I have just been diagnosed with Atrial Flutter.

Hi guys, I have been on here previously talking about my wifes Bisoprol, but now it's me.

I have just been diagnosed with atrial flutter and as I understand it is the lesser evil of the two flutters.

I have no symptoms at all and only found out after having had a blood test. i already take for high Blood pressure which is under control Atenolol 100mg - Doxazosin 12mg - Ramipril 10mg, none of these has given me any side effects.

Two weeks ago I saw the practise nurse who said I need to take Atorvastatin 20mg because I was at as I was on facture 30, I took these for a week and felt really bad nearly passing out during the evening, So I stopped them and it took a few days before I felt right again. If you don't know surgeries receive payment for pushing specific drugs and of course statints have been on the news a lot lately. Statins are used to lower Cholestral and reduce the risk of a stroke.

Getting back to me, I saw for the first time my Cardiologist who has put me on Warfarin which I am yet to take as I could not get an appointment to get the prescription, he has put me down for a Cardioversion at the end of the year to get my heart back in sinc which he said is 90% successful, so we will have to wait and see.

Regards all Ken.

Hi Darcyb71, what a highly interesting and encouraging message!  I have been an AF sufferer for some 7 plus years and now I'm 79 I have lost count of the attacks I've experienced over that period.  My cardio has set me on Flecainide (50mg twice daily) and seems to be better than all the other meds I've been on.  BUT this vitamen D3 seems to be a glimmer of light at the end of the AF tunnel.  I shall definitely be looking into this now that you've reported your success.  What made you start on this vitamin?  Any more info would be interesting.

Cheers, and thanks.

Does it keep you awake or have you getting up to the toilet?

I was taking 180mg of Diltiazem twice a day, and 150mg of Flecainide twice a day.  Now I only take 180mg of Diltiazem once a day, and 100mg of Flecainide once a day, Cutting my meds in less than half.   I started taking vitamin D3 because I was told by my Dr that 4000 to 6000 iu of D3 can reduce your chance of getting sick in winter. Throughout that winter my Atrial Fibrillation seemed to be gone completely, and I even started reducing my meds because I felt so good. I didnt realize that it was the vitamin D3 that was helping my Atrial Fibrillation until spring when I tried to stop taking it. I have also found that when I do go back into Atrial Fibrillation, 2 more D3's and Im back in normal within 20 min.  I have been doing this for over 6 years now with great results.

It keeps me awake all night, But now that you mention it, I often have to go to the toilet at night also. I do try not to take it after 6 pm.

Do you have any idea why Vitamin D should stop you from sleepng? I have not been sleeping well recently no matter how tired I am when going to bed. On a good night I get about four hours in total. Having had my BPH attended to last year I was getting a pretty good nights sleep as I was not having to get up to the toilet.

I was initially blaming Amiodarone but having stopped it due to loss of equilibrium should I now blame warfarin?

A Concern has been raised about a possible interaction between vitamin D and warfarin, but the potential for increased activity of warfarin due to vitamin D has not been confirmed by any substantial research. Normal amounts of vitamin D should not affect INR test results.

I would consult your Dr so he knows to closely watch your INR just to be sure there is no problem.

Anything I take or don't take seems to affect my INR. I started to take my PPI on alternate days and my INR whent from 2.4 to 1.9 and stayed there for the next two weeks. When I mentioned it to the nurse she said that would be the reason. Cod liver oil, cialis and homeopathic remedies have also affected it. I read recently that more that five paracetamol a week will also affect it. I had a Greek meal with a lot of garlic and spices and the next day the nurse was asking what I had done this time:-)   

I just Googled vitaminn D and insomnia with mixed results as always. Some say that vitamin D deficiency can cause insomnia other that taking it causes insomnia.

I dont know If it will help, But It wont hurt. I find that Vitamin D also gives me energy when I need a boost. Taking it 3 or 4 times a day could also be a good idea. 

Hi guys, Further to my posting above. having been diagnosed with Artrial Flutter, my Cardiologist has decided that I need a Cardioversian some time at the end or early next year, so no hurry then.

He has put me on Warfarin, so 10 days later I see my GP who tells me that 3 chemists in my area do the dispensing of warfarin, so now another week plus has gone by and no nearer to getting my drug, what a load of rubbish the system is.

My cardiologist said i am lucky as by volunteering for a cardiac trial the ECG showed I had  AF, otherwise I may have just at some time had a stroke. I have no symptoms at all of AF.

I think in this day and age we should all have an MOT on our body at say 50, this would in the end show up a lot of problems early, like having a Bowel Cancer test at 70 plus that they now do and then if needed 3 years after again, it would save the NHS thousands if not millions.

Best wishes everyone Ken.

 

Surely every chemist in Britain stocks warfarin. Even if an item I need is out of stock they usually get it by afternoon or next day.

You need to be on warfarin for eight or nine weeks before having a cardioversion. Here in East Sussex once you are on the list it is done by nurses within a month.

Hi Derek,

I obviously did not make clear what I said, apparently the Gp is not allowed to give out the first doseage of Warfarin and in Brighton there are 3 chemists who specialise in administering it, I believe just initialy until the blood level required is obtained.

I don't understand chemists administering it. GP surgeries have warfarin clinics as does the Royal Sussex. I was first prescribed it by the Royal Sussex when I was a patient they arranged for me to go to the warfarin clinic at Eastbourne hospital initially twice a week and then once a week for a couple of months until stabilised before leaving it to the warfarin clinic at my GP's. Two nurses there check about 120 patients a week and alter dosage as required. It is just a normal practice not a Health Centre.

The doctors there do initiate warfarin for patients. There is a standard high dosage used to start patients on and it is then reduced until your INR level is in the required range. 

I was off warfarin for some time but went back into AF late last year. After the surgery did an ECG they started me on warfarin that week. After the first sessions the nurses speaks to the doctor to confirm the dosage the computer generates.

 

Would you believe as i posted the last blog, our phone rang and yes it was the R S C hospital Warfarin clinic with a cancelation for 9 am tomorrow.

Yes my GP did say chemists, but forgot to mention Hospital first !!!

That is good, soon you wil have your little yellow book to take everywhere with you:-) I just cannot see three pharmacies having the space or facilities to cover INR testing for the whole of Brighton. The surgery I go to has 300 patients on warfarin but fortunately not all require weekly testing. Some people have their own monitors or if house bound have one supplied and phone their results in at appointed times. They get about £10 a time for testing you.

There will be a lot of patients at the hospital clinic so be prepared to be there for around two hours. First the wait to be called, then blood taken and sent to the lab. Then the best part of an hour for the result to come back and to see the nurse.

At doctors surgeries it is tested instantly on a machine similar to that for diabetic blood glucose testing and you are in and out in about ten minutes.

Always the realist (or party pooper) the first three weeks on warfarin are the most dangerous due to the possibility of a bleed or stroke.

When Brighton started me on it they precribed 5mg a day and built it up till they got the desired reading. In Eastbourne they started me off on 10, 10, 5mg for the first three days before retesting and then 10, 10, 8mg.

and then 7mg for about the next five weeks. After six months it varies between 5 and 6mg. It's a very strange drug and many things can cause your readings to vary.

 

Thanks Derek for the info.

It could be that as a first timer you may not be sitting in a waiting area for a long time. Tomorrow they will have a lot to tell you. Every week I find new things that affect my INR that the parcice nurses do not know about.

Hi Derek, I was in and out of the Warfarin clinic at the R S C Hospital in just one hour in total. the blood test took just 20 seconds to analyst as they now use a machine which looks a bit like a Card machine, they have been using this method for the past 4 years.

There are 17 chemists in the Brighton and Hove area who take over the blood tests once the hospital gets ones blood level at the correct level, i have opted for a Boots that is very close to where I live.

About to take my secnd dose of Warfarin, I know it's early days yet, but so far no side effects at all.

 

Our hospital takes a blood sample to go to the lab. My local surgery uses the machine.

I must ask the nurse next week why Brighton does it that way. Our nurses would love to be rid of the chore. I expect that the surgery wants the income from it.  She has compared hospita blood test results with her machine ones on the same day and they matched up.

I hope that you reach your target level quickly.

In twenty sessions since December I have only been within range nine times although I was initially within range in ten days.

Any side effects slowly creep up on you although most people don't get any. I can't see me staying on it for much longer.

As i understand the chemists in Brighton that do the tests and send of the blood to a lab and don't have the machine to do it straight away, sounds a bit crazy to me as it would make much more sense to have the result straight away.

As the results if variable need to be discussed with you that must mean a return visit to the pharmacy. It often takes a lot of chat to find out what you have done wrong to cause a fluctuation. A Greek meal was enought to put my reading out of step. If you have weeks between appointments you need to book another test after any change in medication.

I had read that pharmcists were going to take over some testing to relieve the strain on doctors but I can't see it being a money saver if blood samples have to be sent to a Lab. 

Your Yellow book has to be kept up to date at each testing and carried at all times in case of an accident or bleed.

I did a Google and noticed that branches of Kampsons pharmacy in Brighton do testing. Our local one in Eastbourne is about to do some building alterations..... I wonder if that could be the reason behind it.

You are correct Derek, Kampsons are on the list in Brighton and was up until last week my chemist, but for some unknown reason it took them nearly 2 weeks to turn around a prescription that I phoned in for and nearly always a week or more, where as my wifes chemist along the road from us turns them around in just 2 / 4 days so I have changed to them.

I (everyone ) has such bad service at our big Boots branch that I stopped going there and loudly told the patiently assembled queue why:-)

The pharmacy over the road from my GP was not very good either until Kampsoms took them over after two previous owners.

They are very good and often point out clashes in prescribed medications. They always check their records to see if you have had a drug before and warn of things like grapefruit or cranberry juice.

Last week someone had a prescription for Warfarin for the first time. She asked him who had prescribed it and why. What dosage did he initially have to take. Did he have a Yellow Book (not yet) when was he going to have his first INR test and when would he be seeing his doctor again.

I congratulated her on her efficiency but pointed out that I had not been warned that warfarin should be reduced when Amiodatraone is first precribed.

She asked if my GP had not warned me. When I said no, she replied that he must have forgotten about the need for that.

A long converstaion then ensued about the problems associated with each drug.