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Dr Hive- Dad bleeds easily


Jasperstone
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My parents have come down for a visit. I haven't seen them for a year. Anyway, my dad bumped his arm lightly on the door and it started bleeding. He is on blood thinners, but this can't be good! He is on them because he had a stroke. Also, while sneezing his belly button popped out! My dad is also shaking pretty badly. I'm shocked at how much he has deteriorated in 12 months! Has anyone experienced this with their aging parents?

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If he is on blood thinners, that explains the bleeding.  It can be alarming, but it is expected.

 

The belly button thing might be due to a hernia.

 

As for the deterioration, is he on other medications? 

 

 

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My DH is on blood thinners and bleeds and bruises easily. Many time he doesn't realize he was injured at the time, and we just see the blood running down his arm.

The belly button thing does sound like a possible hernia.

 

When is the last time he had a complete physical?

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It could be that he needs his medications evaluated.  I know the last few years my Dad was alive he needed a lot of medication tweeking. Sometimes it was also because his iron and B12 (I think it was) were to low.  It was amazing how much energy returned when his vitamin levels were finally back into the normal range.

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He should be getting his blood checked regularly while on blood thinners. Is he going to his appts?

Yes. If he is on one of the most common anti-coagulants, then he should have his PT/PTT levels drawn regularly. Doctors will adjust his med based on his lab values. Now, there is a new blood thinner that supposedly doesn't require frequent checks. However, it really isn't unusual for people to bruise and bleed easily when taking these medications.

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He should be getting his blood checked regularly while on blood thinners. Is he going to his appts?

Yes, it can be a pain to have it monitored properly - make sure he's not skipping blood checks because they're inconvenient. Blood thinners are vital but nasty meds and the proper dosage is important. Changes in weight, diet, etc, can all have effects.

 

But yes, with aging parents, sometimes they do seem to age quickly after a big medical event. But I've seen mine also bounce back pretty well. Self care (practiced or ignored) is a big part of that.

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In addition to the blood thinners, it could be because of the thinner skin people get as they age.  That's just a natural part of aging, and something that causes older people to bruise and bleed easier (even ones who aren't on blood thinners).

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If he has had a stroke, then the blood thinners are necessary.  Like others mentioned before, he needs to have his blood levels monitored regularly.  Dosing blood thinners is a difficult process because everyone responds differently and there can be a fine line between a therapeutic dose and a potential for hemorrhage.  My mom was on blood thinners for her stroke risk (prolapsed mitral valve.)  Her window of therapeutic dosing was very narrow.   Losing 5 pounds would make a big difference in her risk of bleeding.  When her dose was too low, she would have TIAs.  She went monthly for INR tests and they had to constantly alter her dose.  She did have several severe bleeding incidents as a result her levels being too high (sometimes she would forget that they changed her dose.) 

 

Sometimes after a major illness, you may be able to get coverage for PT/OT to help get their strength back.  My mom would get very weak after each hospitalization.  Her hospital had a step-down unit where people who were medically discharged but not strong enough to go back to independent living would get a week or so of PT to help improve strength and mobility. 

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My mom is on Warfarin for heart problems (blood thinner).

Coumadin is the generic name.

She has to be checked every 3 weeks at the Dr's office--even when on vacation or whatever.

 

So I third the question re is he getting checked?

 

There IS a medication that is fairly new that doesn't need as much checking, but it is not covered as completely as Coumadin, so my mom can't take it (it's over $100 a month, and the Warfarin is just 4 bucks a month!)

 

My dad was taking aspirin (baby) and he'd always have bruising, esp on his hands. Thin skin, blood thinning, aging--yep, it can be scary.

 

:grouphug:

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If the shaking hasn't been discussed with a care provider, I would do so.  Is the shaking at rest, or when he's using his body?  Just arms/hands "shaking", or head, etc.?  Is his balance impaired?  With tremors, some are "intention" tremors, and some are tremors that happen at rest. Noting when you see it can provide important diagnostic cues for a physician.  They may not be true tremors, but a physician can tease some of that out.

 

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