# COUMADIN



## TSOJOURNER (Dec 16, 1999)

Does anybody have experience of taking coumadin during long-term offshore sailing? How do you manage your PT/INR and prescription? Thanks for any help!


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## TSOJOURNER (Dec 16, 1999)

i had one crew member on it on the way to bermuda and i swear i will never have a crewmember on it again. we were running in a gale and he lost his footing and slammed into the nav station just below his hip. we had him on morphine for the rest of the trip to bermuda.
the doctors there said he lost 2 pints of blood into his leg. he couldn''t walk properly for a month.

if he had a serious injury i believe he would have died on the short passage to bermuda.
eric


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## rbh1515 (Jul 7, 2000)

There are POC (point of care) devices that will perform a PT/INR from a finger stick. They do a pretty good job. I am sure they are battery operated. Ask your physician. I am a pathologist (lab doctor).
Rob


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## Sailorgal24 (Mar 17, 2002)

What is the situation with Plavix? I understand it is not the same as Coumidin ( I hated that, so ''found'' this) I am in the process of making a decision about whether to keep my boat. I sail in the intercoastal almost exclusively, and do not push it, as far as weather is concerned, but you never know. Plavix escapes the testing, etc., of Coumidin but..........Thanks for any help with this


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## Sonya (Dec 23, 2007)

*Coumadin/Plavix*

My husband had vascular surgery several years ago and because of his allergy to ASA has been placed on Plavix every 2 days, no blood work required, he does bruise easily and he will bleed longer than the average person, anytime this has happened direct pressure to the cut and elevating the cut if possibe above heart level, even if he had to lay down, solved the bleeding issue in a short time.but we have never had a serious incident with the plavix. I would advise you take a first aid course if you haven't already to know how to deal with arterial bleeds, these are quite different from surface injuries. The plavix hasn't slowed us down at all and is easy to deal with.

Sonya


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## sailingdog (Mar 19, 2006)

Sonya-

Welcome to sailnet, but chances are pretty likely that they've all bled out already... the posts you're responding to are FIVE years old.

Please read this post to help get the most out of sailnet.


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## hellosailor (Apr 11, 2006)

sd, it's an old thread but the question is still relevant. 

I know folks who are on coumadin aka warfarin and other "blood thinners". Yo need to treat them the same way that you would treat any other natural "bleeders" (hemophiliacs) on the boat. An injury or bruise needs to be treated promptly and properly. 

For cuts and gashes, there are some marvelous new products (refined from battlefiled medicine) like names like "Quik Clot" that can be poured on a wound to clot it almost normally and immediately. A good thing to have in any boating first aid kit anyway.

For bruises, you need to have ice packs available (chemical "slap" packs will do) and apply them immediately, and elevate the area.

There are also injections that can be given (something like Vitamin K) that rapidly increase clotting ability but that of course will need an RX to be added to the med kit, and some training.

All in all...if you are prepared for trauma (as opposed to simple bandaiding) you can deal with bleeders, but the decision about what kind of crew med risks you are willing to take is something else again, i.e. can you afford to have one crew out of action for 48+ hours at all?


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## sailingdog (Mar 19, 2006)

True, but I don't think the OP is aware of the age of the thread or other posts. 

BTW, one thing to be careful of with the "Quik Clot" is that it generates a fair amount of heat IIRC. 

In terms of treatment, compression bandages (ace bandages) are also very useful in treating bleeders, as is elevation. I would avoid the injections, unless you have the medical training to do it properly, since you can make the situation worse.


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## SailinJay (Dec 6, 2002)

sailingdog said:


> Sonya-
> 
> Welcome to sailnet, but chances are pretty likely that they've all bled out already...


Now *that's* funny!!!  Good one, SD. (I am currently on this medication).


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## hellosailor (Apr 11, 2006)

Heat, hmm, hadn't heard that. Still, there are at least 3 products out now (all based in different chemistry) and they all beat all heck out of the old fashioned way of doing it: Pouring plain white sugar on the wound. Odd as it sounds, that used to be "official" wilderness medicine. Almost every boat or cabin has sugar in the galley, and it is reasonably sterile.


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## sailingdog (Mar 19, 2006)

I'm not sure if it is QuikClot or one of the other brands...but it is a powder, and the way it works causes it to generate a fair amount of heat, so you have to apply it properly...


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## speciald (Mar 27, 2007)

I've been cruising 5+ years on relatively high dose Coumadin because of an artificel heart valve. I don't get routine monthly INR done as there are few places in the islands where it can be done convieniently. I have had a couple of bad bruises after falls but when wrapped and compressed the were self-limited. I looked into buying my own machine to do the testing but it was way expensive. Head injuries are a worry a subdural hematomas are are risk but so far I'm not wearing a helmet. For two years and with monthly testing my dose was fairly stable but remember to balance booze and green vegatables as they work against each ither in determining clotting times.


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