Team Helps Prevent Blood Clots and Strokes

Beaver Medical Group Patient Newsletter - Cardiac Issue 2004

 

	Patients who come to Yolanda Rosales’ course on “Managing Anticoagulant Therapy” all have at least one thing in common - they are at high risk for blood clots which cause strokes, heart attacks, clots in the legs, and clots in the lungs. The risk is serious: The American Heart Association expects that 1.1 million Americans will have a heart attack, and another 700,000 will have a stroke in 2003.	Anti-Coagulation Clinic Staff & Support Staff: (Back) Ralph Bonanza, Cardiology Lab Director; Dr. Gary Marais, Cardiologist & A/C Clinic Director; Chris Fuller, Systems Support; (Front) Yolanda Rosales, MA and Nicole Robolino, RN A/C Clinic Nurses (Not pictured: Maha Osman, MA)
	Many high-risk patients have been prescribed the drug, Warfarin, also known by its brand name, Coumadin. Warfarin is a powerful drug that decreases the tendency of the blood to clot by thinning it. Not enough medication can leave the patient at high risk of blood clots, while too much can cause internal bleeding. Many other medications and some foods react with Warfarin, which requires patients who take the medication to be constantly monitored to maintain their blood clotting levels. Beaver Medical Group began the Anti-Coagulation (A/C) Clinic five years ago to help patients avoid complications. Yolanda Rosales, who has worked in the innovative clinic since its inception, teaches a monthly introductory class for people beginning the program. “Patients feel more comfortable taking the medication knowing the clinic is available to them,” said Yolanda, the A/C Clinic Coordinator. “We have a direct line allowing patients to call in with any questions. Whenever patients receive a new medication, have a scheduled procedure, become ill, or take a bump to the head, they are encouraged to call in.” Dr. Gary Marais, one of Beaver’s Cardiologists, is the Director of the A/C Clinic. With limited space available in the Redlands Cardiology Department, he had the clinic set up in his office. The clinic now has 3 nurses who serve close to 1,000 patients in the program. Once patients have completed the class, they have their blood drawn at least once a month. The results are downloaded everyday into a specialized database and tracking system developed for the A/C Clinic. Patients with abnormal levels are immediately contacted by the nurses at the Clinic and are given directions on how to adjust their medication accordingly. Those with normal results receive a letter with their results. In addition, the nurses at the clinic keep an updated database of hundreds of medications so the staff can quickly look up a medication to see how it reacts with Warfarin. Ralph Bonanza, Director of the Cardiology Lab stated, “The Anti-Coagulation Clinic enables us to have good quality control by centralizing it.” Patients in the clinic are at high-risk for blood clots for a variety of reasons: The most common is Atrial fibrillation which affects over 2 million people in the US every year. In Atrial fibrillation, patients experience abnormally fast and highly irregular heartbeat, and pooling of the blood in the upper chambers which can cause blood clots. Fortunately, Warfarin reduces the risk of stroke by 60 - 80 percent in people with Atrial fibrillation. Other patients may take the medication because they have had blood clots in the past, or a valve replacement. “These patients are more likely to take the medication and less likely to end up with complications like GI (Gastrointestinal) bleeding,” said Yolanda. “We have a very dedicated and conscientious staff. They make it work,” said Dr. Marais.
	Know the Signs of a Stroke. Sudden numbness or weakness of the face, arm or leg, especially on one side of the body Sudden confusion, trouble speaking or understanding Sudden trouble seeing in one or both eyes Sudden trouble walking, dizziness, loss of balance or coordination Sudden severe headache with no known cause Any of the above symptoms may be temporary and last only a few minutes. This may be due to a “Mini-stroke” called a transient ischemic attack (TIA). TIAs are very important indicators of an impending stroke. Don’t ignore them! If symptoms appear, call 911 immediately. Source: American Heart Association
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