Brief episodes of atrial fib can require long-term treatment

by Symptom Advice on January 4, 2012

DEAR DR. DONOHUE: I am 80. I suffer with atrial fibrillation, which began about 11 months ago, when I underwent surgery to replace my aortic valve with a tissue heart valve. At the same time, a bypass on one heart artery was performed. the a fib lasted on and off for about 12 days. since then, it has not been detected. I have been taking Coumadin every day. When will I be able to stop it, if at all? some of my doctors say I can stop after a year or two. Another states that I should never stop. how do you view the possibility of stopping? — J.W.     ANSWER: do you understand why you take Coumadin? It’s for stroke prevention. with atrial fibrillation, the upper heart chambers, the atria, are no longer contracting. They’re quivering (fibrillating) like a bowl of Jell-O. Blood in the fibrillating atria stagnates, and clots form. those clots can be carried to the brain in the circulation and block a brain artery — a stroke. Coumadin prevents that from happening.    you had a 12-day siege of atrial fib. Even a short spell of fib puts you in a group of people who are at risk of having another episode of it. many people have no symptoms when their hearts are fibrillating. you might not know it has returned, but you would be at risk again of a stroke if it recurs.    For that reason, many experts are of the opinion that a person like you should be treated with lifelong Coumadin.    Speak with your heart doctor. he or she knows your heart’s status better than you or I. There could be factors that I’m not considering that would favor stopping Coumadin. If there are none, the conservative approach is to keep taking the medicine.    DEAR DR. DONOHUE: Coffee is my drink. My wife prefers tea, and she constantly tells me all the healthful benefits I miss by not drinking it. It’s hard for me to believe that one simple drink like tea provides so many benefits. Will you set the record straight? — T.L.    ANSWER: the three varieties of tea — black, green and oolong — all come from the same plant. Black tea is produced when the leaves are spread out and allowed to dry. this variety has a deep, rich, brown color and a distinctive flavor. Green tea is the result of steaming tea leaves after they’re picked. Oolong tea is partially oxidized (black tea is fully oxidized) and fits midway between the other two.    Most of the information on the benefits of tea applies to green tea because, worldwide, it is the tea drunk by the greatest number of people. many of the benefits of green tea probably apply to the other two varieties. Green tea, however, does contain more catechins, substances believed to lessen the chances of stomach, pancreatic and ovarian cancers. both green and black teas reduce the risk of heart attacks and strokes. Black tea appears to protect against diabetes.    I’m tempted to do an eye roll when discussing the wonders provided by tea. If you like the taste of tea, drink it. Somewhere along the line, taste of food has become a neglected consideration in its consumption.    DEAR DR. DONOHUE: I am 56 and have my blood drawn twice a year. For three years, my ferritin level has been below normal. I take four medicines. My doctor isn’t concerned. Should I be? I have been checked for blood loss, and none was found. is there a link between my medicines and the low ferritin? — W.H.    ANSWER: Pure iron is toxic to body cells. For that reason, the body attaches a protein to iron. the protein takes away its toxicity. the iron-protein complex is ferritin. it indicates the level of the body’s iron reserves. a low ferritin precedes the onset of iron-deficiency anemia. the anemia hasn’t developed in three years. I’d still put you on an iron supplement. none of your medicines interferes with iron absorption.

    * * *    Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from rbmamall.com.

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