30th April 2012 The consultant said the words I’d been waiting to hear all my life, “it’s time to replace your heart valve.” I’d had my aortic valve stretched in January 1978 when I was 5 weeks old and always knew that it would have to be replaced one day. I was keen to get it done as soon as possible once I knew it had to be done so I asked to see the surgeon as soon as he could fit me in and then push ahead with a date for surgery.
July 2012 I met with the surgeon to discuss the operation and the type of valve I would be given. I was already on warfarin as I was diagnosed with an arterial blood clot in 2004 and so he agreed to give me a metal valve. If I had been given a tissue valve, then I would have had to have had it replaced again in about 10-15 years. Wednesday 29th August 2012 I received a phone call on the train home from work to tell me that they had a date for my
operation. It was the following Wednesday, 5th September! I was due to be off work on Friday and Monday as I had tickets for the Paralympics and I had a friend’s wedding on Saturday. Although I was keen to get it done suddenly the nerves kicked in! Thursday 30th August 2012 I received another phone call from the hospital to tell me that they wanted me to be admitted on Saturday 1st September so I could be safely taken off Warfarin ready for surgery.
I unfortunately then had to tell my friend I wouldn’t be at his wedding and unable to do a reading. I knew that the sacrifice would all be worth it though! I told my boss and finished work just after lunch for 2 months.
organise for me to have a blood test at that time, but once I was able to tell her that I had tested my INR that morning and what the result was, I was able to get away with not having a test that day – I’m not a big fan of needles!
Saturday 1st September 2012 I tested my INR at home on my CoaguChek machine before I left to head up to the Brompton Hospital. I got admitted just after lunch and waited until that evening to see the doctor. She wanted to
Unfortunately I then got transferred to heparin injections but I persuaded the nurses to let me inject myself as I’ve found over the years that it hurts less when I do it myself.
Self testing after surgery A RANDOMIZED TRIAL PUBLISHED IN IMPLEMENTATION SCIENCE SHOWS THAT PATIENT INVOLVEMENT CAN CHANGE PRIORITIES DRIVING HEALTHCARE IMPROVEMENT. Patients are increasingly seen as active partners in healthcare. While patient involvement in individual clinical decisions has been extensively studied, no trial has assessed how patients can effectively be involved in collective healthcare. Priorities selected with patients were better aligned with core components of the Patient-Centered Medical Home and Chronic Care Model, including access to a primary care provider, self-care support, participation in clinical decisions, and community partnership. This study by a team of researchers from Canada and the Netherlands is important as it is the first trial to document the impact of public involvement in collective healthcare decisions affecting the population. Complete results are freely available at www.implementationscience. com/content/9/1/24
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Wednesday 5th September 2012 The big day! Surprisingly slept well the night before and was woken at 6am to get ready for surgery. Went down for the operation at 8am and was woken up in Intensive Care at 11pm all fixed with a new metal valve. Thursday 6th September 2012 Was visited by the surgery team at 8am and was apparently too well to be staying in Intensive Care so was transferred to the High Dependency Unit. I was hooked up to a heparin drive as well as 4 chest drains and a variety of other things. I was made to sit up and try to eat food as soon as possible to make sure that my body started to recover quickly. It seemed harsh but did the trick. Friday 7th September 2012 I had two of the chest drains removed and walked from HDU back to the normal ward. The nurse and mum helped push the heparin drive and carry the other two chest drains – I did still need some help. By this stage, I was on warfarin and heparin and they were hopeful that I wouldn’t have to stay in hospital for too long.
CALLING ALL TRAVELLERS We are updating our useful list of clinics and hospitals around the world where you can get your INR checked. We know that a change in diet and temperature can sometimes affect your INR. We hope that the information will help you enjoy your travels whether they are business or pleasure. Please e-mail any information you may have to inrtestabroad@gmail.com or phone 0208 289 6875
Thank you for your help
My INR had to be 2.5-3.5 and I started to self test on my machine to get the result before the phlebotomists came round with their needles.
Unfortunately after getting through the hospital wards in record time and doing so well, I then crashed the day after I got home. I came down with sinusitis, a chest infection and fluid on the lungs but thankfully I managed to get anti-biotics quickly. I was warned that all the drugs I was on would have an effect on my INR and so I was self testing every day.
Wednesday 12th September 2012 A week after surgery the canula in my arm got blocked and the doctor came to me that evening to tell me she would have to put a new one in. I hate having cannulas put in and asked the doctor if I could test my INR on my machine and if it was okay then she wouldn’t need to put a new one in. The
This is when the CoaguChek machine became worth its weight in gold as I didn’t have to go to the local hospital every day for a blood test and was able to recover at home and just prick my finger and ring through with the results. One evening when I tested, my INR went to 4.6 and so I rang NHS Out of Hours. Unfortunately I wasn’t able to get a
Over the next few days I had various scans, echo, chest x-ray to check everything was okay. The final two chest drains were also removed which was a big relief.
“This is when the CoaguChek machine became worth its weight in gold...” doctor agreed but unfortunately my reading was still too low and so she put a new cannula in. Thursday 13th September 2012 I was awake at 6am and tested my INR straight away. The reading came up as 2.6 and I knew I could go home that day – hurrah!! The night nurse removed the cannula and got a blood test done for me straight away which confirmed the reading on my machine. I was back home mid afternoon with a bag full of drugs.
STATIN TREATMENT HAS FAR FEWER SIDE-EFFECTS THAN PREVIOUSLY THOUGHT, A LARGE META-ANALYSIS HAS FOUND. The research, involving more than 80,000 patients across 29 randomised trials, found almost all reported side-effects of taking statins were also present in patients taking placebo. Dr Judith Finegold from the National Heart and Lung Institute in London said it was unsurprising that many patients on statins reported side-effects, in spite of the study’s findings. She said: ‘Most people in the general population, if you repeatedly ask them a detailed questionnaire, will not feel perfectly well in every way on every day. Why should they suddenly feel well when taking a tablet after being warned of possible adverse effects?’ http://cpr.sagepub.com/content/early/2014/03/06/2047487314525531. abstract#aff-2
straightforward answer out of them as to what I should do, they told me to just wait until the morning and then go to the warfarin clinic. I decided to take matters into my own hands and didn’t take any warfarin that night and then tested again in the morning and it had improved. I then rang the clinic and let them know and they were able to advise me over the phone. If I hadn’t of had my machine, I would have taken warfarin again that evening and would have made my blood even thinner.
As I reduced the amount of drugs I was taking and came off the pain killers, I was able to reduce the amount of blood tests I did until I was back to normal. Although I seemed to sail through the operation and the recovery, it was exhausting and I know that having my machine really helped me as the thought of having to keep going out to have a blood test those first few weeks after surgery was not one I wanted. I like to be in control of my health and it was good to be able to retain even a small amount in a situation where I had to hand the majority of the control over to the professionals. I also believe that showing the consultants that I could self test helped them see that I was competent at managing as much as possible when I got discharged. They knew that I would be able to test every day if necessary and that I would be able to ensure that my INR stayed at the new level they had set for me even with all the drugs they sent me home with. I would thoroughly recommend to anyone who is thinking about buying a CoaguChek machine to get one. Although my recent experience of using it is in quite a drastic situation, it helps me on a daily basis with my day to day life too. By Jocelyn Shakspeare, ACE contact for Kent.
TAKING DICLOFENAC CAN INCREASE YOUR RISK OF HAVING A HEART ATTACK BY 40% According to the Medicines and Healthcare Products Regulatory Agency (MHRA). It says people with heart and circulatory problems should no longer take it. Diclofenac is a non-steroidal anti-inflamatory (NSAID) drug available on prescription and over the counter. It is commonly used to treat the pain and inflammation caused by arthritis, Is also taken to treat headaches.
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