Warfarin

Did you know that Warfarin, the breakthrough drug used by millions to prevent strokes ("thins your blood") was discovered in Wisconsin?  Warfarin stands for  Wisconsin Alumni Research Foundation.  I guess they just added in the -arin to make it sound better. 

 Grandma (L) and her sister Elizabeth

These pretty ladies are 87 and 91!

 Grandma and her 4 kids

Millions of people take Warfarin.  One of those patients is my beautiful Grandma.  She was diagnosed with atrial fibrillation about 10 years ago.  Atrial fibrillation is when the atrium (small compartments in your heart) just kind of quiver, rather than pumping efficiently.  One of the risks of a dysfunctional atrium is that of clot formation.  Clots can form on the valves and then dislodge and travel to the brain which can lead to a stroke. 

Thankfully, Warfarin works really well. Unfortunately, it works so well at thinning your blood patients usually have to stop it for a  number of days prior to invasive procedures.   Depending on the procedure, and how high of bleeding risk is associated with it, you can sometimes bridge a patient with a faster acting anticoagulant (that can be stopped quicker if need be).  Anytime someone stops their anticoagulation, their risk of stroke increases.

My grandma is 87 years old!  If you met her, you'd never guess that though!  She could beat just about anyone at a game of cards and bakes the best oatmeal cinnamon bread you've ever tasted (although her daughter's are quality competition).  She's smart and fit (swims 4 days a week).  She's been such a wonderful grandma and friend to me my entire life.  (For the past 15 years I've talked on the phone with her about once a week, often more that that.) 

Although she is as "healthy as a horse" her heart recently decided it needed a little attention.  Her aortic valve is not working properly and needs replaced.  This week, as part of her pre-operative work up she had to have a cardiac cath done.  She passed this test with flying colors.  Because that's an invasive procedure she had to stop her warfarin. 

Well, as you may have guessed my dear Grandma had a massive stroke last night.  This was her biggest fear in life!  Give her anything but a stroke or alzheimer's and she wouldn't complain but everyone who knows her at all knows she does not want to be compromised by either of those!

Apparently, after watching K-State lose to University of Kentucky she got up and noticed her legs were wobbly.  So she pushed her emergency call button (amazing she had it on her, she usually doesn't) and laid down.  When the emergency personal arrived to her apartment she informed them she was having a stroke and was able to tell them that she'd had to stop her coumadin for the cardiac cath earlier that week (very important as that was a good indication as to the type of stroke).  They rushed her to her local ER where the doctors gave her a dose of TPA (powerful clot busting drug).  Her symptoms seemed to improve for a short time.  They then flew her (bet she never thought she'd ride in a helicopter) to Kansas City. 

Once she got there the invertentional radiologist trained in neurology was able to perform cerebral angioplasty and place a stent.  When she woke up her symptoms seem to have resolved (her speech is normal, cognitively normal, and while required to lay flat all day her limbs seem to be working well too)!  The pictures of her brain perfusion before and after stent placement are just amazing!!  How thankful I am that all the right people were lined up at the right time and that my Grandma realized what was happening and was able to get help immediately!

Grandma still needs her heart valve replaced which is a big procedure - I am hopeful they will be able to do that before she is discharged.  She is in the ICU still but doing quite well.  I'd appreciate prayers for her complete healing and that she is able to tolerate the valve procedure without any further hiccups.

My grandma is my biggest blog reader, she also e-mails, has a cell phone, an ipad, and likes to "facetime" us!   I love her dearly and hope I am just as healthy, smart, and fit as she is in 50+ years. 

Perfusion Before:

Perfusion After:

Perfusion Before:

Perfusion After:

I could show you pictures of the large clot they removed but my Grandma is super tough and I'm 

afraid she might just kill me if I share that with you! Ha!