Pulmonary Embolism Support Group
By far the most common form of pulmonary embolism is a thromboembolism, which occurs when a blood clot, generally a venous thrombus, becomes dislodged from its site of formation and embolizes to the arterial blood supply of one of the lungs. Symptoms may include difficulty breathing, pain during breathing, and more rarely circulatory instability and death.
My INR has not been stabilized, which means a third week of shots with a potential of longer. Obviously, I also need to quit smoking to make my future more promising (with the hope I can eventually get off Coumadin). My experience with all my doctors, even my pulmonary specialist and Coumadin Clinic nurse, has offered very little information. Therefore, I have spent countless hours researching everything, as I am sure most of you have too. All of this got me thinking.....how does smoking affect my Coumadin dose and INR.
After reading multiple articles, it appears that the toxins from smoking (not necessarily the nicotine) cause your liver to work overtime to try to remove them, and in turn it works harder on your Coumadin (since that is processed by your liver) and can therefore result in a low INR. The articles state that people that will be quitting smoking while on Coumadin need to be careful because they are likely to have a rapidly increased INR. Wow, interesting.
I am making tomorrow the day where I will give up this nasty habit that has probably contributed to me being in this position day. I know this will be really hard, because I have tried so many times before. But I know I can't wait another day, or have another excuse. I am sure this will only contribute to my recovery. Wish me luck!!!!
After reading multiple articles, it appears that the toxins from smoking (not necessarily the nicotine) cause your liver to work overtime to try to remove them, and in turn it works harder on your Coumadin (since that is processed by your liver) and can therefore result in a low INR. The articles state that people that will be quitting smoking while on Coumadin need to be careful because they are likely to have a rapidly increased INR. Wow, interesting.
I am making tomorrow the day where I will give up this nasty habit that has probably contributed to me being in this position day. I know this will be really hard, because I have tried so many times before. But I know I can't wait another day, or have another excuse. I am sure this will only contribute to my recovery. Wish me luck!!!!
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Look at what my best friend did with my picture!
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We all have 24 hours in a day. How we spend these hours is important. Watching a little bit of a video about how sitting affects us made me aware of how much sitting and laying down I do. Gonna have to work on that.Your turn. Tell me another truth.
I would also think that quitting might speed your recovery.
But regarding your INR, the fact that it's not stabilized yet is not uncommon at all. It took me almost 6 months to ever get an INR to 2. I don't smoke. I'm not saying that is going to happen to you, but for some people it just takes a while. Warfarin is such a strange drug, and everyone reacts differently.
I've been on warfarin for over 4 years and have seen my INRs do goofy things for no reason, it seems. And I've been on many different dosage combinations. Recently, I had to be off all anticoagulation for 10 days after a procedure, and so started up my warfarin again just last week. Right now, I'm taking 13 mgs a day and have been for about 6 months. Well, after 7 days of being on 13 mgs again, checked my INR yesterday and it's a big fat 1. That's what most people's INRs would be if they weren't on warfarin. Why 13 mgs worked then and now it doesn't seem to be doing anything at all for me is beyond me. The only thing I can think of is that due to the holidays, I'm totally out of my food and work routine.
My point is that I wouldn't over think the INR too much. Docs needs to find the right dosage for you. And that can take some fine tuning and tweaking to get there.
Talk to your doc about quitting smoking though for sure. He'll want to know any changes your making, plus it's a good source of support to have a doctor behind you.
There is a stopping smoking group here on DS, if you'd like some extra support! Best wishes!
In actuality, and something I had forgotten, smoking does somewhat increase the risk of venous thrombotic events. When I get some time I'll dig up the source where there was an at-a-glance analysis of odds for VTE for women in the general population, those with FVL heterozygous/homozygous, Factor II het/hom, if taking oral B/C, if smoking, etc. With each risk factor the odds, starting around 1 in 10,000, could reach as high as 1 in 150 per year with enough risk factors.
Purely a guess would be that the role of the smoking may have really not been significant as far as getting the VTE/PE without another 'trigger event" but figuring all that out can come in time. What I'd be wondering is how it could be tolerable to take a puff after such trauma to the lungs. Many people in this forum had lifelong problems giving it up or had been in the habit since their teens, but could barely get a breath if lighting up again after PE. Unfortunately my work sometimes involves having to load cargo alongside an outdoor smoking area, and that passive secondhand smoke is more than enough.
As for how it affects INR, there does not appear to be anything specific one way or another that applies uniformly to all cases, but like everything else there can be a vairiance of outcomes from one individual to another.
Good luck!
http://www.medscape.com/viewarticle/588677
I smoked up until about 2 weeks before I was diagnosed. I just couldn't do it any longer...Physically impossible. I am really shocked that you can still smoke, honestly. For me it wasn't difficult at all. When I found out what was wrong, I vowed to never smoke again and I haven't.
As for being able to smoke with PE.... before I was diagnosed and I started getting the shortness of breathe it was hard to smoke and it scared me so bad I quit right then and there. Then after I was diagnosed and put on Lovenox, the SOB lessened and the chest pains set in. A few days after diagnosis I was breathing normal and so depressed I did the only thing I have ever done when I feel that horrible....reach for my smokes.
As for smoking causing my PE....my doctors doubt it plays a pivotal role because of my age. But I am sure it contributed. The more I contemplate how this could have happened I begin to think that my immobility during depression episodes may have likely played the largest role.
Thanks again for the support. Looking forward to reaching a "smoke-free" marker, like a one week or one month smoke-free. Then it will feel more solid to me that I am no longer a smoker.