How to Engrave Your Medical ID

How to Engrave your medical IDAfter spending a week in the hospital, whether or not I needed to wear a medical ID bracelet was the last thing on my mind when I was finally discharged. In a matter of days, my entire world was turned upside down when I was diagnosed with blood clots in my leg (DVT or deep vein thrombosis) and lung (PE or pulmonary embolism).

I was worried about the new job I was supposed to start, what an INR was, when I could run again. I also wondered why this happened when I was doing my best to take care of myself for first time in my entire adult life. I felt scared, alone, sad, overwhelmed and I decided it would just be better for me to stay indoors rather than worry about what would happen outside where I could fall and hit my head on concrete or – my worst fear – get in a car accident. It was then that I realized that without a medical ID, no one would be able to help me if one of these accidents occurred.

Why You Need a Medical ID if You are Taking Blood Thinners

Blood thinning medications or anticoagulants save lives because they treat or prevent potentially life-threatening blood clots. However, they also pose one possible and very serious side effect: Bleeding. Since blood thinners slow the clotting of blood, unwanted and sometimes dangerous bleeding can occur with the use of these medications – especially with a fall, a head injury or a traumatic accident.

A medical ID or medical alert bracelet or necklace is a very important tool that could save your life in an emergency situation. If you are ever hurt or injured – and not able to speak for yourself – a medial ID may be the only way first responders or doctors know how to begin treating you. If you are taking blood thinners – especially warfarin for which vitamin K exists to slow or reverse bleeding – medical professionals need to know immediately. If you are taking a new oral anticoagulant  for which there are no reversal agents,  doctors still need to know so they can care for you to the best of their abilities.

How to Engrave Your Medical ID

Medical IDs do not need to be elaborate and must be able to convey life-saving information as quickly and clearly as possible. A medical ID must be immediately recognizable as a medical ID – if it’s too pretty or cute, it might not get notice in an emergency.

Information that should be included on your medical ID (in order of importance or room you have to engrave):
  • Specific name of the medication(s) you are taking that affect life-saving treatments (i.e. anticoagulants, heart medications, aspirin, insulin, etc.)
  • Allergies (especially to medications like penicillin)
  • Whether or not you are diabetic
  • Name
Information that can also be included on a medical ID:
  • History of medical conditions (i.e. DVT, PE, heart attack, stroke)
  • Date of birth
  • Doctor name and phone number
  • Emergency contact name and phone number
  • Your address
  • Your phone number
  • Your blood type
Where to Get Your Medical ID

There are countless places to order a medical ID. They range in price from free (a wallet card or mobile app) to a few dollars (i.e. silicone bands) to hundreds of dollars (i.e. gold charms and bracelets). Here are a few of my favorites:

  • BCRN’s Shop on Amazon – My shop has some of my personal recommendations for a variety of styles (not personalized), for almost any budget, including silicone IDs that are great for quick ID and outdoor activities.
  • American Medical ID – A variety of styles, which you can personalize with your information, and prices. I wear an American Medical ID daily. Read my complete review of my American Medical ID here.
  • Road ID – Perfect for sports and outdoor activities, and displays a lot of information.
  • My MedicAlert Foundation – A classically designed medical ID that comes with a virtual subscription to a 24/7 Live Emergency Response Team for delivering accurate and clear health information securely to first responders and healthcare professionals during an emergency. This is where I ordered the medical ID that I wear when a lot when traveling.
  • Stay safe on the go with the Road ID mobile medical ID
  • You can also carry important medical information on a written or typed card in your wallet
  • You can order medical IDs from pharmacies
Medical ID Quick Tips
  • Be specific in what you engrave on your medical ID. An ID that says “blood thinner,” “anticoagulant,” “medical condition” or just displays a medical or red cross symbols is not specific enough.
  • Your ID, at a minimum, must say what anticoagulant you are on.
  • Make sure your medical ID looks like a medical ID. The purpose is functionality, not fashion.
  • You can carry multiple ID’s. I have one that I wear (bracelet or necklace), one on my keychain and the mobile app on my phone.
  • More reasons why you should wear a medical ID.

Share your story. Do you wear a medical ID? Are you planning on ordering one? Where is your medical ID from? Has it saved your life in an emergency? Do you think you need one? Why or why not?

There is hope for healing and you are not alone,

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Warfarin and Vitamin K – Why You Need Both

Why you need warfarin and vit k

If you’ve been diagnosed with a blood clot, chances are you are taking a blood thinner, which is very commonly Coumadin or warfarin. If you’re like me and have been diagnosed with a clotting disorder or have a high chance of re-occurring blood clots, you might even be taking warfarin for the rest of your life. The prospect of having to monitor a potentially dangerous condition, let alone take medication forever, is overwhelming and worrisome for many, including myself. Warfarin can be difficult to manage, is not entirely safe for your liver over an extended period and has some pretty notable interactions with other vital nutrients, mainly vitamin K. In fact, you may have even been told by a medical professional to stop eating foods high in vitamin K. While warfarin and vitamin K do interact, the potential harm of completing eliminating vitamin K from your diet may be proven to be more dangerous than creating a consistent level of it in your blood.

Why Vitamin K Matters

Vitamin K is a naturally occurring vitamin most commonly found in green, leafy vegetables such as spinach, broccoli and lettuce (see an extensive list of foods here). Your body uses vitamin K from foods you eat and also bacteria in your intestines to produce some of the factors that help your blood to clot.

Why Warfarin Matters

Warfarin interferes with how your body uses vitamin K by preventing the production of vitamin K clotting factors in your liver. This can cause clotting to occur at a much slower rate and creates the potential for unwanted bleeding problems or additional clotting in your veins.

How Does Vitamin K Affect My INR?

Changes in the amount of vitamin K you consume through your diet can alter the liver’s ability to process warfarin and change the amount of blood thinning properties in your body. Your INR refers to a standardized way to measure how quickly your blood is clotting. The lower your INR, the more quickly the blood clots or the “thicker” the blood. If your INR is too low, you could be at risk for further clotting. The higher your INR, the longer it takes the blood to clot or the “thinner” the blood, putting you at risk for bleeding problems. With an increase in vitamin K your INR level may drop, creating the potential for unwanted clotting.  A decrease in vitamin K intake may increase your INR, creating the potential for unwanted bleeding.

What We’ve Been Told

Most of us have been told to avoid vitamin K like the plague.

Beyond the Blood Thinner – Why You Need Vitamin K

You may have seen this article posted on the internet or in a variety of forums you visit. I first found the article through Stop the Clot National Blood Clot Alliance. The headline screams, “Warfarin a potential heart-attack risk,” which immediately elicited concern from myself and I am sure many others. I started reading, expecting to find something about some horrible thing warfarin was doing to my heart (instead of my liver) and was shocked to read this instead, “Vitamin K deficiency caused by the long-term use of warfarin has a wider range of health implications than commonly known, including the calcification of organs that can lead to life-threatening problems like heart attack.” And then, “Warfarin is a commonly used medication in the prevention of blood clots but depletes vitamin K levels. However broader effects of the deficiency on various organs and functions are not well understood.”

We are taking warfarin, it’s depleting our body’s natural vitamin k stores – which are important for a variety of things, most notably the hardening of arteries in the heart, potentially creating serious health implications – and we are being told not to replace it.

Let that sink in.

In our need to manage a serious clotting condition, have we been creating potential problems for our hearts and maybe other organs? I’m not willing to take that chance.

A New Way of Thinking

It is not about eliminating vitamin K from your diet. Per Stop the Clot, “One good way to think about vitamin K and its importance while taking warfarin is that you need to maintain a balance between the amount of vitamin K in your body and the amount of warfarin prescribed by your health care provider.” You should aim to keep the amount of vitamin K in your diet consistent. For example, if you eat two servings of foods per day that are high in vitamin K, you should continue doing that. If you don’t eat foods rich in vitamin K at all, do not suddenly decide to eat large amounts of them. Clot Care also confirms, “It is a common misconception that people on warfarin should avoid vitamin K. Reducing your vitamin K intake can cause your INR to increase and may make it more difficult to control. Rather than avoiding vitamin K, you should maintain a consistent intake of vitamin K by maintaining a consistent diet. In other words, from week to week, you should eat the same types of foods.”

Nowhere does it say, never ingest vitamin K, you can never eat salad again or kiss that calming cup of green tea goodbye. It is about consistency and slowly reintroducing vitamin K foods into your diet if you desire to and have previously eliminated them.

Yes, You Can and Should Consume Vitamin K

You do not have to avoid foods or other products that are high in vitamin K; these foods have many other vitamins and minerals that are part of a healthy diet, particularly when it comes to your heart. The most important thing to remember about vitamin K intake is being consistent as much as possible and communicating any changes that may occur.

But that’s Not What My Doctor Said

Unfortunately, I think it is easier for doctors to tell you to avoid vitamin K (and all of the wonderful, nutritious, satisfying foods that go with it) because it is just plain easier. This way, doctors can build a baseline for your warfarin dosing without having to worry about vitamin K obtained from foods and nutrients affecting your INR. Chances are you were not consuming green leafy vegetables on a consistent enough basis to include a vitamin K allowance in your treatment planning. Sure, we all enjoy a salad now and again or eat broccoli once in a while with dinner, but how many of us (truly, honestly, let’s top kidding ourselves for one moment) could say without a doubt that we were eating three cups of spinach four days a week, a half a cup of broccoli or green beans two nights a week and scallions in our omelet every other Sunday? It’s difficult to say unless you are very conscious of it and most of us grossly underestimate the amount of greens we actually consume, even though we should be consuming them frequently.

Almost Everyone I know who takes Warfarin Avoids Vitamin K

Not anymore. I remember the first time I posted that I was taking a vitamin K supplement in an online forum. It was in regards to a forum member’s frustration over her inability to maintain a therapeutic INR level. I posted- “I am taking warfarin and also vitamin K, both prescribed and monitored by my doctor. I started taking vitamin K after being on Arixtra injections [blood thinners that are injected into the stomach daily] for over ten months, which was concerning to my doctor because Arixtra is non-reversible [you cannot be given an anecdote to stop bleeding if you are seriously injured, for example in an accident] and there is not a lot of research about adverse effects to the body [beyond a typical-length pregnancy in which women are often put on injections to reduce the risk of clotting]. In light of some successful research, my doctor decided to actually put me on a low dosage of vitamin K to create a balance of warfarin and vitamin K in my blood. Within a month or so, my INR stabilized for the first time since leaving the hospital and I have not been on injections since. I also posted this link to some of the research that I could find myself.

I remember the first comment my reply received, “Sara, you need to get a new doctor pronto because yours will certainly kill you if you are taking vitamin K.” More of the like ensued and no one backed me up, leading me to believe I was alone in my treatment and my treatment’s success.

I was horrified. Since the beginning, I had trusted my doctor – he had after all found the Antiphospholipid Antibodies when the Emergency Room Doctors were all too hasty to send me away with three month course of blood thinning therapy blaming my DVT and severe PE on birth control and birth control alone. My case was so severe that a specialist was called in, my now hematologist, who I credit with saving my life and providing me with the ongoing care I so desperately need and will need from here on out. He had not yet steered me wrong. He explained what happened, my treatment and what to expect in recovery when no one else had, not a single person.

There was no chance I doubted him on vitamin K. I kept up with my treatment. I ate greens about as consistently as I had – a few times a week and slowly increasing as I worked to get my diet and weight loss back on track. Through it all, I keep him informed of any major changes and continue to get my INR monitored at the least, bi-weekly.

What Should I Do?

Talk to your doctor. We need to be an advocate for our own health and we cannot let blood thinners determine how we choose to live our best lives.

Discuss incorporating vitamin K rich foods back into your diet with your doctor; taking a supplement or alternative treatments (i.e. Xarelto) that do not affect vitamin K. Also discuss the implications of the absence of vitamin K in your body.

In is also important to keep in mind that other things impact the body’s vitamin K production and warfarin’s ability to metabolize including, but not limited to vitamins, nutritional supplements, antibiotics, bacteria/viruses, illness and stress.

Resources

Share your Story. What are your thoughts on vitamin K and warfarin? Do you take or eat foods rich in vitamin K? Why or why not? What did your doctor tell you about vitamin K? Did you read the heart-healthy article? What are your thoughts on needing vitamin K?

There is hope for healing and you are not alone,

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The Great Blood Thinner Activity Debate (“I can’t do that, can I?”)

The Great Blood Thinner Activity Debate

For those of us on injections, warfarin or other blood thinning medications, whether or not to engage in physical activity, at what time and for how long remains a constant source of personal and, as I have noticed, even medical debate. What forums, articles and websites exist are full of questions about can I do this or that, when can I do it  and for how long can I do it, and they accumulate into what I like to call The Great Blood Thinner Activity Debate (“I can’t do that, can I?”)

I remember quite vividly sitting in my doctor’s office one week after I was discharged from the hospital for my first follow-up appointment when I asked him, “Can I run again?” He assured me I could and would in fact if I so desired. “Can I run again now?” I questioned. He actually said I could run anytime I wanted, but my body would most definitely let me know when I was ready and when enough was enough. I set out that weekend to walk to the mailbox and back (thinking I would leave my oxygen tank inside for about 10 minutes) and I made it about six steps before my body said, “Enough is enough.” I retreated to the air conditioned living room, oxygen and a seat on the couch. I hated being inside, but I wasn’t ready to be outside in the dog days of summer, let alone on my feet for more than a minute or two. Emotionally, it was a setback I wasn’t at that time prepared to deal with; physically it was exactly what my body needed.

As the weeks and months went by, my doctor and I made several attempts to transition from injection thinners to warfarin, but the attempts failed and I remained on injections for about nine months since my diagnosis. It was only recently that I made the transition to warfarin and was able maintain healthy INR levels. It has taken me even longer – about 12 months – to get back to running with any degree of regularity and there are still days when I wonder, “What the heck am I doing?”

Once you are required to take blood thinners, especially if it is a lifelong prescription, you start to view life and the activities of it differently. A side effect of warfarin, combined with increased INR levels, is the potential for internal bleeding that can be dangerous, and even life threatening. The fact is, blood thinners do save lives because they treat or prevent serious blood clots; but they also pose one potentially serious side effect, which is bleeding because they slow the clotting of blood.

I don’t believe you have to stop living your life the way you want to when taking blood thinners. I believe we can still participate in the same activities we did before – or even new and better ones – we just have to be cautious of the potential side effects. It doesn’t mean we have to stop living, after all, many of us feel like we were given a second – third or fourth – chance, why not spend it how we want? You can still run, bike, hike, ride roller coasters, swim, travel, ride horses and learn archery along with a myriad of other activities. While a certain level of caution is necessary, especially if we hit our heads or see unusual bruising, there is nothing on the prescription bottle that says, “People taking this blood thinner should not___________.” I personally was never given a restriction on any activity, just to listen to my body – I would know what I could do, when I could do it and for how long. So far, that has been true.

Most of the time, bleeding caused by blood thinners is not serious or life threatening, although it is worrisome and inconvenient. Some examples of non-life-threatening bleeding are nosebleeds; a small cut while shaving with a razor; or minor cuts or skin tears. All of these types of bleeding may bleed longer than normal, but are not necessarily cause to panic and seek medical attention because they are superficial and can usually be controlled with added pressure apply to the wound for a longer amount of time. It takes me about 20 minutes to stop a nosebleed, which sometimes happen with the slightest wrinkle to my nose. Several products also exist to aid with clotting such as bandages, gels and powders like QuickClot, which aid in blood clotting, but do not disrupt the blood’s natural clotting abilities.

People taking blood thinners do not need to stop the activities they once enjoyed, especially after we are feeling well enough to participate in them again. They just need to take some extra precautions to maintain safety and peace of mind. For example, we do need to be cautious about things like high risk sports that may result in a head injury, but we do not need to stop them. We need to take extra precautions to increase our safety like wearing proper head gear when biking; gloves when gardening or working with tools and taking care with a few extra minutes when trimming hair and nails. Many people taking blood thinners also wear a medical alert bracelet to let others know they are on certain medications – like first responders in an accident – which can really add to peace of mind. You can find a myriad of medical alert bracelets on the internet and even find ones specific to sports and physical activity through RoadID. It could really save your life in an emergency or accident, especially if you are not able to speak for yourself.

No matter what activity we participate in, accidents do and will occur and sometimes these can produce superficial bleeding like from a cut or nosebleed and sometimes it could be serious, like if in a car accident or fall down the stairs. Just because we are taking blood thinners does not mean we need to stop or stop considering participating in activities that are viewed as dangerous. We can still participate in them, or even learn them for the first time, with a few extra safety precautions and common sense awareness. If you see unusual bruising or sustain a serious head or abdomen injury, you should contact medical professionals. There is no reason to stop living – even the life we’ve always imagined – when taking medications that undoubtedly save our lives. After all, it’s why we’re still here.

Share your story. Does taking blood thinners impact your decisions about normal day-to-day activity? What about extreme activities or sports? Have you given something up because you are worried about life-threatening bleeding? Did you start an activity you had always dreamed of participating in because of taking blood thinners?

 

There is hope for healing and you are not alone,

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What recovery from a pulmonary embolism looks like

What does recovery from a pe look like

Over the course of my entire life – childhood and adulthood – I had never been hospitalized, and I had never been as sick as I was with my pulmonary embolism. Recovery for me was taking a few days off work to get over a cold or stomach virus or having to stay in bed most of the day and not eat anything with a sore throat. When it came to running, words like recovery meant things like not running for three or four days after a race and taking it easy on my muscles, even icing and massaging, after a big event. I never looked at the time after my mother’s passing as recovery, but as grieving and settling into what became for me, a new normal. Recovery for other people might be time off their feet due to a broken or fractured running bone, but even they always came back within a matter of months. So, recovery was not a very deep word in my vocabulary and I soon found out, that I really had no idea what recovery from a pulmonary embolism looks like.

I vividly remember my first doctor’s appointment with my hematologist after being discharged from the hospital. It was about a week later, and I was feeling bad, beyond what I understood to be tired (I mean, truly feeling fatigue throughout every inch of my body), carting an oxygen tank and convinced my summer was ruined since flip-flops (my warm-weather footwear of choice) could not be worn with my flesh-colored compression stockings. He asked how I was doing and said, “It’s good to have you with us!” I blinked in bewilderment at him and he said, “For as long as I’ve been doing this, you were the sickest I have seen a patient in a very long time. You’re lucky to be here, actually, what you just survived is not something to be taken lightly.” Okay, but I’ll be running and working again in no time, right?

He stopped what he was doing and sat down in front of me. I was perched on the end of the exam table, legs outstretched and not at all comfortable. It was hot, I was hot and I felt like I was suffocating inside the small exam room, not to mention I suddenly just wanted to go home.

“Sara,” he said, “Everything just changed for you. I mean everything. Your body has been through some pretty severe trauma and you aren’t going to be better in a week or a month or even a few months.”

More blinking.

And?

“The recovery we see from this, from people who have been through something like you have, it takes some time. A long time.”

So?

“You are looking at 1-2 years of recovery at this point. We’ll know better after a year what to expect with how things are going to go. You’ll probably be on oxygen for about a month, I would suspect. I don’t want you to stop wearing your stockings everyday for about six months or so from here, well, you need to see me if you think you can stop wearing them daily. And, you’re going to be on blood thinners now.”

What do you mean, like, forever?

“It’s early to say, but you will probably have to manage this illness, to some extent your recovery and yes, blood thinners, for the rest of your life.”

Wait? What? One to two years? As in, YEARS?

He proceeded to talk about how while it was going to take some time, it didn’t mean I wouldn’t find a new normal and probably even go back to activities I enjoyed like running.

Activities I enjoyed? I was tunneling out of the conversation as the projection of my future played out in my mind.

That was just a week shy of one year ago. My doctor and I would have this conversation a minimum of six or seven more times because I couldn’t comprehend at that time why or how I would need that much recovery, what it felt like to be recovering at all and, as I would later find out, I was struggling with cognitive and memory delays that would alter my state of thinking and later contribute to my inability to successfully do the work I needed to for my job.

Still, I was devastated when I left the doctor’s office with my husband that day. Not even convinced I would do everything I could to recover faster, which I later found was impossible too. Just plain devastated. We had planned to stop at Chipotle for lunch and when we pulled up, just on the other side of the building where the doctor’s office was, I couldn’t get out of the car. There was a group of women about my age sitting out front at the picnic table in cute summer dresses and high heels. I was wearing sweats (that were cut-off nonetheless), tennis shoes and carrying an oxygen tank at 29 years old. I wasn’t getting out of that car. My husband finally convinced me we could get it to go and I did get out – after stashing my tank in the back seat – and only made it to the door, with his assistance, before I was gasping for air in the summer humidity. About the same time, I felt a rush of blood down my legs (the first time of many unfortunately over the next year) and I burst into tears. We did not eat Chipotle that day. In fact, I stayed home for the next month, except for appointments.

My reason for sharing this day with you is two-fold. One, I don’t think enough survivors are told what their recovery time will look like. I don’t think they are told to expect months if not years of recovery – that it is normal and to be expected. I don’t think a lot of doctors even know to tell their patients this because maybe no one has gone back to let them know what recovery looks like. This illness/injury isn’t, for many people, a-here’s-your-pill-and-you’ll-be-fine-in-a-couple-of-weeks-once-your-body-adjusts-treatment. This illness/injury

And two, there is hope for healing. I only have myself to compare myself to, but looking at where I was a year ago to today, as I write this post, the improvements I have made are nothing short of amazing. I even feel like a different person now. My mind is more clear, I’m walking again and I can talk about what happened to me.

Some things to keep in mind as you begin recovery:
  • Every person will have a different picture of what recovery looks like. Some people will return to work and normal life in a few days or weeks, some will be in recovery for the remainder of their lives and still others don’t won’t even have the chance to recover because a PE will claim their lives. Recovery and treatment are unique to each of us.
  • This recovery is full of ups and downs and it is not uncommon to continue experiencing symptoms of the PE during recovery. No day is the same and while you may be fine one day, you could be feeling horrible the next. High anxiety about trivial things or a returning clot are not uncommon either. Depression is also a notable symptom of recovery as all of this is very difficult to deal with and understand for some. Make sue you follow up with your doctor if you are struggling with anxiety and/or depression because he or she may be able to prescribe medications to help you.
  • Often the symptoms that diagnosed the embolism are some of the same things that will be experiences during recovery too – swelling and tenderness in the leg and shortness of breath or pain in the chest. Be sure to follow-up with your doctor or emergency room if, at any time, you question what you are feeling to rule out a recurrent clot. My doctor told me, he still sees patients after a couple of years who experience the initial symptoms of their DVT or PE.
  • After a pulmonary embolism the body spends a lot of energy on healing the heart and lungs, even if they were minimally effected. You may feel more tired, more often and be more sick, more often then before your PE. A day of gardening or a bike ride or even a full day of errands or work can leave you ready for bed before dinnertime. This is normal and if your body asks for rest, give it what it needs! It will take time to get back to even a low level of activity.
  • You may come home from the hospital with no physical restrictions, which is confusing after feeling so horrible and being told you have a long recovery ahead of you. My doctor told me I didn’t have any set restrictions on activity because I would know exactly what I could and could not handle and this turned out to be true. I was convinced I could run in a few weeks. I could not, in fact, walk to the mailbox the first month without stopping to turn around halfway down the driveway after taking the step down from my front door. My body simply would not let me move that much. At the same time, exercise helps to decrease your chance of additional clotting, but do not rush this – you will know when it is time to exercise again, if even for a few minutes.

Share your story. How long have you been in recovery? Where you told by your doctors what to expect in terms of recovery? What does your picture of recovery look like?

There is hope for healing and you are not alone,

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