For the two that have asked, info on Clexane is here and here. I haven’t read it all but I prefer it to the warfarin. The Clex you just do. The warfarin needs, in my case anyway, weeks to work out the dose, which are punctuated by blood tests and doctors, initially every day and then every few days, and eventually once a week, with corresponding dose changes. The Clexane you just do and that’s it.
In fact, I’ve been a-wondering if it wouldn’t be easier to simply ditch the warfarin and stick with the clexane. But I googled and I think it might be that Clexane shots are exponentially more expensive than warfarin tablets. But as I’m also wondering if the warfarin is responsible for the weight gain (official views seem to say no, lots of people on it seem to say yes) as I don’t think I’m eating all that differently now I’m home. I might ask the GP anyway, sooner rather than later if it doesn’t stabilise anyway. Issues such as osteoporosis, risk of bleeding to death, etc. etc. are manageable. But I’m not putting on weight because of it. End of!
However, I have been thinking for a while that I probably need to respond to some of the outrage that, perhaps, I didn’t get all the information on the drugs (in chronological order: heparin, clexane and warfarin) before I started taking them. Some were particularly concerned about the side effects from the warfarin. So let me respond on that one because, as always, I have a view.
When they started the heparin drip, about 28 hours after the first stroke, I wasn’t in any state to really know much about what was going on anyway. The spinning world I could quell to a great extent by keeping my eyes closed, so my efforts were going on trying to speak loudly enough to boss them into keeping me still so I didn’t throw up. Comprehending anything beyond that wasn’t going to happen. I felt a definite need to stay alert right up to the point I got out of the MRI and they said, “We can see what it is, we’re putting a line in your venflon and we’re taking you back to our hospital with us.” After three previous diagnoses, knowing he knew what he was talking about meant I could Stop. With an intentional capital S. Frankly I would have let him put poison in my arm after he’d said that,. I felt released from any kind of responsibility for anything at that point, and the world – in the best way: I can’t explain the effort to keep sounding normal before that moment – receded and became a bit more blurry for many hours after. So no probs with the heparin.
I can’t remember when we started the Clexane. I don’t remember anyone telling me about it and I guess it must have been the day after they took out the heparin, but I don’t remember it. Oh, yeah, actually, maybe I remember at least one… no two… because I was telling friends they didn’t need to leave while it was done. Anyway, you get the point – I had no idea what was going on really – and I didn’t really care: I was going with the flow. It was an endless round of blood pressure, discussion on whether temp needed yet another line in for IV antibiotics (was up for the first few days because, as I kept pointing out, I just had a cold – and yes, many thanks to some of my work colleagues for that one, (I bloody told you to go home…!)) and blood tests. And moving those from every 4-6 hours to every 8 was a welcome luxury. Anyway, you could have told me about it at the outset, but I didn’t really care.
Warfarin. At the beginning of the warfarin I didn’t get the most grown-up and comprehensive spiel. It was a key to my release so I would have done it anyway, and I didn’t think to ask. Take a look at the second half of the last sentence, particularly if you know me well. It has ramifications. I didn’t think to ask. So do we think I needed to know right then? Um, no, I didn’t think to ask! (He definitely told me some stuff because I distinctly remember teasing him during a conversation about me not being able to do contact sports and it not good time to get in a car accident (Me: So does this mean I can’t play rugby on Sunday, Him (sympathetic and worried): Oh hell, do you play rugby? Me: No of course not, let me out of here.) By the day I went to the anticoag clinic though, I’d cared for a couple of days, which is partly why it was so frustrating with she-who-shall-not-be-named. If I’d been firing on all cylinders it would’ve been sorted there and then, but I wasn’t, so even more frustrating. Thankfully my GP surgery has a warfarin clinic which is fab. Nurse does it all and then calls up to the doc if she needs orders. They are utterly nice, fit me round other stuff (“When you come in don’t bother going to reception cos they won’t know you are coming. If they ask just say ‘[name] said’ and come knock on my door.”) and the GP waves if she sees me. If you’ve got to do these things, and you live anywhere near me, you need to switch to here, seriously.
Sorry deviating. My point is that I didn’t know a lot for a lot of the time, but I only got interested time went on. I might be in a position now to ask questions and be involved in decisions where there are choices. But I wasn’t. And more importantly, this needs some perspective:
If the heparin hadn’t been started in my veins, the strokes would have kept on coming; I’d already had three in the first 28 hours. If I hadn’t had the Clexane, which I’m still on, they would have kept on coming. If I don’t have the warfarin (or something else that does the job) then, quite probably, they would keep on coming. Right up to the point where the clot goes in 3-6 months time. So, basically, without this stuff, I would likely have experienced brain damage followed by death. If I don’t keep taking something, I’d likely experience brain damage followed by death. So let’s chill about some of the side effects and remember the most important one: I’m still here.
Which I suppose it’s possible you may not like, but you will get over it, I promise, given enough time!