Warfarin

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BurnitBlue

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How do users of Warfarin handle the regular blood tests when cruising or living aboard out of the UK?

It seems that Warfarin is a preventative medicine that will ensure a low risk that someone who fits the profile will, at some time, need a hospital bed due to a blood clot. Its usage is on the increase because of the benifits to the hospitals. According to my brother, half his mates are on Warfarin for the that reason.

Unfortunitely, Warfarin needs careful monitoring via regular blood tests. Too little Warfarin and it is not effective, too much and it reverts to the rat poison it was originally developed for.

If what I am told is correct then there must be quite a few sailors who now take Warfarin.
 
Yes, there are self testing machines. Not sure what is currently available as it is some time since I discussed this with my medical advisers. Have been a warafrin user in the past and I was fairly unstable so needed regular dosage adjustments. However, I understand that particularly for low dosage many people are very stable so limited risk. Suggest you discuss with your GP. Don't think the primary reason is for the benefit of hospitals, but for the benefit of patients in high risk categories. Having spent time in cardiac wards watching 55 year olds recovering from their first warning heart attacks, suggest its not a bad idea if you are in the category!
 
Thanks for the reply. I am interested for obvious reasons and I am not looking forward to what is essentially a virtual house arrest.

Interesting. Is self testing allowed? Seems to be a professional nurse is required to suck the right amount of blood from a vein. Isn't there a danger of introducing air if the "tester" is not careful?

Why a machine anyway. I have just googled and from what I have read it is only a tip of the finger prick and some litmus paper. Maybe google is not the best source of info.
 
Agreed with advantages for the user of warfarin. I was only passing on info I got from my brother who is a bit cynical of NHS because he still lives in UK.

Anything that reduces the risk of stroke is a good thing by me.

Thanks for the reply.
 
Self testing is allowed, if the 'Warfarin nurse' thinks you're up to it. The machine only requires a single drop of blood from a pinprick to the finger. The INR reading appears on the machine within a few minutes. I imagine the only problem you'd have using one of these little desktop testers at sea is that they are mains powered.
 
Phew! I am so greatly relieved. You have no idea how much better I feel right now.

Thanks to all. My house arrest threat is lifted. Good result.
 
[ QUOTE ]
Anything that reduces the risk of stroke is a good thing by me.

[/ QUOTE ]

There is more than one type of stroke, please don't see warfarin as a 'cure all'. It can be useful in preventing the type of stroke caused by a clot in a blood vessel in the brain. However, the type of stroke caused by a bleeding vessel in the brain will obviousely be made far worse by blood thinning drugs such as warfarin. Lifestyle changes are important in reducing the risk of strokes, hence living aboard away from all the main hassles of life!
 
Catch 22 in action. I would like to re-join the liveaboard community for a healthy life, but the demands of warfarin blood tests to improve my health is getting in the way.

Thankfully, this thread has provided some answers.
 
In my seven years of working as a community Pharmacist in Belgium, I never once dispensed warfarin; then I moved to the UK and every third patient seems to be on it!
Warfarin is a "dangerous" drug, very high up there in the Top Ten of causes for hospital admissions; there is a rather narrow gap between the "safe" dose, and the toxic one, and a lot of drugs and food items can interact with warfarin. The NHS chooses to recommend it anyway because it's cheap, but there are alternatives, with a much better safety record, and that don't require the intricate monitoring that warfarin brings with it. Acenocoumarone (Sinthrome®), for instance...
If INR monitoring is preventing you from living your life like you intend to, then IMHO I'd consider discussing this with your GP, even if it meant going private...
 
Snip ...then I moved to the UK and every third patient seems to be on it!

Snip ... there are alternatives, with a much better safety record, and that don't require the intricate monitoring that warfarin brings with it. Acenocoumarone (Sinthrome®), for instance...
-----------------------------------------------------------------------

Thanks for that info. I will certainly bring this alternative up with my GP next time I see him.

Your observation of the number of folk prescribed warfarin is in line with my brothers opinion.

My wife is a Swedish pyscho-therapist (or whatever the english translation is) and she knows full well that her main target in the Swedish Health care system is to keep as many patients out of mental institutes as she can. Curing patients is way down the list while keeping them on the streets is top. Because it is cheaper for the state.

It is this knowledge about wifes goals, plus comments from my brother that caused me to post on the forum my fears that warfarin is being used as a cheap method of keeping patients out of hospital.

Although I also recognise that there is an advantage to me if the medication works, your post has re-ignited my original fear that this medication is very dangerous especially if it is used because I fit a profile that may one day need a hospital bed.
 
Interesting. I fit the profile for a potential warfarin user because of a long term condition coupled now with age. However because of close (NHS provided) monitoring my consultant has always backed off because I travel a lot in less developed parts of the world and I have a fear of ending up in a hospital after an accident and not being able to communicate about warfarin. Probably illogical, but he seemed happy to not press the point. Unfortunately he has just retired after knowing my condition for 36 years, so no doubt his replacement will want to go through it all again with me!
 
Just recalled that I did make a complaint about the blood tests when I was discussing excercise with my GP a few weeks ago. I told him that I cruise my boat for months at a time and the visits to a lab would restrict my excercise of choice, which of course is sailing long distance.

He told me that there is a large group of patients who cannot be trusted to remember to take warfarin in the recommended dose. Either age related memory lapse or poor personal organisation. In those cases, half an asperin a day is prescribed.

The difference between asperin and warfarin seems to me to be tremendous wide gulf. Your post informing of an alternative medication will certainly come up first item when next I see my GP. Thanks again.
 
Regarding communicating to (for instance) an ambulance crew that I am on warfarin, I have to wear a brass plaque about the size of a postage stamp round my neck.

If I am in an accident this is supposed to warn them that I could suffer severe blood loss.

Asprin is looking tempting. The more I learn about warfarin the more I look at asprin.
 
Yes, The plaque will help - if they can read English! I already take aspirin, but it is very low dose.

Suggest you Google Warfarin as there is masses of on line information about it. You are then better prepared with all the jargon and pros and cons to have a meaningful dialogue with the medics.
 
[ QUOTE ]
He told me that there is a large group of patients who cannot be trusted to remember to take warfarin in the recommended dose. Either age related memory lapse or poor personal organisation.

[/ QUOTE ]

When I left hospital in October, they would only give me 1mg tablets, whereas I knew that there were 3mg and 5mg available. The excuse they gave me was as you were given above... that many patients get the tablets mixed up, so might take the wrong dose - There was no way that this would apply to me, but they wouldnt budge.

However, a GP at my practice was happy to prescribe a mixture, but only a 14 day supply - he gave some reason for not giving me a month or two supply which related to a tendency to take the wrong dose - again, this wouldnt be me.

Another GP has since prescribed me 50 of each tablet, which should last a few months.

So there seems to be no consistency in the "rules" and it may be worth seeing another GP, just to see how the land really lies.
 
Hi Richard.
I don't have a problem with the tablets. I currently have over a hundred 2.5mg. I have an open prescription at the pharmecy. In Sweden Wafarin is marketed as Varon.

It is the blood tests that cause me some difficulty in wondering how I can achieve the schedule while cruising on my boat.

I did receive a PM from a forumite who informed me that blood tests can be taken in France for £10 to £20 while travelling. this is an option I am chasing up to see if I can get a list of lab locations who can do this service across Europe. I am told that once the warfarin nurse has worked out a safe dosage for me, the blood tests will reduce to one a month which is (almost) acceptable.

Thanks for the post. i wish you the best of health in the future.
 
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