Pulmonary Embolism
WRT to Warfarin versus the newer oral anticoagulants: a lot of medics are a bit leery of the new kids on the block.
The great thing about Warfarin is that if somebody has an accident, bleed to the brain etc... it's easy to reverse so you can get on with treatment. The not so great thing about it is that it needs monitoring. Some people (I suspect those who have very methodical lifestyles) seem to do OK and stay on the same dose for years at a time. Other people never seem to find the right dose. Home monitors seem to help a lot, and there are computer programs that will let you calculate the correct dose (there's quite a lag in the effect so the possibility of PIOs).
The newer anticoagulants aren't so easy to reverse, and there's a feeling that they aren't quite as straightforward as the drugs companies would have us believe. Perhaps we should be monitoring and adjusting the dose to suit. One of those situations where a lot of money was at stake and experimental results just may have been reported selectively and interpreted optimistically.
So, as a PPL I would probably opt for warfarin with a home monitor for myself, but I can certainly see the attractions of one of the novel anticoagulants for a comercial pilot. Ask about them... but there are reasons other than tradition/lack of knowledge/stinginess why doctors still tend to prefer Warfarin.
Hoping your friend gets it all sorted out and back in the air.
The great thing about Warfarin is that if somebody has an accident, bleed to the brain etc... it's easy to reverse so you can get on with treatment. The not so great thing about it is that it needs monitoring. Some people (I suspect those who have very methodical lifestyles) seem to do OK and stay on the same dose for years at a time. Other people never seem to find the right dose. Home monitors seem to help a lot, and there are computer programs that will let you calculate the correct dose (there's quite a lag in the effect so the possibility of PIOs).
The newer anticoagulants aren't so easy to reverse, and there's a feeling that they aren't quite as straightforward as the drugs companies would have us believe. Perhaps we should be monitoring and adjusting the dose to suit. One of those situations where a lot of money was at stake and experimental results just may have been reported selectively and interpreted optimistically.
So, as a PPL I would probably opt for warfarin with a home monitor for myself, but I can certainly see the attractions of one of the novel anticoagulants for a comercial pilot. Ask about them... but there are reasons other than tradition/lack of knowledge/stinginess why doctors still tend to prefer Warfarin.
Hoping your friend gets it all sorted out and back in the air.
Last edited by abgd; 18th May 2016 at 07:31.
Join Date: May 2016
Location: In the hills
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Wondering,
Perhaps someone who is knowledgable in this area can chip in if there have been changes in the decision making process to duration of treatment? In my case, it was some time ago and the decision for long term medication was based on the fact that it was unprovoked. I know of three others on warfarin (for various reasons) who were able to return to flying (different companies). I'm sure there are many more.
I was very fit and very active prior to this event.
Why would you be permanently on medication if it was a one time event?
...not moving/exercising a bit certainly puts one at risk.
Last edited by Uplifting; 18th May 2016 at 17:58. Reason: clarification in first sentence.
