UGENT: Do any of you use Warfaran and continue to sail.

Ralph Johnstone · Aug 18, 2015

Sorry I can't offer any first hand recommendations but I can only wish you the very best of luck in this operation.

Davidasailor26 · Aug 18, 2015

Sorry I don't have any knowledge specifically, but as a note of encouragement, my grandfather had a prosthetic heart valve implanted when it was still very new technology. I have many fond memories of going out on his powerboat with him when I was a kid, for years after his surgery. As far as I knew he had no apprehension about going out and enjoying the water. I know he was taking aspirin each day that slowed him from clotting, and I remember him bleeding when the damn green head flies would bite, but I don't know if he had any other anticoagulants.

Marc14857 · Aug 18, 2015

Warfaren

Though no longer on it I was on Warfaran for awhile during sailing seasons and really did not think twice about it. I'm no doctor and you should obviously check with yours but the various bumps and scrapes that one might routinely get on a sailboat was not a big concern for me or my Dr.

31seahorse · Aug 18, 2015

Caguy, Best wishes with your choice and procedure.

I was on Warfarin for two weeks after my hip replacement surgery. The doctor warned me against shaving with a safety razor due to bleeding and also warned me to guard against infections. That would also be appropriate for you I suspect. The Warfarin also required blood testing. Twice a week to begin until they would get the level to the appropriate point. With complications due to intermittant home nursing care (no offense intended) I was told to discontinue the Warfarin and go to adult aspirin twice per day for the next two weeks. Then the need for blood thinning was reduced in my case. I would believe your regamin would continue longer, but remember I got my medical training watching Dr Kildare, Rescue 8, Mash, and Doogie Houser!

weinie · Aug 18, 2015

You may have test your INR levels weekly with a self administered blood test and call in your results. They get sent to your doctor who can advise you whether you need to adjust your dosage.

njlarry · Aug 18, 2015

Every case is different.
Talk to your doctors and your crew.
Good luck.

Ilanortho · Aug 18, 2015

Warfarin use

weinie said:
You may have test your INR levels weekly with a self administered blood test and call in your results. They get sent to your doctor who can advise you whether you need to adjust your dosage.

I am a surgeon who routinely prescribes warfarin and other anticoagulants after joint replacements. I suggest the following:

1) when using these drugs you will bleed more easily if injured whether from blunt trauma or penetrating injuries. Small cuts can easily be dealt with with pressure and rest and ice; bruises will be common and cosmetically displeasing. A major fall may cause a contusion with subsequent hematoma formation; if it is large it can be disabling or even become infected and/or require drainage.

2) Above all, do not climb heights or use a bosun's chair. A fall from a height may cause fatal bleeding if you strike your head or other parts of your body which can cause internal bleeding. A few years ago I was in the ER when a man came in having fallen off a ladder about 8 feet up. While smiling and conversive on arrival he was dead 1 hour later from a tamponade of his heart (bleeding into the sac around his heart which then constricts it and prevents it from doing its job). I saw this with my own eyes and in spite of measures to drain the heart sac immediately the bleeding could not be controlled.
I also happened to be in Sturgeon Bay last week when a boat sailed in after having sustained a knockdown during a white squall. The 1st mate was slammed down and sustained major bruising of her thigh. Had she been on a blood thinner this may well have caused a major problem although not life threatening.

3) If you are cruising for any period of time you will still need to have your blood protime checks, often daily or weekly at first to make sure your levels are therapeutic and just as important not too high so that you do not bleed; you will also have to watch what foods you eat as they affect the actions of coumadin. This however is not necessary if you are allowed to take an oral blood thinner such as Arixtra or others, but I don't know how this applies to heart valves and whether Coumadin is preferred.
4) Easy for me to say, but go with the best heart valve option; everything else beside loved ones is secondary

Ranger_12 · Aug 18, 2015

I have been on Warfarin for 10 years since having an artificial Aortic Valve replacement in 2005. I normally have my PT/INR tested once a month. I have learned to regulate my diet so my PT/INR pretty well stays within limits 95% of the time.
There is the danger of bleeding and I have had a couple of minor instances where it was an inconvenience. If you need surgery or dental work or even a colonoscopy you will have to take shots and stop warfarin.
The upside to a mechanical valve is that it will last forever. I have a friend who has had 3 tissue valves installed, I understand they only last 8-10 years.
I sail singlehanded all the time and do anything I want to do, I just try to be careful.
I am 67 yrs old now and healthier than when I was in my early 50's due to diet and exercise.
My advice to you is to consult with your Doctor and follow the recommendations and options provided.
Good luck to you. If you want more input pm me.

Jimm · Aug 19, 2015

caguy said:
I have to have a valve replacement and have to make a decision to day between an mechanical aortic valve and a tissue.
The mechanical valve is superior to the tissue valve but requires anticoagulants.
Those of you who require it understand the risks.
Thanks in advance for your feedback.

SAIL! I've had two aortic valve replacements - at age 42, then again at 62 - both tissue values. Daily 82mg asprin. Add a cardiac arrest 4 years ago, now with an implanted AED.
I sail solo often, and took my Catalina 30 to Key West & back two winters ago, and have done off-shore deliveries. I refuse to stop living. There are worse places/ways to die.

Finally Free · Aug 19, 2015

I also had to take Wafarin after my knee replacement. I would suggest having some Quickclot on board in case you do sustain a major cut.

Gunni · Aug 19, 2015

Yes to quikclot! This hemostatic product should be in every boat's medical kit.
http://www.quikclot.com

And kudos to all you boaters who manage the risks and continue your active lives in spite of the challenges! Well done.

Jimm · Aug 20, 2015

caguy said:
Thanks to the input from all of you. I've consulted with the Cardiac surgeon this morning and I am going with the tissue valve. He suggested that a person my age should have the tissue valve due to bleeding complications later on. I do have a bad back that my need surgery later. I also read that very few people are able to keep their anticoagulant within recommended levels. I like to ski and work on old cars and boats in addition to sailing. I cut myself often. I am also banking on improved techniques over the next 10 to 15 years. It looks like their have been significant improvement in tissue valves and approximately 50% last 15 years. Their will definitely be some life style changes that I can live with. Including diet and exercise.
Thank you to the members of this forum I knew I could count on useful input.
I am schedule for tomorrow or Friday for the procedure.
See you on the water soon.

Best wishes for a successful procedure and quick recovery! BTW - Note that life expectancy for tissue vales is much extended - I got 20 years on the first one - and, expect longer from the second. Even at age 42 for the first one, I have no regrets for opting for the tissue valve - much better quality of life !

Eddie7045 · Aug 20, 2015

Have you tried looking at the web-site

"Ask a patient" ?

woodster · Aug 21, 2015

wow just read this thread for the first time ....hears hoping you recover soon .....

Bad Obsession · Aug 21, 2015

I hope that you recover quickly.

If you ever go to the trouble of buying products like QuickKlot then make sure you know how to use them correctly and when to use them. QuickKlot is some pretty serious stuff.

Part of some of the work that I do involves training for Active Shooter Response. I teach instructors how to teach it. Over the last few years the idea of carrying IFAK (Individual First Aid Kit) or TEMS (Tactical Emergency Medical Supplement) Kits has become really popular in LE circles. These kits are similar to what the military carries into combat. There are Youtube Videos that are very good on how to use these things. Watch them if you carry that stuff.

My other thoughts are to just do it! Be careful and move more carefully. Wear long sleeve clothing and pants with good shoes. That can be a good first line of defense.

dreuge · Aug 4, 2017

I hope all is well. I appreciate the discussion as a valve replacement is in my near future.

UGENT: Do any of you use Warfaran and continue to sail.

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