Blood Coagulation Monitoring

As I mentioned in Let's Do This!, my On-X mechanical valve will allow me to take a lower dose of blood thinners.  It's not a recommendation that the surgeon could make to me because it is still under trial by the FDA, however it is likely that during my life, I will be able to stop warferin and manage my blood coagulation using aspirin.Why are blood thinners needed with a mechanical heart valve? How does it work?I'm glad you asked. (I know you didn't but it's my blog...) 

With a mechanical heart valve, there is an increased risk of blood clots around the valve.  Obviously blood clots = bad.  Blood clots can inhibit the valve function but they can also lead to a stroke or heart attack. To combat this, patients with mechanical valves take blood thinners for the rest of their lives.  The most common is warfarin (branded as Coumadin). 

Users of warfarin (and anyone with a mechanical heart valve) are required to monitor their International Normalized Ratio (INR) on a frequent basis to measure the tendency of their blood coagulates.  This INR can be significantly impacted by what you eat and the medication that you take.  Foods rich in vitamin K can have a significant impact to blood coagulation. Thus, patients taking warfarin are normally advised to avoid significant changes in the consumption of leafy dark green vegetables, broccoli, cabbage, prunes because of their high concentration of vitamin K.  Also, with the use of blood thinners, patients are advised to avoid fad diets and extreme and immediate changes in eating habits.  

Blood thinners like warferin work by blocking the Vitamin K-dependent blood clotting factors. So the balance for a patient is essentially the amount of vitamin K vs the amount of blood thinners.

Home INR Tester

After my surgery, I will be having daily, then weekly, then bi weekly, then monthly INR checks.  Because I've clearly shown an organized and technical leaning (like having the questions printed organized and up, working for a tech company etc.) the surgeon is recommending that we purchase a home-testing kit so that we are not reliant on other medical professionals to manage my blood thinning over time.  Obviously immediately post-surgery this will not just be me going solo.

I will track and own all of my INR readings over time and will become an expert in how changes in my lifestyle or medications impact my readings. Having access to a full history of readings will allow other medical professionals the take into account how my body reacts over time.  The surgeon said that most of the time, a doctor will prescribe a new medication for me and I'll simply follow up with the pharmacist about how it may impact coagulation.