Hubby Home from Hospital After Pulmonary Embolism,now on Coumadin-what to Expect

Updated on December 17, 2008
T.C. asks from Grand Rapids, MI
9 answers

My husband (age 41)and I had a scare when he was put into the hospital with a pulmonary embolism that had moved from his calf to his lungs. He has several embolisms (clots) in his lungs - 2 of which are larger. He was hospitalized for 8 days and just came home today. He is on Coumadin (a blood thinner). We have been told that the clots will not desolve for a few months, but that after a couple of weeks he should be feeling back to normal.
Has anyone else gone through this. I think this is more common than I ever realized, but I don't know anyone to ask - and the doctors can be vague. With the holiday here we have many gatherings planned. I am wondering how my husband is going to feel as he is recovering. He is fatigued easily right now. I am not sure if this is from the medicine, the clots in his lungs, or the fact that he has been lying in bed for the last week. He was not complaining of any lack of energy before we discovered what he had.

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J.B.

answers from Grand Rapids on

My husband has had 3 PEs in the last 10 yrs. Two of them required an ambulance since he passed out, and one he recognized himself and awakened me at 5 am to take him to the ER. He was implanted with a Greenfield filter in his venacava on the third episode and told he'd be on Coumadin for the rest of his life. Whenever he has a surgery scheduled, I take him off the Coumadin and give him injections of Lovenox (another blood thinner that exits the body faster than Coumadin) twice a day for a week prior and a week after the surgery until his INR numbers are back where they need to be. He has a blood draw every month unless he's had too many oranges! Those affect the blood and throw his INR way off so he has to have a draw every week or two in order to adjust the Coumadin.

Food plays a part, obviously, so follow the booklet they gave you in the hospital when they put your husband on Coumadin. It will guide you through the maze until you have it all figured out. Keep that information to review every once in awhile, even if they take him off the Coumadin. He might have to go back on it someday.

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K.V.

answers from Detroit on

All that I know is that if he has anything done, even a dental cleaning, they MUST know that he is on coumadin at least a couple of days before the appointment. They will need to coordinate his dental treatment with his physician, so that he doesn't bleed out.

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L.N.

answers from Benton Harbor on

He'll be tired and weaker from a combination of everything. However, once he recovers, the Coumadin shouldn't make a difference in his energy level. He will bruise easier and bleed longer if he gets cut, but that should be the only effect of the meds. If you notice any unusual side effects, call the doc right away. You will probably be in contact with the docs office for a while anyway, because he will need to have weekly (or so) PT/INR tests to monitor the clotting time of his blood.

~L.

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F.W.

answers from Detroit on

My father has been on coumadin for awhile. lso, a friend of mine just went through the same thing your husband did and is on coumadin. First, make sure you understand the dietary restrictions when someone is on coumadin. The philosophy has changed recently, so go by what his dr. recommends. Since cranberries are every this time of year, know that he will have to avoid eating them. His energy is going to be down because his body has just suffered an insult, and it will take time to get it back to normal. Coumadin levels fluctuate, and after he fully recovers down the road, maybe he will see if there is a correlation between his coumdin levels and his energy levels. Right now, he just needs to recouperate, and it could take until the clots dissolve. This is going to be a very thankful holiday for your family!

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D.H.

answers from Detroit on

the pulmonary embolism itself, the bedrest in the hospital, not so much the coumadin cause him to be fatigued. Portions of his lung are not getting proper ventilation through decreased blood flow while the clots are present. You should anticipate him becoming fatigued easily during his recovery. He should try to balance rest and activity and some holiday activities may need to be scaled back. Good Luck. You have alot to be thankful for that he is recovering.

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O.K.

answers from Lansing on

I've been on Coumadin for about three years and have extensive family history of blood clots. About two years ago my grandmother had a large PE extending over both lungs.

He may be tired from all of those. I know it took her a long time to recover from hers. I suggest he just take it easy, especially with the holidays. No need to over do it and be back in the hospital.

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K.W.

answers from Jackson on

You can initially expect alot of blood draws, either once or twice a week to check the coumadin (also known as warfarin) levels and see if his blood is what they deem thin enough....once they have gotten it thin enough, his bloodwork will slow down. Do not take aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) unless your doctor has told you to. NSAIDs include celecoxib (Celebrex), diclofenac (Voltaren), ibuprofen (Motrin, Advil), indomethacin, naproxen (Aleve, Naprosyn), piroxicam (Feldene), and others.These medicines can affect blood clotting and may cause serious bleeding in your stomach or intestines.

Avoid sudden changes in your diet. Vitamin K decreases the effects of warfarin. Large amounts of vitamin K are found in foods such as liver, broccoli, brussels sprouts, spinach, Swiss chard, coriander, collards, cabbage, and other green leafy vegetables. Do not change the amount of these foods in your diet without first talking to your doctor.

Avoid eating cranberries, drinking cranberry juice, or taking cranberry herbal products.
noalcohol Avoid drinking alcohol, which can increase some of the side effects of this medication.

Avoid sports or activities that could result in a bruising or bleeding injury. Use extra caution to avoid cuts when brushing your teeth or shaving.
What are the possible side effects of warfarin?
emt Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
emt Call your doctor at once if you have any of these serious side effects:

* skin changes or discoloration anywhere on your body;
* purple toes or fingers;
* pain in your stomach, back, or sides;
* low fever, loss of appetite, dark urine, jaundice (yellowing of the skin or eyes);
* diarrhea, fever, chills, body aches, flu symptoms;
* easy bruising or bleeding that will not stop;
* blood in your urine;
* black, bloody, or tarry stools;
* nosebleeds, bleeding gums, coughing up blood;
* feeling weak or light-headed;
* sudden headache, confusion, problems with vision, speech, or balance;
* sudden leg or foot pain; or
* sudden numbness or weakness, especially on one side of the body.

Less serious side effects may include:

* nausea, vomiting, stomach pain;
* gas and bloating; or
* hair loss.

This is not a complete list of side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.Warfarin can interact with the following herbal (botanical) products:

* bromelains;
* coenzyme Q10;
* danshen;
* dong quai;
* garlic;
* ginkgo biloba;
* ginseng; or
* St. John's wort.
http://health.yahoo.com/heart-prevention/warfarin/healthw...

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E.M.

answers from Grand Rapids on

My mother has been on coumadin for almost 20 years. A very good friend of mine has been on it for about 6 years. I have noticed that my mom has had enough time to "figure out" how her body works with it and so she has little problems with it. My friend, however, has a specific condition which makes her blood too thick. So it's a little harder for her to predict. However, They both go through the same effects. When they feel too tired it usually is because the blood got too thick. Maybe they ate the wrong thing. Thicker blood means the heart works harder to pump it so you feel more tired and winded.
My best advice is plenty of rest, plenty of liquids, take your coumadin on schedule, and stay away from vitamin K.
Good luck...E.

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V.G.

answers from Grand Rapids on

Although I don't have any first hand experience with pulmonary embolisms or coumadin, I did have a co-worker that is on coumadin (he's still with the company, I am not). He didn't have a problem with being tired all the time, rather just bruising easy. Him and I had talked at some length, as there was a point where we thought my husband would be put on it. I was on activity restrictions (could only do light chores and couldn't be on my feet for more than 30 minutes at a time) when pregnant with my youngest and my energy level seemed to slowly go down. After I had her, and was able to get up and do more, it again got slowly better (if I forced myself to move more). You may want to call the doctor or talk with a pharmacist though to make sure it isn't a side effect of the drug (just because one person didn't have it doesn't mean another can't) or check out www.webmd.com to see what they have to say about the problem and the meds.

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