushing for Pradax (Pradaxa in the USA) since I had no side effects on it(I was using Dabigatran for a year, year and a half) meaning no INR, no diet change, BUT the thing that I'm still sitting on the fence about is that there is really no reversing agent for it like you can use Vit K to reverse warfarin's anticoagulant effect in case of an emergency.
http://clotconnect.wordpress.com/2010/12/06/pradaxa-management-of-major-bleeding/
There is one but "in theory" still would like to see more lit on this. I have many other "Lifers" talking to me about other options.
One thing for sure, I have a better state of mind this time, probably because I've been down this road before (in a freaked out way) I have learned so much about DVT since then, yes as this site grows, so does my knowledge on DVT.
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LLR1917




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PostSubject: Re: My story...   My story... - Page 6 Icon_minitimeTue Jul 19, 2011 3:26 pm

Salut Dero!

Désolé d'apprendre que tu as fait une seconde phlébite. Je te souhaite bon courage pour la suite des choses! En espérant que tu trouves rapidement la meilleure solution pour ton dosage de médicaments!
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dero
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dero


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PostSubject: Re: My story...   My story... - Page 6 Icon_minitimeWed Jul 20, 2011 1:56 pm

Merçi,
jusqu'à date le dosage n'est pas un issue, je fais seulement des injections de Tanzaparin donc, pas de warfarin et pas d'INR.
Le problème c'est que le médicament donc je voudrais prendre (Pradax) n'a pas vraiment d'agent qui renversse l'effet anticoagulant de celui ci en cas d'urgence (comme un accident de route avec du sang partout...)
A part de cela, j'ai les idées très claires, quelque choses qui m'as surpris. Avec l'expérience, on devient plus sage, Very Happy

J'ai envoyé un mail directement a la compagnie qui produit ce médicament et je leurai demadé POURQUOI? On va voir, j'attend la réponse, je m'attend a un mail corporatif, débutant avec
Cher monsieur xxxx
Nous somme content que vous vous interessez à notre produit... Blah, blah, blah...
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dero
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PostSubject: Re: My story...   My story... - Page 6 Icon_minitimeThu Jul 21, 2011 3:13 pm

I have made my choice, Pradax starting tomorrow.
I have to bridge over, from Tanzaparin to Pradax, meaning tomorrow ONLY
(july 22-2011) I will do:
-a morning 150 mg Pradax pill
-a Tanzaparin injection at 4PM and a 150mg Pradax pill
for THAT day only
then it will be
-a morning 150 mg pradax pill
-an evening 150mg pradax pill
every day.
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dero
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PostSubject: Re: My story...   My story... - Page 6 Icon_minitimeFri Jul 22, 2011 5:17 pm

Did my morning pill and my 4PM injection (that is one injection I'm glad is DONE)
still need to do my evening pill.
Starting tomorrow, pills ONLY. cheers

Adendum: evening pradax, done.

Day one and no stomach ache, that seems to be the most common side effect from Pradax.


Last edited by dero on Fri Jul 22, 2011 11:30 pm; edited 1 time in total
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T-Bone




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PostSubject: Re: My story...   My story... - Page 6 Icon_minitimeFri Jul 22, 2011 9:29 pm

I will be reading your updates with great interest. I am not so sure Warfarin for life is my best option. Starving the body of Vitamin K has some negative consequences.
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PostSubject: Re: My story...   My story... - Page 6 Icon_minitimeSat Jul 23, 2011 1:17 pm

-1 X 150mg pradax in the AM
-1 X 150mg pradax in the PM



* thing to keep an eye on also are "unusual" bleeds (gums, stools...)
None so far.
_____________________________________________________________
T-Bone talk with your Hemo, they usually know what is best for YOU. Starving your body of vitamin K is not what you are suppose to do while being on warfarin.



Last edited by dero on Sat Jul 23, 2011 6:07 pm; edited 1 time in total
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T-Bone




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PostSubject: Re: My story...   My story... - Page 6 Icon_minitimeSat Jul 23, 2011 1:54 pm

dero wrote:
Starving your body of vitamin K is not what you are suppose to do while being on warfarin.


Sorry, poor choice of words...

I try to keep my intake of vitamin K steady only avoiding large portions of my wife’s favourites - spinach and asparagus.

I was referring how Warfarin works against the vitamin K and effects some of the good things that vitamin K brings to the body.

I hope things go well for you on the new drug as the alternatives are more painful.

I am off to have the INR checked. Seems my Dr. is on vacation but he is now confident I know how to manage my dosing and said he will follow up when he returns.
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PostSubject: Re: My story...   My story... - Page 6 Icon_minitimeMon Jul 25, 2011 11:23 am

Sunday
1X 150mg pradax AM
1X 150mg pradax PM

no abnormalities to report, well does the alien count?
___________________________________________________________
Monday
1X 150mg pradax AM
1X 150mg pradax PM
------------------------------------------------------------------------------------
Tuesday
2X 150 Pradax

Went and saw my primary Dr. to update my files with all this new info. Will do a bloodwork in a month from now just to check how all my drugs are behaving with Pradax. Just to check...
------------------------------------------------------------------------------------
Wednesday
2X 150mg Pradax
-------------------------------------------------------------------------------------
Thursday
2X pradax 150mg
-------------------------------------------------------------------------------------
Friday
2X pradax 150mg
-------------------------------------------------------------------------------------
Saturday
1X pradax 150mg
-------------------------------------
Sunday
2X pradax 150mg
--------------------------------------
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dero
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PostSubject: Re: My story...   My story... - Page 6 Icon_minitimeMon Aug 01, 2011 11:50 pm

Monday
2X pradax 150mg
-----------------------
*Nothing really to say, no side effects whatsoever.
I went for a walk, bored sitting at home(10klm walk)call it X-country, the left ankle swelled up, to be expected this was really my first activity I did in almost 3 week, did a daily walk of 2 klm for the last two weeks. Kept my leg up most of the evening, the swelling came down.Need to find out if it's too early to start with a FUGLY on that leg, specially when I go out like that...
-----------------------------------------------------------
Tuesday
2X pradax 150mg
-----------------------------------------------------------
Wednesday
2X pradax 150mg
------------------------------
Thursday
2X pradax 150mg


Last edited by dero on Thu Aug 04, 2011 11:07 pm; edited 1 time in total
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PostSubject: Re: My story...   My story... - Page 6 Icon_minitimeThu Aug 04, 2011 4:50 pm

Article seen in www.theHeart.org

Arrhythmia/EP
Caution needed with dabigatran in the elderly
August 4, 2011 | Lisa Nainggolan

Paris, France - New reports of two elderly women faring badly when taking the novel anticoagulant dabigatran (Pradaxa, Boehringer Ingelheim) for stroke prevention in atrial fibrillation (AF) have prompted more discussion about the caution needed with this drug when treating the very old or those with renal impairment [1].

In an accompanying commentary [2], Dr Jeremy M Jacobs (Hadassah Medical Center, Jerusalem, Israel) and Dr Jochanan Stessman (Hebrew University-Hadassah Medical School, Jerusalem, Israel) say: "These cases require careful attention and serve to highlight a unique problem associated with oldest-old patients and novel drug therapy.

"It is of concern that those most likely to need anticoagulation are potentially those most at risk of its adverse effects—ie, frail, oldest-old patients among whom poorly diagnosed renal impairment, sarcopenia, and altered body composition are common. The lack of a specific antidote for dabigatran further renders this vulnerable group at risk," they state.

One of the investigators of the RE-LY study— the pivotal trial on which approval of dabigatran for the prevention of stroke in AF was based—Dr Lars Wallentin (Uppsala Clinical Research Centre, Sweden), told heartwire that while it could not be proven that individuals who have fared badly on dabigatran would not also have done poorly on the alternative, traditional treatment of warfarin, he agrees that caution should be exercised with the new drug in the very elderly and frail. "Both the case reports and the commentary are relevant and appropriate," he observes.

Two very elderly, frail women fare badly on dabigatran

In most countries in which dabigatran is approved, the choices of dose are 150 mg twice daily, which was shown to be more effective than warfarin in RE-LY but carries a higher risk of bleeding, or 110 mg twice daily, which was shown to be equivalent to warfarin. In Canada, the EU, and other countries, dabigatran was approved for the stroke/AF indication in both the 110-mg and 150-mg doses, but the US made the controversial decision to approve only the 150-mg dose and a 75-mg dose for patients with severe renal impairment, stating that the data in favor of a 110-mg dose "were suggestive but not entirely convincing."

Dabigatran is primarily eliminated via the kidneys, so the patient prescribing information advises "dose adjustment" for renal impairment and notes an increased bleeding risk among those older than 75.

In one of the case reports just published, an 84-year-old woman taking 75 mg of dabigatran twice daily for AF, who weighed just 40 kg, developed massive rectal bleeding, had a cardiac arrest, and died, Dr Matthieu Legrand (Lariboisière Hospital, Paris, France) and colleagues report in the July 25, 2011 issue of the Archives of Internal Medicine. In the other case, an 89-year-old woman weighing 45 kg who had been taking 110-mg twice-daily dabigatran for AF for five months was found to have increased bleeding times and an elevated plasma level of dabigatran when tested prior to cochlear implant surgery. She had suffered recurrent nosebleeds for a week prior to this. Treatment with dabigatran was stopped, and the outcome was favorable.

110 mg twice daily a "good choice" for the over-75s

Jacobs and Stessman state in their editorial that they would like to see a subanalysis of the RE-LY data by age group. Another RE-LY investigator, Dr Salim Yusuf (McMaster University, Hamilton, ON), told heartwire that a "detailed analysis of RE-LY by age" is at an advanced stage.

"In the meantime, increased vigilance is warranted for bleeding events among elderly patients, particularly those with renal impairment, as dabigatran enters the market and gains popularity and we accumulate more data via clinical trials, registries, and case reports [such as these]," the editorialists conclude.
Many of us in the RE-LY group believe that for those aged >75 years, 110 mg twice daily seems to be a good choice.

Wallentin says: "Based on RE-LY, we have evidence that 110 mg twice daily is as effective as warfarin with a lower risk of bleeding, and some doctors might prefer that dose because usually physicians like to stay on a safety course, especially for elderly patients with many other medications. Many of us in the RE-LY group believe that for those aged >75 years, 110 mg twice daily seems to be a good choice."

He and his coinvestigators believe the decision not to approve the 110-mg twice-daily dose of dabigatran in the US is thus leading to a reluctance to use the drug among doctors there, and they have repeatedly called for the FDA to reconsider its decision.

Monitoring with dabigatran may even be required in high-risk groups

Wallentin also told heartwire that a pharmacokinetic analysis, which is in press, shows that the 75-mg dose "might be recommended for those with a creatinine clearance at or below 30 mL/min," as per the recommendation made by the FDA for those with impaired renal function.

And he says that, in the future, "there might even be a reason to tailor the dabigatran dose based on measurements of dabigatran plasma concentrations or eventually thrombin time in patients at high risk of bleeding or risk of exposure to too-high dabigatran plasma concentrations."

Asked by heartwire whether this would not negate one of the big advantages of dabigatran over warfarin—no monitoring required—he stressed that, if agreed—"and it still needs further discussion"—this would be necessary only in certain select groups, rather than in everyone, as is the case with warfarin.
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dero
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PostSubject: Re: My story...   My story... - Page 6 Icon_minitimeFri Aug 05, 2011 1:12 pm

Friday
2 X 150mg pradax
------------------------------
Saturday
2X 150mg pradax
------------------------------
Sunday
2 X150mg pradax
-------------------------
Monday
2 X 150mg pradax
-------------------------
Tuesday
2X 150mg pradax
------------------------
Wednesday
2X 150mg pradax
--------------------------
Thursday
2 X 150mg pradax
--------------------------
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dero
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dero


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PostSubject: Re: My story...   My story... - Page 6 Icon_minitimeFri Aug 12, 2011 9:18 pm

Friday,
2X 150 mg pradax
-------------------------
I actually went for a 20 K bike ride today, did it on a rail/trail so no real elevation I think it's a 14% grade at the MOST and I did not push the cardio being that this is my first ride of the season AGAIN...
Tomorrow is my one month post diag, I don't want to push it just now.
I wore 2X 20/30 compression sock (one on each leg, not two on the same leg lol! ) For my every day use, I wear 2X 30/40 compression rate sock.
It felt GREAT, physically and mentally.
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T-Bone




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PostSubject: Re: My story...   My story... - Page 6 Icon_minitimeFri Aug 12, 2011 9:43 pm

Good to hear you are starting to get back riding!

Still no idea what made you clot for the first and/or second time?
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PostSubject: Re: My story...   My story... - Page 6 Icon_minitimeSat Aug 13, 2011 1:49 pm

Eh, T-Bone!!

Naaw, the first was classify as Idiopathic and the last one, I have not seen my Hemo since then...
I suspect that both are unrelated since they happened in opposite legs. scratch
How are things with you?
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T-Bone




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PostSubject: Re: My story...   My story... - Page 6 Icon_minitimeSat Aug 13, 2011 4:50 pm

I am doing as well as can be expected.

My PTS is on the milder side so long as I limit the amount of time I go without the fuglies. I wear them at work week days. I can usually string together a couple of days on the weekend without them (as long as I sit with my legs raised in the evening and I always sleep with 2 pillows at the foot of the bed to keep my lower legs higher than my heart).

I struggle most with the aches and pains left from the accident. A day doesn't go by that I am not reminded of the injuries. As someone called it... "background pain" - that sums it up fairly well most of the time.
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PostSubject: Re: My story...   My story... - Page 6 Icon_minitimeSun Aug 14, 2011 10:49 am

Saturday
2X 150mg pradax
(my one month post diagnose)
did a 10k bike ride, I pushed a bit more the cardio,
was wearing my 20/30s during the ride and my 30/40s after, it kept the swelling down cheers
--------------------------------------------------------------------------------
Sunday
2 X150mg pradax
10K bike ride (cardio push)
--------------------------------------------------------------------------------
Monday
2 X 150mg pradax
--------------------------------------------------------------------------
Tuesday
2 X 150mg pradax
------------------------------------------------------
Wednesday
2 X 150mg pradax
------------------------------------------------------
Thursday
2 X 150mg pradax
------------------------------------------------------
Friday
2X 150mg pradax
----------------------------------------------------
Saturday
2 X 150mg pradax
----------------------------------------------------
Sunday
2 X 150mg pradax


Last edited by dero on Mon Aug 22, 2011 12:47 pm; edited 1 time in total
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DVT

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PostSubject: Re: My story...   My story... - Page 6 Icon_minitimeSun Aug 21, 2011 2:36 am

Since I've been in and out of the hospiital, and quiite far behind on forrum Sad, are you in Praddax now insteaad of Warffarin or Ccoumadin?
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PostSubject: Re: My story...   My story... - Page 6 Icon_minitimeMon Aug 22, 2011 12:46 pm

Yes, I'm on Pradax now, just over a month, you know how I react badly to Warfarin, turns me into a monster, worst is, my hemo is the one that recommended this.(she remembers the Mister Hyde of me)
So, since you are out of the hospital, there must be some improvement?
I hope...

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PostSubject: Re: My story...   My story... - Page 6 Icon_minitimeMon Aug 22, 2011 12:48 pm

Monday
2 X 150 pradax
-------------------------------
Tuesday
2 X150mg pradax
-------------------------------
Wednesday
2 X150mg pradax
-------------------------------


Last edited by dero on Wed Aug 24, 2011 8:12 pm; edited 1 time in total
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PostSubject: Re: My story...   My story... - Page 6 Icon_minitimeTue Aug 23, 2011 2:48 am

I sent you a PM Derro.

I'm glad the Prradox is working bettyer for you, yes I rememmberr you had a heck of a time on Warfaarin Sad. Is your Protime in norrmal rannge on Pradoox?
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PostSubject: Re: My story...   My story... - Page 6 Icon_minitimeWed Aug 24, 2011 8:21 pm

Been trying to get in touch with my Hemo, she's been on holidays and the government is forcing the clinic to shut down for some time affraid
But my next schedulled apt is in October( 6 month thing)

I had an apt with my GP the week post diag(back in July) and I had a bloodwork done yesterday, he wanted to see the interaction of my cholesterol meds and Pradax a month after (guess I'm a still a labrat after all.)That is one thing I like about my GP, he is well educated on DVT-PTS and what he does not know he finds out as oppose to many Dr who just shrug it, know what I mean?
I'm sure I'll be seeing him next week when he gets the results of the tests...
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PostSubject: Re: My story...   My story... - Page 6 Icon_minitimeThu Sep 01, 2011 9:55 pm

Thursday
2 X 150mg pradax
---------------------
friday
2 X 150mg pradax
--------------------
saturday
2 X 150mg pradax
---------------------
Sunday
2 X 150mg pradax
----------------------
Monday
2 X 150mg pradax
---------------------
Tuesday
2 X 150mg pradax
-----------------------
Wednesday
2 X 150mg pradax
-----------------------
I'm thinking of stopping this diary, I think nothing is going to change, I'll keep on taking "2 X 150mg pradax" for the rest of my life... scratch
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PostSubject: Re: My story...   My story... - Page 6 Icon_minitimeTue Sep 20, 2011 7:26 pm

Sept 20th and still, all is good with Pradax, just started my third box
(30 days per box). No side effect so far. cheers

-I have an apt for a pelvis/abdomen ultrasound Sept 29
-A Doppler apt for my left leg booked .Oct 06
-Followed by an apt with my Hematologist that same day. Oct 06
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PostSubject: Re: My story...   My story... - Page 6 Icon_minitimeThu Oct 06, 2011 7:58 pm

Well, four years, two clots and still, I am idiopathic. With all the Ultra Sounds I did last week (leg,pelvis and abdomen) still can't pin why I clotted.
Ah well Rolling Eyes does it really matter now?
I'm taking my two pills a day(pradax) I should be alright, as long as my body does not build an immunity to the drug... What a Face
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