Flu vaccine and coumadin

[Sharon]

Just had a flu shot and one of the questions on the sheet that had to be filled out asked if you were on any anticoagulants, like coumadin, heparin, aspirin etc. I've had the shot before and never had that question asked. Has anyone heard if the flu shot can have an effect on our blood?

[hensylee]

Great question! Hope somebody has an answer. Some of us NEED TO KNOW.

[Sharon]

Hensylee,
Just noticied a similar post a few threads down the list. I got my answer there. And as usual it's WHO KNOWS? It might or might not effect it. It could make your inr go up or down. It might be good or it might not be good for you. The usual stuff!!!!

[LUVMyBirman]

Your correct Sharon. You can swing either way when you take the vaccine. Had mine last week. Tested myself with the Coaguchek 24 hours later. No effect if that's any consolation.

It would be nice if everyone could report their findings post vaccine so we can see the differences.

[Simon Gee]

Hi everyone.

I had my flu jab last Thursday followed by my regular monthly blood test on Monday. INR was unchanged, although I guess I had the weekend to recover!

Best wishes from Simon

[cookie]

I also had my flu shot last Thursday and had my INR checked Monday and nothing had changed. I ask my pharmacist that does my blood test and he said there should not be any change in levels.:)

[Herb M]

I took my flu shot yesterday and the form did not ask questions about medications. The only questions were related

[ticktock]

Hi Guys
I had my flu vaccine last week, got the flu this week!!! YUCK! Shouldnt we hearts be exempt or something from trivial illness? My INR is like a rollercoaster right now, but unusual for me. Had this client who sat in my office, apologized for his "bad cold", and sneezed and blew, and I thought GET OUTTA HERE!! Well, sure enough, 3 days later, Im sneezing and blowing, and then my body said "thou shalt not eat!". So. I quit. That will mess up my INR!
mindy

[LUVMyBirman]

Hi Mindy

That blows! Literally!

Hope you get to feeling better soon.

Three years ago (the flu season after surgery). Took the vaccine for the first time ever and got the flu twice within a month. This happeded about 4 weeks after the injection. Have heard it takes about that time to build immunity Dunno? Also taking it does not guarantee you will not catch it. But.....it could lessen the effects. Mine was so bad that the doctor said if I did not take the vaccine it might have done me in. So to make a long story shortly take it as directed.

We hear there is a pretty bad flu going around up north. Hope my vaccine kicks in before it works it's way south.

Feel better
Take care....

[Lorraine]

Received my flu shot today. I looked over the questions carefully. I did not see a question relating to anti-coagulants. This will be my first flu-shot post-surgery. I hope I don't get the flu like you did Gina. In two weeks we have Registration at the Law School and I better be well. They can register online, but if they run into problems and can't register, I need to be there to investigate the problem. Wish me luck. I'll keep you posted.

[LUVMyBirman]

Hi Lorraine

I am sure you will be just fine. It just happened the winter proceeding my MVR was the worst recorded flu season in years. Remember they were closing the emergency rooms down?

Your immune system may not be as strong this winter due to immune resistance, i.e. healing time from surgery.

Caught everything under the sun. I had one thing you don't though....a three year old in preschool that brought me EVERYTHING. Lucky me.

Make sure you get plenty of rest when you can, take your vitamins and throw the smokes out;). I know, easier said than done.

Hope everything else is well with you.

My husband took his first post op trip up to Chicago this weekend. He's with my father at the Bulls Game:mad: I always get the raw end of the deal

Talk soon

[Lorraine]

Hi Gina,

I would like to think I'm going to do just fine. I do have about 1200 law students roaming our halls and coming to see me on various occassions. Believe me they are germy. The first years don't take great care of theirselves because they are stressed about exams. It's worse after they have come back from winter break. They have all these different sicknesses. I've worked for the law school for two years. The first year I was there I had a flu shot and I came down with the flu right near the end of exams. I couldn't work the last two days. I'm really doing a lot better for the time of year it is. Last year and previous years by now I would have what the doctors thought was bronchitis. It probably wasn't. I have been trying to cut back on the smokes again. I did it before so I know I can do it again. I think I smoked moreat the reunion then i did in a long time. Being around my sister, the chain smoker didn't help. I do take my vitamins faithfully. I also do a lot od zinc. the doctor said it wouldn't effect me so I take a lot. Everything else is good with me. I fnd the Nashville magical. It was so neat.
So does it look like you'll make it in for Thanksgiving? Would love to get together with you and your husband and Perry and his wife. So your husband got to come into town, huh? Well, hopefully we'll see you soon. I'll let you know if I have any reactions to the shot. Take care! it was good hearing from you.

[allodwick]

I have tested many elderly people who have had a flu shot. I found that many of them have a transient increase in their INR to about 4 or so within 24 to 48 hours after they have a flu shot. However, it goes right back down and I do not adjust their warfarin doses.
One month ago, the day the bombing in Afganistan started, I had breakfast with the physician who is in charge of vaccines for Kaiser-Permanente (a big HMO) in Denver. They have about 5,200 people on warfarin and a fabulous data base. He was going to run a study when the flu season dies down.
By the way, the flu shot is for influenza, a serious, potentially fatal illness. When someone says that they got a flu shot then got the flu the next day, they are usually talking about stomach flu. The flu shot does nothing to prevent this.

[Tammy]

I received my flu shot a few weeks ago and all seems well so far with INR results. I am going tomorrow for another INR check. I am trying to get back on track from all the antibiotics I took for dental work a few months back.
I have taken the flu shot for 12 years and the only time I got kinda sick was with the first one (other than the year I skipped-bad girl). I have heard that some people get a mild case of the flu from the shot especially if it is the first time getting the shot.
Can't recall where I heard that, my memory ain't what it used to be...LOL
I do think we all need to get the flu shot. There seems to be a shortage of them available so don't wait. I was lucky enough to get one at the Fire Station, thanks to friends. All the fire department personnel are required to get one this year because of the Anthrax situation.
Gina - glad to hear your hubby is back on track.
Lorraine - You CAN quit smoking, mind over matter. I smoked for almost 20 years and quit but some days I REALLY need one. I know you can accomplish whatever you set your mind to. You are a strong person.
Take Care,

Tammy
MVR 04/06/89

[hensylee]

HEY ALLDOWICK - haven't seen you for a while. Thank you for making it clear about "getting the flu the day after I got the shot". Many people have said this to me and I was told by drs that they probably already HAD the flu when they got their shot. Didn't know about the stomach flu. How is it different from the regular flu?

[Christina]

Hello....

Had my flu shot yesterday. Had to wait in line about 3 hours at the grocery store.
My doctor told me that the vaccines wouldn't come in until end of the month, and that he wouldn't get many. His advice to me was to go wherever I can get one.
I did an INR on Tuesday and it was 3.9. Did another after flu INR test today and the results were 4.3. So a bit of a raise, but I am happy with the numbers! And I am still doing great with my new doctor. Will see him next Tuesday.

Christina...

PS..No questionnaire to fill out beforehand.

[allodwick]

I haven't felt like doing much lately. All I've done was watch TV about the war. Maybe it brings back Viet Nam memories.
Hensylee, where are you located in Florida? I'm doing a talk on warfarin in Hollywood on the 19th.
Influenza is viral infection which, in some forms, is life threatening. The most common onset is that you will be doing something feeling OK and instantly you are hit with a fever of 101 - 103 degrees, you feel weak have chills, severe pain in the head and back. Frequently the person can say, I got sick at 4:18 PM or whatever, it comes on so fast. It is usually respiratory and after a few days may cause diarrhea.
What most people call the flu may be viral or bacterial and usually starts with diarrhea or vomiting. It may have a sudden onset but there is hardly ever the respiratory problems associated with influenza. You feel terrible but if the fluid loss is replaced it is seldom life threatening.
Flu vaccine protects against the former since it takes place in the body itself. It has no effect on stomach or intestinal flu which occurs in the intestinat tract.

[Sharon]

Thanks everyone for your input. Sorry to hear that you got the flu Ticktock. Gina M glad to hear that your husband is doing ok. I think next year to satisfy my own curiosity I'll have to have my inr checked the day after I get the flu shot.

[allodwick]

When you do, just remember that it is only for curiosity. If you reduce your warfarin dose for a transient reason, you risk having a low INR. Always remember that clotting is much more serious than bleeding. It is almost always better to have an INR between 3.5 and 5.0 than it is to have one below 2.5.

[Sharon]

Allodwick,
I never worry too much if I go above 3.5 a bit, but 5.0 would worry me. I do worry if I go below 2.5. And never would I lower my coumadin intake without first talking it over with my dr. I'm going to your site next to check it out.

[allodwick]

One of the hematologists in Denver who does quite a bit of lecturing on anticoagulation says that she ignores all INRs less than 10.
That seems a bit extreme to me but she makes her living in this specialty.

[Nancy]

WHAT??? Whoa, stay away from her. I think if we saw an INR of 10 and it was ignored, someone would be in BIG trouble.

[Rain]

A few months after the surgery, when I was still on the warfarin.... my INR shot up to 6.9! I had the “little red spots” not only around my ankles and on my chest.... but ALL over my body! They were everywhere!

It may not be true with everyone, but after about 4.0 “things” start to happen to my body. I can’t imagine what would happen if it got to 10?!!

I haven’t totally proved it to myself.... but the ‘little sqigglies’ in my vision also seem to happen when my blood pressure is low and my INR is high. Don’t know when I will consider myself convinced..... but it sure is a huge coincidence. It also seems to happen most often after my exercise class. ??

[allodwick]

That sounds like you are not getting enough oxygen to your brain. Low blood pressure or after exercising would both be times when this could happen. Low blood pressure would mean that blood was not being pumped hard enough to get to your brain. Lying down with your feet up should stop this. If it does, that is pretty good proof. After exercise, your muscles are demanding oxygen and it is not getting to your brain. It should stop as soon as you are not breathing rapidly any more.
It is hard to see a connection with a high INR because that is just a measure of how rapidly your blood could form a clot.

[Rain]

Allodwick,

That all makes sense... Thank you. I will try putting my feet up next time the thing with my vision happens.

I probably overreact about the coumadin. When it’s way out of whack, I look for reasons why... most of the time I can’t find one. Very irritating, this coumadin stuff!

I’m positive the little red spots are caused from the high INR though. I never had them before and the higher the INR the more little red spots.

Rain

[allodwick]

Sorry, I forgot to cover the part about the little red spots. They ARE caused by the Coumadin. If you want to impress people they are called petechiae - pronounced pah TECH e i. In essence they are tiny bruises. The higher the INR, the more likely they are to show up.
I was watching a biography of Ozzie & Harriet. Toward the end they had a picture of Harriet with her family. She had many spots on her arms. I said to my wife, "I'll bet you anything that she was taking Coumadin."
My main message to people about warfarin is to not let it rule your life. Be aware of what is going on so that you notice any changes, and take action. But do not let it be foremost in your mind all the time.
There is a replacement for warfarin in the pipeline.

[hensylee]

Allodwick, I am in NW Fl (DeFuniak Springs). Long way from Hollywood - raised in Miami, eventually spent 20 yrs in Arcadia, now even farther north where it actually gets cold and snows now and then.

[Rain]

Hey Allodwick,

‘Petechiae’! I knew it was true! Thank you for putting a name on it for me. My cardio also confirmed the ‘spots’ are caused from the coumadin. Strange, I’m the only one on this site it seems to happen to.

I don’t let coumadin run my life..... that’s probably part of the problem. It’s hard to use “Rain” & “consistent” in the same sentence. It’s also hard not to freak just a little when the test is always either high or low. I find myself thinking, “Oh please!! I have to deal with this for the rest of my life!!”

I try not to complain about coumadin... especially here. I certainly wouldn’t want anyone making a valve choice because of my inability to manage coumadin. I honestly think my body is much more sensitive to the stuff than most people’s. This coming January I will have been taking it for two years and HEY, I’m finally starting to get regular readings! Your everyday rat would probably be dead by now!

Thanks for offering encouragement and hope for something better. (Cardio also told me something is in the works)

Not your everyday rat,
Rain

[Mb]

Hey Rain!
Wow! You are the first person I've seen her that has posted about the red spots. My husband has them on his legs. They did some blood testing last week to rule out something, but his PCP thought it was from the coumaden. His INR actually is usually too low, but he did have one test where it was at 5.6 about four weeks ago. He is just 6 weeks out from surgery. I will tell him tonight though about your expereince with the red spots. His Dr. also called them petechia. He was told to stop wearing socks for a few weeks. He also has a few others on his body, but mostly his lower legs. Marybeth

[allodwick]

Rain,
Two years without any real problems - you are doing things right. Actually I think you are a good example of what I try to teach people. A little high, a little low, no big deal - make a small adjustment and get on with life. If you have a choice, be off a little on the high side - it is easier to stop a bloody nose than to put in a new valve. A few little red spots - so what! By consistent, I don't mean boring. What I mean is that I have never seen even one homeless person who could take warfarin for more than a month. There is so much inconsistency in their lives that they can never get a medication routine established. Warfarin is a factor in your life, not the ruler.

[cookie]

Hey guys,
I also have the "little red spots" on my legs, but the catch is, I've had them even before surgery! One leg is worse than the other. There does seem to be more since taking coumadin, but, like I said, one leg is worse than the other. I always figured it was poor circulation or something like that. My coumadin levels have stayed pretty steady here lately. Between 3.o & 3.4. So what else can cause "little red spots"? Doesn't make for a very sexy leg - looks more like I have something contagious! Also it's just from the knee down. Stange?:confused:

[allodwick]

Petechiae are like tiny bruises. They can come from any number of things dealing with circulation. The are not much cause for concern if you have had them for a long time. It would be a concern if they suddenly increase - that is the area they cover suddenly increases. Many women and a few men want to complain about them and show me patches. They are usually below the knee. I keep telling them that I am not a doctor and to keep their clothes on. I probably tell more women to keep their clothes on than any other man. Good thing that my office has a glass wall that looks out into the cardiac rehab clinic!!!