New kid on the block

For more than 60 years, Coumadin, (generically known as Warfarin), has been the only “blood thinner” available for millions of people with a common irregular heart rhythm known as atrial fibrillation. A newly approved alternative to Coumadin (Warfarin) known as Pradaxa, fights stroke better than Coumadin for patients with atrial fibrillation, with less bleeding into the brain, less interactions and without the need for blood tests.
Atrial fibrillation is an irregular heart rhythm that is associated with an increased risk of developing a harmful, or possibly fatal stroke, due to the formation of a blood clot. To reduce the likelihood of blood clots being formed, patients with atrial fibrillation must take specific types of blood thinners. Up until recently, the best available drug was Coumadin (Warfarin). Warfarin is a very good drug, and remains a mainstay for many patients with a history of mechanical heart valves, irregular heart rhythms and blood clots in the legs, lungs, etc. Coumadin effectively prevents the formation of clots in the bloodstream. It is widely available, and inexpensive. However, anyone who has either taken Coumadin or managed patients taking Coumadin, knows it can be difficult to regulate. Blood tests must be done regularly to determine the proper dosing regimen. A standardized blood test, called an INR, is used to evaluate the effectiveness of Coumadin. Regulating Coumadin levels is a delicate balance between too much and too little. If the INR is too low, you’re not receiving enough of the drug, increasing your risk of forming blood clots. If the INR is too high, your blood is too thin, making you prone to bleeding. In addition, there are multiple factors that can affect Coumadin – what you eat and drink, your health, and a number of drugs, vitamins, supplements, and herbal remedies.
Several alternatives to warfarin have been developed over the last few decades. Some had fewer side effects than warfarin, but weren’t as effective. Others worked as well as warfarin, or better, but were harmful to the liver.
Pradaxa beats warfarin in both effectiveness and safety: in clinical trials, it decreased the risk of stroke or death more than warfarin with fewer episodes of major bleeding.
Here are answers to some common questions about Pradaxa:
How does it work?
Pradaxa prevents blood clots from forming by blocking the action of thrombin, a protein that circulates in the bloodstream. One of thrombin’s key jobs is to convert another soluble protein, called fibrinogen, into strands of fibrin. These strands stick to the blood vessel wall, forming a net-like complex. A blood clot forms as red blood cells become entangled in the fibrin web.
Who is it for?
The FDA approved Pradaxa to reduce the risk of stroke and other problems caused by blood clots in people with nonvalvular atrial fibrillation. Trials have not yet determined if Pradaxa can replace warfarin for people with other conditions, such as deep-vein thrombosis or a mechanical heart valve. Only your Dr. or healthcare provider can advise you as to whether or not you are a candidate for taking Pradaxa.
What are its advantages?
Pradaxa isn’t affected by diet, as is the case with warfarin, so you can eat green, leafy vegetables and other foods rich in vitamin K without worrying about it effecting the drug. The dose of Pradaxa needn’t be calculated for your weight; it is more a one-size-fits-all medication, like aspirin. Finally, you don’t need routine blood tests to measure your international normalized ratio (INR), as are needed with warfarin.
What are its disadvantages?
The main drawback is the upfront cost. A year’s supply of warfarin, which is available as a generic medication, costs about $360. Pradaxa will cost nearly $2,500 a year. But this could be offset by the cost (not to mention the time spent traveling to the doctor’s office) of not having to do repeated INR tests.
How do I take Pradaxa?
Take one capsule in the morning with breakfast, and another about 12 hours later with your evening meal. Do not break open the capsules or chew them.
What if I miss a dose?
If you forget to take Pradaxa at breakfast, but remember a couple of hours later, go ahead and take it. If you remember later, and are supposed to take the next dose within six hours, wait until then and take only the evening dose. Do not take a double dose. If you forget to take your evening dose, take only a single dose at breakfast.
What are the common side effects?
Because Pradaxa inhibits clotting, bleeding is the main side effect. This runs from easy bruising, or shaving cuts that seem to take forever to stop bleeding, to more serious bleeding into the stomach or brain. The drug also causes marked stomach upset in about two in 100 people who take it.
Thoughtful switch
At first glance, it looks like everyone with nonvalvular atrial fibrillation should swap their Warfarin for Pradaxa. But it’s worth taking a longer, harder look. The main clinical trial included 18,000 people who took Pradaxa for two years. We will undoubtedly learn more about the drug — its effectiveness, side effects, safety, and interactions with other drugs — after it has been used by hundreds of thousands of people, and for longer periods. For some people, switching right away to Pradaxa makes sense. For others, it is worth adopting a watch-and-wait strategy.
Talk with your doctor to see which approach is right for you.
Lisa M Ennis FNP

Nibbling on chocolate may help your heart !

Valentine’s Day is almost here and amidst the traditional exchange of valentines, flowers and the like, I love getting chocolate.
That’s because I love chocolate, and I know I’m not alone.
Did you know that chocolate is America’s favorite flavor and the food most commonly craved by women? As a nation, we consume 10 – 12 pounds of it each year! We’ve all heard that dark chocolate is good for our hearts, but does the data really support the notion? We all want to believe that chocolate protects the heart and arteries, so what’s the truth about its’ protective effects on our hearts?
Some studies show a strong connection between eating chocolate and less heart disease. In a survey of nearly 5,000 American adults, those who said they ate chocolate five times a week were 40% less likely to have ever had a heart attack or to have needed an artery-opening procedure (Clinical Nutrition, December 2010). A similar trend was seen in a large German study. However, it is impossible to tell if eating chocolate protects the heart and arteries or if people who eat chocolate also do other things that are responsible for this trend.
There are clinical trials showing that eating dark chocolate can help lower the blood pressure of patients with high blood pressure (hypertension). However, chocolate had no effect among people with normal blood pressure (BMC Medicine, published online June 28, 2010).
Other possible ways that chocolate might protect the heart and arteries include providing antioxidants, stimulating artery walls to generate artery-relaxing nitric oxide, inhibiting the activity of a blood pressure–raising enzyme. However, there is no definitive proof. Eating dark chocolate is promising, but an unproven way to treat or prevent heart disease.
It’s also worth considering the extra calories you’ll consume, since 2 ounces is equal to approximately 300 calories. Without cutting back elsewhere, you could easily put on 20 to 30 pounds over the course of a year.
We recommend eating chocolate as a snack or treat. You might also consider incorporating it into your own homemade trail mix or other snacks that could do some good for your heart and arteries, like pumpkin seeds, raisins, almonds, oatmeal or pears. In addition, how about some “guilt free” chocolate options such as chocolate bubble baths, candles and lip gloss?

Lisa M Ennis FNP

Meet Makeover My Heart Featured Designer, Elizabeth Cissi

Makeover My Heart is pleased to announce this year’s Featured Designer -Elizabeth Cissi, from Embellishments Hand Knitting.   We asked Elizabeth to design a beautiful scarf that incorporates all the colors of Makeover My Heart – wonderful shades of rose pink, grays and a touch of sparkle.    We can’t wait for you to see it.   This beautiful hand made scarf will be a wonderful addition to your wardrobe, allowing you to be stylish, yet toasty warm.   Scarves are $30 each with proceeds going towards the event.  You can purchase yours at the 3rd Annual Makeover My Heart on Saturday, February 5, 2011 at the Radisson Hotel – Utica Centre. 

More about Elizabeth.  Elizabeth Cissi is a lifelong knitter.  Her love of fiber began at the age of five, when her mother taught her to knit.  Since then she has designed and created an array of garments and accessories, drawing inspiration from many different knitting traditions.  Elizabeth particularly enjoys experimenting with color and texture.  Her work has been displayed in area gift shops and fine arts and craft shows.  Elizabeth teaches English at New Hartford Senior High School where she serves as English department chairperson.  She resides in Utica with her husband, David Shove, and her daughters, Katharine and Julia.

If you don’t already have your ticket to the 3rd Annual Makeover My Heart, now is the time to get yours.  Tickets are on sale now for $20 per person and can be purchased on-line at www.makeovermyheart.org.  Or, in person at Slocum Dickson Medical Group’s 1st floor Registration Desk.  If you would like more information, or to receive a brochure, please call 624-1974.

Meet Susan Sady, of Susan’s Cooking School

Makeover My Heart is very excited to be adding  a new workshop this year – Heart Healthy Cooking Classe -                                         Featuring Susan Sady of Susan’s Cooking School.                          Guests at the 3rd Annual Makeover My Heart will have the opportunity to learn some great recipes and tips for cooking in a heart healthy way.                            Susan Sady owns and operates Susan’s Cooking School, which currently offering classes in the kitchen of Grace Church, in Downtown Utica.  In addition, she teaches classes and workshops at Munson Williams Proctor Institute and Mohawk Valley Community College.  From 1982 – 2001, Susan was the Chef at the Polonaise Restaurant in South Utica, which she operated with her husband Dariusz.

Susan holds a BS in Biology from the University of Nevada at Las Vegas, and a Master of Music from Syracuse University.  For more information about Susan, including her classes, recipes or videos, please visit her website at:  www.susanscookingschool.com

Meet Dr Ken Murphy

One of our most anticipated workshops at Makeover My Heart is our                         “Taste of Wine Series” sponsored by Bremer’s Wine and Liquor.  This years featured speaker is  Dr Ken Murphy, Interventional Radiologist at Faxton St. Lukes Healthcare.                                                                                                                            His talk  – “A Heart Related Condition that has “Legs” will focus on the relationship between poor circulation and heart disease (PAD/peripheral artery disease)

Dr. Murphy earned his Bachelor’s Degree at Union College in Schenectady in 1982 and then attended The State University of New York Upstate Medical University at Syracuse where he earned his medical degree.  He is currently a practicing physician with Radiology Asociates of New Hartford.