Questions for the Stroke Clinic

This one could be dull. It’s a brain dump from a brain injured.  You have been warned.

I’ve been considering the whole warfarin dosing thing.  I tend to think in diagrams (e.g. I prefer a map to a list of countries and capital cities).  So I did an up-to-date graph of my drugs v INR.  Warfarin ‘loads’, i.e. dosing is progressive as it stays in your system for 2-5 days.  My ‘theraputic INR range’ is between 2 and 3, so the aim is to get it to about 2.5 and keep it there.  So far I’ve never stayed at/over 2 on a consecutive blood tests:  it always drops back. I’m getting bored of it.  Warfarin is evil stuff anyway, so if it’s not working then I’m not sure if I want it to work or if I want to use it as an excuse to explore alternatives.

 

Notes for medics: Clexane is 1 if I had 100ml, 0 if I didn’t; Warfarin is in mg (evened out over the week since 11/11 when the dosing became a weekly planner of different per day  doses);  INR is actual but each INR data is noted on the day before the test took place, to make visual sense of the dose increase on the day an INR decreased.

I’ve been compiling my list of questions for the Stroke Clinic on Friday.  I’ve been back to the hospital loads, but it’s all been about blood, clotting and anti-coagulation appointments.  This is specifically about the stroke.  The deal is this is when they’ll be prepared to talk about timescales (though my GP may have beaten them to that, by putting an end date on my sick note for me). I suspect the list will be long, and I won’t ask half of them, but they include those below:

  • How come my face still goes numb sometimes (and when will the left side of my lips stop being numb?!) ?
  • How long until everything is permanently normal?
  • Why warfarin (esp. since its not working)?  Why not keep Clexane and drop Warfarin?  What about aspirin; what about Pradaxa?
  • When is the scan to see if the clot is gone?
  • Who organises the thrombophilia test?
  • I can definitely come off the drugs when the clot has gone?
  • Any issues around going back to work in Jan?
  • Sleeping – why don’t I?
  • Flying – am I cleared to fly?  How do I get a note to carry syringes on flights?
  • Travel insurance – do I say stroke or vertebral dissection or clot or… what?  If stroke, do I say 1 (stroke event) or 3 (strokes)?
  • Is there anything that won’t return to normal?
  • Should I be worrying about headaches/neckaches? (I’m not, but someone else is!)

Can you message/email if you know/think there are more?

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4 comments

  1. Kate says:

    Hey there,

    Have sent you a mail :-)

    K x

  2. Tony says:

    GP letter for syringes on flights – I have one that I get updated (i.e. they charge me £20 to send same letter with new date) that says I am IDDM and need medicines and syringes and then its the usual clear plastic bag job.

  3. Andy(L) says:

    I said that your graph looks like a classic ringing filter – where overshoot is used to approach a line as quickly as possible. Here’s a link to explain what I mean: http://en.wikipedia.org/wiki/Ringing_artifacts. Have a look at the graph in the “Introduction” section.

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