OT: Lost a dear friend, very skilled accountant and above all, my dad.

[Robatoy]

Sorry to hear about that. My dad was more like that too. Mom, however, will demand care and attention...I'm not sure which is better.

[Han]

Robatoy wrote in news: [e-mail]:

That's malpractice (IMNSHO). Grandma (son-in-law's) once had an INR of

8, but survived that. Took her a long time of declining health to die at over 95. Not pretty.

[krw]

My mother had an INR of 8+ once or twice and survived, for a while. She died at 95+, too, but had been living by herself in a senior home until the last year, when she moved in with my brother.

I was on Warfarin for a short time (AF) but had the opposite problem. It took forever to get my INR up to 3 so they could do the jump-start.

[Robatoy]

[e-mail]:

Angela taught Medication distribution and the associated MAR paperwork and one totally useless 'doctor' has been reported to the College. That sweet woman turns into a pitbull when it becomes obvious that somebody is incompetent.

[Lew Hodgett]

------------------------------------- Speaking of which, how are your parents doing these days?

Lew

[Han]

" [e-mail]" wrote in news: [e-mail]:

My boss (before my retirement) needed to go on warfarin according to his doctor. I am totally against doctors selfdiagnosing and treating, but that my boss (a chief of hematology) submitted to this for his not so great problem surprised me. That he stayed on warfarin despite the big swings in INR surprised me even more. And then considering he is a nitpicker of sorts and certainly kept to his diet ...

In summary and in my never humble opinion, if you do not absolutely have to be on warfarin, stay off it. If you do have to be on it, do your utmost to get an in-home machine for checking your INR.

The INR is a measure of blood clotting speed. It is called International Normalized Ratio because every lab (at least used to) have its own way of measuring clotting by adding several substances to blood to start the clotting process. By comparing the test on blood of a patient to that of a normal with standardized reagents, the ratio turned out to be independent of the lab where the tests were performed. A normal INR should be 1. If they INR is lower than 1, you're more prone to forming clots that could lead to DVT, stroke or heart attack. Above 1 by quite a bit and you're in danger of bleeding (gastrointestinal isn't good, but brain is terrible (hemorrhagic stroke)). If you are in danger of forming clots for other reasons (e.g. arrythmia) that would give you DVT, stroke or heart attack, the INR the doctors strive for is from 1.5 to 3. If your INR gets higher than 4 or 5, the doctors start to worry. Above 7 is reason for grave concern or panic because of the enhanced risk of bleeding, especially in the brain. At that end of the spectrum (very high INR), the therapy is stopping the warfarin and intravenous vitamin K. And monitoring the INR carefully.

The way warfarin works is by inhibiting formation of vitamin K, which is needed for a certain special kind of protein modification called gamma carboxylation. This promotes formation of calcium bonds between several blood clotting-promoting plasma proteins and cells. When the (gamma- carboxylated) proteins get bound to cells, clotting goes literally hundreds of thousands times faster than when the proteins are free- floating in plasma without gammacarboxylation.

It takes time for warfarin to effect a new equilibrium of the degree of gammacarboxylation (a day or two) because the vitamin K present takes time to be used up. Vitamin K is also in the diet (broccoli and generally green leafy vegetables are relatively rich in it). So it is very important that someone on warfarin therapy keeps to a constant intake of dietary vitamin K. And that isn't so easy ...

[Swingman]

I never heard of the problem before but suddenly know three people who have had a battle with warfarin and bleeding in the brain just this year .... Guess my acquaintances are getting old.

[krw]

In my case it was because of arrhythmia (Atrial Fibrillation) and only temporary. It took a few weeks to get it up to 2-3 (they wanted it closer to

3). It was stuck at 1.5 or 1.8, or some such. They wanted my INR at 3 for three weeks before doing a cardioversion. It's over four years, and so far so good.

My mother, OTOH, was on Warfarin for a decade or so. Only the last year or so did they have trouble regulating her INR, I suppose as the kidneys and heart competed for the doctor's attention.

Yes, my wife was instructed to leave that crap out of my diet. I've been telling her that for forty years, though. ;-)

[Robatoy]

Have her send my wife those recipes. I don't do broccoli...and if I have to, raw in a dip...maybe. That shit's rabbit food, man.... I mean WHO wants their proteins free-floating in plasma without gammacarboxylation. Seriously.. I ask you!

[Robatoy]

THIS will creep you out a little... but my mother's blood was so thin, that one time I assisted her from her bed to her wheel chair and that same afternoon, Angela showed me my hand prints on my mother's upper arms..bruising. She's 90 pounds, not as if I was working her over like an 8 man.

[Edward Hennessey]

OH:

I thought the Wikipedia article informative:

Edward Hennessey

[Han]

Robatoy wrote in news:17268281-38df-416f-8b5e- [e-mail]:

LOL!!!

[Han]

"Edward Hennessey" wrote in news:-LOdnQyxD_

30AETQnZ2dnUVZ [e-mail]:

Yes, indeed.

[Larry Jaques]

Decarboxylation Kills. Vote Republican!

-- Doubt 'til thou canst doubt no more...doubt is thought and thought is life. Systems which end doubt are devices for drugging thought. -- Albert Guerard

[Rich]

Thats a good point. Well it sounds like you may find out. My mother was only

78 which came as a complete shock because she was in such good health a year ago. Well at least I thought she was!

[Tim W]

Mate. Can't imagine how you must feel. Hoping you find courage in your grief.

Tim W

[Robatoy]

It is already getting better. I'm going through his slide collection as we speak. We had time-shares in Italy, Bavaria, beach front in Holland, he did just fine. Above all, he was a straight shooter. Never any bullshit from him.

[nailshooter41]

As good as they can, I guess. They just found a malignant growth on my Dad's face and removed it, and he now has a hold the size of a nickel just under his cheekbone that oozes all day long. A specialist will look at it to see if they need to cut more off, or to have chemo/ radiation (that won't happen). He is now completely confined to his wheelchair, and has lost most of his dexterity. He is almost completely incontinent.

I don't know how he does it, but he is in a strangely good mood most of the time. We have just finished redoing all his legal stuff from wills, powers of atty., etc., etc., so he is pretty relaxed about that. I have cleaned out and am selling his old house after a bunch of repairs, so that is almost off his plate. He stays active mentally, so he loves it when I bring barbecue over to him (verboten at his joint because of the onions and spices) and we have a nice chat. If I cut up his food, he can spear it, so he feels pretty good about that.

Mom.... well Mom is starting to check out mentally. She has a lot of maladies that old folks have in her 80+ years, but her mental faculties just aren't holding up. In a weird way, this works well for my Dad as he says "I can't leave yet, someone has to take of the old woman" and he makes sure she takes her medicines, goes to her balance classes, makes her doctors appts. and eats. He has a sense of purpose with her around, so it keeps him occupied.

[Neil Brooks]

My condolences to you and yours.

Like so many ... been there ... done that.

May your grief be relatively painless, and your memories of the man be sweet, and permanent.

[Lew Hodgett]

---------------------------------- Understand, watched my mom slip away over a year and a half period.

She finally cashed her hand at 103.

As I opened your post and read your description of your Dad's skin cancer, I'm thinking "What the Hey", small world.

I'm also recovering from a skin cancer procedure on my cheek

Certainly no where near as serious as your dad's, but still a skin cancer.

Good luck.

Lew