Patient Blogs | Atrial Fibrillation
Blood Thinners: They’re Not as Scary as You Might Think
photo of doctor writing prescription

You’ve been diagnosed with AFib, and one of the first things your medical team talks about is blood thinners. If you’re like me, your immediate response is “Do I have to?” Or when I was younger, “No thank you, not for me!”

So why blood thinners? When you have AFib, the atrium is not beating (it’s fibrillating), which can cause blood to pool, which can cause blood clots. Blood clots can get stuck as they move around your body, which then can cause a stroke. Blood thinners prevent blood clots, which, in turn, prevents strokes.

I’ve had a long and tortuous history with blood thinners, but I’ve come to a place where I recognize their value and I’m comfortable with the kind I’m taking.

When first diagnosed with AFib at age 24 (in 1979), they didn’t know what to do with me. They said that they’d put me on blood thinners if I was 70, but at my young age that didn’t make sense to them. I was told to take an adult aspirin daily and that would adequately thin my blood. It sure did. Over the years, that recommendation was lowered to a baby aspirin a day, which I took for decades.

No changes were suggested for my first pregnancy (in 1991), and all went well. During the pregnancy  for my second child (in 1994), the doctor put me on the blood thinner heparin. This entailed my getting a shot of heparin daily. Not only was I too squeamish to give myself the shots (my husband had to do it), each insertion spot bloomed a beautiful black and blue bruise. Six-plus months of daily shots in a different spot every day, you can imagine what a colorful pregnant lady I was! I’m told that heparin is no longer used as a daily blood thinner for AFib patients.

I had to be on blood thinners for several months after my first ablation (in 2009), and they put me on warfarin (Coumadin). I had to be tested weekly to confirm drug levels (a trip to the lab each time, and continual dosage adjustments) and my diet was severely limited. Any foods high in vitamin K can mess with warfarin’s effectiveness. And many of the foods that are good for you and happen to be my favorites were off-limits (green leafy vegetables, Brussels sprouts, broccoli, asparagus, chamomile or green tea). And while I was not injecting warfarin (phew!), we used to joke that I’d bruise if you looked at me funny. It was a highly successful blood thinner. I was thrilled when the mandatory post-ablation period ended and I could go back to my baby aspirin. Doctors still regularly prescribe warfarin for AFib patients.

At some point around my 60th birthday, the doctor persuaded me that I should be taking blood thinners prophylactically, as risk of stroke increases with age. By this time, there was a whole new class of blood thinners available: non-vitamin K oral anticoagulants (NOACs, sold under brand names like Eliquis, Pradaxa, Xarelto and others). I have been taking this type of blood thinner since then and have not regretted the decision. I eat whatever I want, and my blood is checked once a year. I do bleed a little longer than non-medicated people do if I get cut, but applying pressure to the spot has worked so far. I also bruise more easily than I used to, and the bruises hang around a long time, but no one’s going to rush me to the ER based on how I look. It has not affected my lifestyle; in particular, I have not stopped hiking in remote areas. My family doesn’t like me to use knives because I’m clumsy, but I do anyway.

There is a trend to call these medications “stroke prevention meds,” possibly to be more accurate, but my cynical self thinks the name change is also to make them sound less scary. Whatever you call them, the purpose of these meds is to thin your blood so that you won’t have clots big enough to cause a stroke. And that’s a very important outcome. If your medical team talks to you about blood thinners (or stroke prevention meds), listen carefully. Do the nature of your AFib (paroxysmal or permanent), your age, or other medical conditions increase your risk of stroke? Or are they just saying AFib = blood thinners? If you decide to take a blood thinner, do your research about which kind to take. The quality-of-life implications are huge.

 

 

 

Photo Credit: Jamie Grill / Tetra Images via Getty Images

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Michele Straube

Michele Straube

Diagnosed since 1979

Michele Straube has lived with atrial fibrillation (AFib) for 42 years. Recently retired from a long career as an environmental mediator, her plans include travel and trailer camping with husband Bob and puppy Tux. She currently teaches ESL to adult immigrants and refugees, and she delivers Meals on Wheels to homebound seniors. She enjoys chatting with AFib patients to explore their path to living with the condition.

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