rat poison

Warfarin is a class of anti-coagulant drugs that acts to inhibit the synthesis of vitamin-K dependent clotting factors in the blood. This makes it safer than some more modern drugs in that its effects are relatively quickly reversible by giving large doses of vitamin-K.  Wikipedia tells us that it was initially marketed as a pesticide for rats and mice and is still popular for this purpose, although more potent poisons have since been developed. It is marketed largely as "Coumadin" and this is its common name. (I referred to it by this name in a previous post.)

The dosing of the rat-poison is very dependent on food intake, metabolism and interactions with other drugs.  Given the risks and the difficulty adjusting doses, initially (until the INR stabilizes) I need frequent blood monitoring of my “International Normalized Ratio” (INR) that measures time for blood to clot.  One of course is the normal IRN value, and therapeutic  (on what I presume is a linear scale) is two to three.  So today I went to a “Warfarin education” lecture which was given as a power point presentation to an audience of three patients (myself included) and two care-givers (Meg included).  The other patients were elderly heart patients.  Meg had to give me "the signal" as I was anxious and bored and asking too many questions.  I am still in a highly agitated state (prednisone ? oxycontin withdrawal?) and often need to be "reeled in" in public situations (the kids are watchful of my behavior as well).  I tried to focus on boredom.   

I did in fact learn a few things, particularly things to avoid when your blood clotting is slow.  A partial list:

• surgery
• tooth extraction
• banging of head
• policemen with truncheons
• the front line in occupy (99%) protests
• crocodiles (who by the way have the strongest bite in the animal kingdom, stronger than the great white, and to set the scale over a factor of ten stronger than that of a rottweiler like my dog Fido)
• tug of war with Fido, where I win
• hidden carry states where bicyclists can get shot in the head by gun totting firemen (NYT, today!)