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Dr. SH
Dr. SH, Board Certified Physician
Category: Medical
Satisfied Customers: 8770
Experience:  Doctor of Medicine
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Is it a medical necessity to take additional blood thinners

Customer Question

Is it a medical necessity to take additional blood thinners if the heart left appendage has been surgically closed during a routine quadruple by-pass. Since I have three stents in my lower body for blood flow to my legs, I do take Plavix and plan to take 1 small aspirin/day after stopping Xarelto. I have been free of atrial flutter or fililbration for five years following 3 ablations, but my pacemaker tells the cardiologist that I am experiencing A-Flutter so another ablation was performed in July and the electrophysiologist MD is rather insistent that I continue to take Xarelto or warfarin. Warfarin has the side effect of turning my urine brown indication bleeding through my kidney. I am very thin skinned due to treatment for psoriasis several years ago and without any medicines to make my blood slippery or thinner I bruise and bleed most easily. So, I am afraid of continuing to take thinners other than Plavix and aspirin. I have just completed 30 days on Xarelto. I am a 78 year old male that stopped smoking in 2012 after 54 years for which I am not proud. I weigh 165 #'s, am 5'10" and I have hypertension for which I am taking a combination drug lisinopril/hydrochlorothizaide, and 100 MG Metoprolol ER in the morning and 50 MG Metoprolol ER in the afternoon. Tom R
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. SH replied 2 years ago.

Thank you for your question.

The main thing here is that if your atrial fibrillation or flutter still do happen from time to time then you will need to be on an additional blood thinner like xarelto.

However if you have not had any episode of atrial flutter of fibrillation then you may opt not to be on xarelto.

Our main aim, as you may know, with giving xarelto (which is different from aspirin or plavix in that aspirin and plavix act on platelets whereas xarelto and warfarin act on various coagulation factors) is to reduce clot formation in patients who have atrial fibrillation because if a clot does form in such patients there is a high likelihood of stroke or other catastrophic consequences.

So your question to your doctor should be that if you are not having atrial fibrillation or atrial flutter then what is the need of being on xarelto? If you have not had any heart rhythm problem for years then there is no reason that you should be on an additional blood thinner like xarelto as far as I am concerned.

Let me know if you have more questions.

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Kind regards