Information you will hopefully never need to know
the average human being's clotting PT/INR (Prothrombin Time/International Normalized ratio) is 12-15secs/0.8-1.2. This is how long it is taking your blood to clot normally. The INR = (PTtest/PTnormal)SI (SI = sensitivity index 1-2).
Ok I have a point. When you have blood clots, they put you on a blood thinner/anticoagulant (neither of those terms are really accurate btw, but they are commonly used). Usually this is Warfarin(generic)/Coumadin(brand) in pill form. There is another commonly used called Heparin which is used for those who cannot take the pill, it is IV delivered, and is commonly used when blood clots are first discovered because you need a faster input of the chemicals, and also in pregnant women because Warfarin is bad for the fetus. (War/Cou by the way is VERY hard to regulate, as its effectiveness is determined by whatever happens to be lining your intestine, what i have heard referred to as "intestinal flora". You change one small thing about your diet, have one extra stalk of broccoli, or one extra drink, or just one drink at all, and your PT/INR will be effected.)
The normal being wants 12-15/0.8-1.2. People on blood thinners want 2-3 INR. Over 3 and you have a much increased risk of internal bleeding or hemorrhage. When you have a bleed inside, in a vessel or lining, the platelets rushing by go "ZOMG a tear! HELP!" and they flood the tear to plug it while waiting for the clotting to occur. It is a safeguard. They meanwhile use a positive feedback response to call more and more platelets to the site. When you are on blood thinners, obviously, there are less platelets swimming by to see the tear, less to plug, and less to call. Your clotting time is much slower, and again, your risk of continuing to bleed is increased.
You have to weigh the risk. Do you want blood clots? or hemorrhage? blood clots are the #3 cause of in hospital deaths. they are seen often after surgery, in pregnant women (due to influx of hormones, which is leading cause of blood clots in women, see me for example and my birth control usage.) Once you have had clots, or PEs, your chance of getting another is 30% higher. And your chance of dying is greatly increased with each subsequent clot. They are silent killers, usually misdiagnosed, or not seen at all until the person collapses because they cannot breathe, or because it hits the heart and the heart stops working, or hits the brain and brain gets no oxygen. The internal bleeding is only a risk when the thinning gets too thin, and if you are getting your blood tested every day, the chance of that is pretty low.
(Coumadin is more annoying because there are pages and pages of medications you cannot take while on it, foods you can't eat, and drinks you can't drink).
Sound scary? it is. Typically PEs will travel from a DVT (deep vein thrombosis) in the leg or pelvis. You can have clots in the leg that are on the surface (superficial) which will not really travel, and don't carry a lot of risk). the deep ones however, will travel all the way up your body, through the heart, and then often break as they leave the other side of the heart from the sheer pressure of the heart pumping. Little clot pieces settle down deep into the lungs, at the bottom, where the blood vessels which serve to carry O2 into the blood stream are very very tiny. With each clot, O2 does not reach the tissue, and the tissue dies. This is called "infarction".
I had blood clots on both sides of my lungs, (bilateral), but the left hand side took the brunt of it. I had a pulmonary infarction - the lower lobe of my left lung essentially turned black, died from lack of oxygen, and the body being the amazing machine it is, liquefied the dead tissue for nutrients and the nerve endings (which are screaming in pain the whole time, because their little nerve partners are dying) sent a message to the brain. Soon after, the lung tissue begins to replicate itself. Yes, it can really do that. Soon enough (few months or so), I have a new lung (sort of).
Meanwhile, I am taking Coumadin daily. in the beginning, my numbers were very regular, and I stayed on 4mg a day for about a month or 2. Since then, my numbers are all over the place. For awhile they were constantly low, which means I was at much higher risk for a clot.
Then two weeks ago, I had a bit of a surprise. They tell you to look out for bloody urine or stool, noses, gums, and easy bruising. The bruising and the gums I had seen and sort of written off as being nothing. Turns out I should have paid more attention, as my PT/INR had shot from about 20/1.5 to 53.8/4.3. That is VERY high. To give you an idea. imagine pricking your finger. Then imagine holding pressure on it, and then count to 50. Take the pressure off and you are still bleeding. The count to 50 is much longer than you think when on average, you should have stopped bleeding at 15.
They lowered my dosage, and as of today I am back at a cool 30.8/2.5 . Very happy. the bruising gets annoying. you find it in weird places, like between your toes or your cheek. You don't remember being hit there, but there is a bruise.
Anyway, I am writing this all out because several people have asked what is going on with me, what's happened and what is currently happening. They also want to know why I avoid certain foods, and why I pop pills every day at 6pm. There are your answers friends.
Peace :)
Ok I have a point. When you have blood clots, they put you on a blood thinner/anticoagulant (neither of those terms are really accurate btw, but they are commonly used). Usually this is Warfarin(generic)/Coumadin(brand) in pill form. There is another commonly used called Heparin which is used for those who cannot take the pill, it is IV delivered, and is commonly used when blood clots are first discovered because you need a faster input of the chemicals, and also in pregnant women because Warfarin is bad for the fetus. (War/Cou by the way is VERY hard to regulate, as its effectiveness is determined by whatever happens to be lining your intestine, what i have heard referred to as "intestinal flora". You change one small thing about your diet, have one extra stalk of broccoli, or one extra drink, or just one drink at all, and your PT/INR will be effected.)
The normal being wants 12-15/0.8-1.2. People on blood thinners want 2-3 INR. Over 3 and you have a much increased risk of internal bleeding or hemorrhage. When you have a bleed inside, in a vessel or lining, the platelets rushing by go "ZOMG a tear! HELP!" and they flood the tear to plug it while waiting for the clotting to occur. It is a safeguard. They meanwhile use a positive feedback response to call more and more platelets to the site. When you are on blood thinners, obviously, there are less platelets swimming by to see the tear, less to plug, and less to call. Your clotting time is much slower, and again, your risk of continuing to bleed is increased.
You have to weigh the risk. Do you want blood clots? or hemorrhage? blood clots are the #3 cause of in hospital deaths. they are seen often after surgery, in pregnant women (due to influx of hormones, which is leading cause of blood clots in women, see me for example and my birth control usage.) Once you have had clots, or PEs, your chance of getting another is 30% higher. And your chance of dying is greatly increased with each subsequent clot. They are silent killers, usually misdiagnosed, or not seen at all until the person collapses because they cannot breathe, or because it hits the heart and the heart stops working, or hits the brain and brain gets no oxygen. The internal bleeding is only a risk when the thinning gets too thin, and if you are getting your blood tested every day, the chance of that is pretty low.
(Coumadin is more annoying because there are pages and pages of medications you cannot take while on it, foods you can't eat, and drinks you can't drink).
Sound scary? it is. Typically PEs will travel from a DVT (deep vein thrombosis) in the leg or pelvis. You can have clots in the leg that are on the surface (superficial) which will not really travel, and don't carry a lot of risk). the deep ones however, will travel all the way up your body, through the heart, and then often break as they leave the other side of the heart from the sheer pressure of the heart pumping. Little clot pieces settle down deep into the lungs, at the bottom, where the blood vessels which serve to carry O2 into the blood stream are very very tiny. With each clot, O2 does not reach the tissue, and the tissue dies. This is called "infarction".
I had blood clots on both sides of my lungs, (bilateral), but the left hand side took the brunt of it. I had a pulmonary infarction - the lower lobe of my left lung essentially turned black, died from lack of oxygen, and the body being the amazing machine it is, liquefied the dead tissue for nutrients and the nerve endings (which are screaming in pain the whole time, because their little nerve partners are dying) sent a message to the brain. Soon after, the lung tissue begins to replicate itself. Yes, it can really do that. Soon enough (few months or so), I have a new lung (sort of).
Meanwhile, I am taking Coumadin daily. in the beginning, my numbers were very regular, and I stayed on 4mg a day for about a month or 2. Since then, my numbers are all over the place. For awhile they were constantly low, which means I was at much higher risk for a clot.
Then two weeks ago, I had a bit of a surprise. They tell you to look out for bloody urine or stool, noses, gums, and easy bruising. The bruising and the gums I had seen and sort of written off as being nothing. Turns out I should have paid more attention, as my PT/INR had shot from about 20/1.5 to 53.8/4.3. That is VERY high. To give you an idea. imagine pricking your finger. Then imagine holding pressure on it, and then count to 50. Take the pressure off and you are still bleeding. The count to 50 is much longer than you think when on average, you should have stopped bleeding at 15.
They lowered my dosage, and as of today I am back at a cool 30.8/2.5 . Very happy. the bruising gets annoying. you find it in weird places, like between your toes or your cheek. You don't remember being hit there, but there is a bruise.
Anyway, I am writing this all out because several people have asked what is going on with me, what's happened and what is currently happening. They also want to know why I avoid certain foods, and why I pop pills every day at 6pm. There are your answers friends.
Peace :)