Passenger on blood thinner

[ssneiderma]

Was just diagnosed with irreg heart beat and put on Coumadin. My husband and I love to cruise. Now I am concerned about cruising and keeping my blood levels where they should be. Any encouraging words would be great. Does it mean only short cruises are in my future?

Thanks

S

[fllady]

Was just diagnosed with irreg heart beat and put on Coumadin. My husband and I love to cruise. Now I am concerned about cruising and keeping my blood levels where they should be. Any encouraging words would be great. Does it mean only short cruises are in my future?

Thanks

S

 

this is too important to ask on CC you should talk with your doctor.

[Splinter]

Check with the cruise line medical department. If they have a machine in the ship's sick bay for checking your INR, you can pay (it won't be free) to have your blood drawn and your level checked, and the physician can adjust your dosage. You may want to have them communicate with your physician by e-mail or phone (also a charge for you) to make sure that the adjustment is done properly.

 

There are also now some home INR tests kits that you can do with a finger stick (like a diabetic checking their sugars). They are not inexpensive, but if you physician will agree to you using this, you could also check the results with them via e-mail or phone and then adjust your dose accordingly.

 

Keep in mind that diet and drug/food interactions are important as well when you are on Coumadin (warfarin) so you need to try to not eat different key foods on your cruise compared to your usual diet at home.

[kyriecat]

Cruising is definitely something to discuss with your doctor. My husband developed a blood clot early Feb. 2009 and we were scheduled for a cruise mid-April. His doctor put him on warfarin. For the first weeks he had to get his blood checked weekly and had his dosage adjusted almost every time. The doctor wanted hubby's blood stable for at least 4 weeks before she would clear him to sail. Once his level was stable, he could get checked every two weeks. We were scheduled to leave on a Friday and were cleared the Wednesday before. It was cutting things close! I considered cancelling but doctor said hubby should be fine, just try not to do too many things.

 

HAL can test blood if needed, probably other cruiselines as well. I think they told me it was $80 for the test, but I'm not positive about that. We were only on a 2-week cruise so hubby's doc didn't think he needed checked while we were gone unless he developed problems. She checked him two days before we left and the day after we got back. If we'd been gone longer, she would have wanted him tested and had the results sent to her. Hubby was fine during the cruise and his blood level was still within the appropriate range when we got back. I don't remember the doctor givinig him instructions on things to eat/not eat while away, but it's something to check.

 

One thing the doc recommended was getting a MedicAlert necklace. She was concerned that if something happened to both of us on the trip, no one would be able to tell the medical staff that hubby was on blood thinner. She recommended keeping a list of his medications and dosage taped to his ID as a secondary precaution. Also, buy cruise insurance that covers pre-existing conditions. You usually have to purchase that within a couple days of booking your cruise. There are a couple of companies that have policies that will cover pre-existing conditions if you purchase within 48 hours of final payment being due, but they tend to cost more.

 

Hubby is off warfarin now but he still takes low-dosage aspirin as a precaution against future blood clots.

[PennyAgain]

Yes, you need to talk with your own doctor about this. I would also have both medical insurance and medical evacuation insurance. Some people believe that Medicare will pay their expenses when away from US, but that is absolutely not true.

[Arlened236]

The advise to check with your doctor is a good one...depending on how stable you are with your coumadin levels, and how often you need a PT/INR test may determine your ability to cruise. Our doctor told me to eat my normal diet (watching the amount of green leafy vegies we eat) and he will adjust my diet accordingly. But you have to be very consistant with your diet. I have learned what and how much I can eat so I only need to have my blood tested once a month now. If you have questions about your diet, have your doctor refer you to a good dietitian for a consult...she/he can tell you all the foods that you might need to modify

 

I follow my usual diet on board (which is not difficult) and I have never had a problem. If they give me too much of somthing I cannot eat, I just leave it or I ask for 1/2 portions.

 

I get my blood tested the day before I leave and as soon as I return.We prefer 14 day cruises and so far no problems with my blood levels.

 

I also wear a medic-alert bracelet as was suggested, and we always get trip insurance that covers pre-existing conditions.

 

I will be on coumadin for the rest of my life due to an auto-immune disease that causes blood clots. This will not stop me from cruising.

 

good luck...wishing your sunny skies and smooth sea's

[LuLaLuvlee]

My DH is on coumadin for the rest of his life. Our first cruise, we TOTALLY forgot about lettuce and he had Ceasar salad several nights lol lol lol His blood was wonky when we returned and we couldn't figure out why:o:o What we've found in the years that he has been on it, is that if you eat pretty much "home normal", your blood work will be fine. Just be aware that if you forget one of the "K" items and indulge like he did, it could have consequences.

 

We joke about it now but it could have been ugly.

 

Do remember when you pack to take a few extra days of meds just in case your travel is delayed. I also think that a review with your hemotologist might be good prior to your trip :)

 

Have a wonderful time!

[claypot_mdh]

Hi, I'm so glad I found this post as my mom was just put in the hospital yesterday for a Pulmonary embolism. She is doing well, just difficulty breathing. They have started her on an injection and will then begin Coumedin. We were supposed to be leaving on Aug. 28th for an Alaskan cruise with Princess. We did buy trip insurance but we're both concerned about not being able to go. We live in Texas so the flight is going to be a long one (4 hrs and 5 hrs) and the doctor seems most concerned with it rather than the cruising and getting her INR checked. Does anyone know if airlines will upgrade at a discounted price to business class if you have a valid medical reason??? The doctor said if she wears the support hose, keeps her legs elevated and walks frequently it should be okay... granted her blood levels are stable at the time. Obviously, we won't be going if there is a real medical concern but we are trying to figure out a way to still make it possible. Any advice or experience is greatly appreciated! Thanks!!

[dreamer320]

Claypot, sorry to hear about your mom, and hope she's able to cruise. I'm also going to Alaska on Aug 28, but on the Rotterdam.

 

I had a PE in January and will be on coumadin for the rest of my life. I'm coming from Virgina, so it'll be a long flight. I have compression stockings for the flight, and have gotten into the habit of doing some little leg exercises/movements several times during the day at work, or watching tv, so it will really become a habit for the flights. My INR levels still haven't stabilized to the point where I can get it checked monthly or so; I'm still going it every two weeks, and will likely have an extra one done right before I leave, to make sure I leave with the correct dosage. For about a month after my PE, I needed to have bloodwork two or three times a week.

 

As others have said, the biggest thing, especially when she's not been on it for long, is consistency in what she eats. (Ginger interacts with coumadin, so plan on Bonine or something else for seasickness.)

[katisdale]

You will pay full price to upgrade to business class in my experience, limited as it is.

[ssneiderma]

Want to thank you all for your help. My Dr said I could go for a 7 day in Aug and won't need to fly for this one.Really haven't even thought about flying yet. Am sure will want to. Does being on coumadin have more of an effect on flying? Should it not relieve some of the tension about blood clots? My DH and I always get insurance now that we are getting into some health issues. One thing some of you did bring up about flying was the feet swelling. I have had this problem cruising and combined with flying can be bothersome. Dr at this time does not seem overly concerned about my feet. Dr has suggested that I may need to be on coumadin rest of my life...Have read about a new drug approved in Canada which is taking place of coumadin( sounds like a miracle) no more blood tests etc. Still needs to be approved my our FDA.

Hope to do a longer cruise in Oct. Still trying to figure out the bit about eating leafy veggies. On days I dont eat them I drink a can of V8. May need to take V 8 on ship with me.

Appreciate all of your suggestions

Sue

[xxoocruiser]

. Does being on coumadin have more of an effect on flying? Should it not relieve some of the tension about blood clots?

Appreciate all of your suggestions

Sue

 

There is always the potential for blood clots for anyone when flying due to the fact that you're sitting in a tight position with very little movement.

I know when my father flew he had to take extra precaution and met with his doctor each time before he flew. On a side note - while on coumadin my father also had to consult with his doctor before having any dental work done.

 

It's Vitamin K that is the cause for concern. While it's contained in a lot leafy green vegetables, there's also other vegetables that contain a high amount of Vitmain K such as cabbage and Brocolli that doctors generally advise to avoid. Since V8 is made up of vegetables that contain vitamin K have you asked your doctor if it's OK to to drink V8 ? My father couldn't.

[martinimadam]

First, like others have said, check with you doctor.

 

From my experience, being on warfarin for about 1 1/2 years, the Coumadin/Warfarin and diet issue is a bit confusing. My levels fluctuated terribly at first. Then my doc sent me to a nutritionist who specialized in Coumadin/Warfarin issues. My mistake was eating too few, like almost no, items with vitamin K. The way she explained it was, if you're only eating about 1 "unit" and then you suddenly add 10, you've increased your intake tremendously compared to if you usually eat about 100 units and then suddenly add 10. This isn't to say that you should overdue your intake of vitamin K foods, just that you shouldn't not eat any. The trick, for me, has been to try to keep the intake close to the same amount.

 

Good point, dreamer320, about the ginger. Few folks realize that.

 

kyriecat - it's good to know that HAL can do the tests! I'm on once a month, now, but, if I should slip up before I next cruise (a 14 day trip) it will be good to have that bit of reassurance.

[DesrtDrmr]

As others have suggested, do check with your doctor before you go and develop a plan for you.

When I was first put on coumadin, I was also booked for a cruise in two weeks time from then. My cardiologist wanted my blood checked every week at that point, as I was not regulated. I called the medical or special services department at the cruise line. They had my doctor fax them a form, and a prescription or note (can't remember which) for the co-ag or pro-time test. When on board, I checked with the medical office, and was told to return on the appointed day. I spoke with the doctor, and then they did the test. They faxed the results back to my doctor. I knew what my level was supposed to be, and it was right there, so there were no problems. I am now on a monthly program, unless something changes, so we just plan tests around that. It has been several years now, so even if it slips a few days, it is planned for.

It is VERY important though, that you and your doctor have an individual plan just for you and your situation. I don't think anyone is the same when it comes to coumadin.

Having said all that, buy your insurance, get your medic alert bracelet/necklace, take your meds, and have a GREAT time! :)

[DeepWaterMariner]

My DW is a warfarin user and had a nose bleed episode on a recent Princess cruise. The doctor was able to check her INR, adjusted her dosage, and did another INR the next day to make sure her number was headed in the right direction. Our doctor at home has stuck with the same dosage as suggested by the Princess doctor. A scary episode but in my wife's situation, which was relatively minor, the shipboard medical department was well equipped and staffed to handle it.