If you would have told me nine years ago when I was first diagnosed with atrial fibrillation that in the near future I would be wearing a medical ID bracelet and carrying around a medical ID card in my wallet for the blood thinner I would be taking in preparation for a catheter ablation, I would have told you you were crazy!
My ablation is scheduled for March 5th. Dr. Natale wants his patients on a blood thinner for 3-4 weeks prior to the procedure so I officially started on Eliquis (Apixaban) on February 12th at exactly 10:15 a.m.
I was really nervous about taking these so I waited for as long as I could to start them. Since the beginning of the year a day didn’t go by that I didn’t think about these stupid blood thinners. I dreaded going on them. I was concerned about the potential side effects, and I probably watch too much sci-fi (thanks Walking Dead) because I was also freaking out about bleeding to death. I imagined I would be sitting at my computer or watching TV and suddenly blood would start flowing from every orifice of my body. Yes, my imagination was running wild.
The first step in the process was getting the prescription filled. I was shocked at how expensive it was. I knew it was $300 – $400 for a month’s supply but I never gave it any thought because until now it wasn’t something I had to deal with. The retail price on the receipt was $325. Fortunately, since we surpassed our high deductible months ago, our “full insurance” kicked in so my out-of-pocket cost was only $22! Our insurance plan restarts in April so our high deductible will be in place again. At that point I’ll be paying the full $325.
If all goes accordingly to plan, I will only need to be on Eliquis through May so I shouldn’t need to spend more than $650. Don’t get me wrong, that’s still a lot of money but at least I don’t have to pay that much every month for the rest of my life like so many people have to do. I honestly don’t know how people do it. $300 – $400/month for just one drug is a lot of money!
As soon as I got the prescription filled I put it in the back of our medicine cabinet so I wouldn’t have to be reminded of it. That didn’t help any because I’m a heavy supplement user. Every time I would take my supplements I would think about the damn blood thinner sitting in my cabinet.
The reality of the situation really hit me when Shannon, the editor over at Afibbers.org, advised me to get a medical ID bracelet just in case I was in major accident. I hadn’t even thought of that so I promptly ordered one.
As I was ordering my bracelet and filling out the form for what I wanted engraved on it I couldn’t believe what I was doing. Was I actually ordering a medical ID bracelet for a blood thinner I was going to be on at the age of 42? I’m not one to get depressed but I did get a little angry about the whole situation.
When the bracelet and ID card arrived I looked at it with disgust. I always thought medical ID bracelets were for really sick people or for people in their 80s and 90s. I’m not “sick” and I’m not old. Why did I have to wear this damn thing? Why did I have to be on a stupid blood thinner? Yes, I had myself a good old fashioned pity party.
Then a few days later the big day arrived. It was time to swallow that first pill. I just sat and stared at it for a minute, wondering what was going to happen after I took it. I threw it in my mouth and chugged it down with water and went about my day…waiting for the internal bleeding to start.
In all seriousness I did constantly wipe my nose to check for a nose bleed that day. And even now when my nose runs I immediately “check for blood.” Yes, I’m still very nervous about the whole bleeding thing.
While I didn’t bleed out that first day I did experience some minor side effects. Later in the afternoon I had an upset stomach with the strong urge to go to the bathroom. When I went, I had very loose bowels – borderline diarrhea. I thought maybe it was something else but I had a suspicion it was the damn Eliquis.
For the first three days on Eliquis I was experiencing those side effects but only in the late afternoon hours (usually right around 4 p.m.). They only lasted for a couple hours but it drove me crazy because I didn’t have control over it. By that I mean, I knew it was the Eliquis but unlike a supplement I might experiment with, I couldn’t just stop taking it. I was stuck with it and I had no control over the side effects.
I’ve been tweaking my supplements and trying different things with my diet to keep these side effects to a minimum and I’m happy to report that now on day four they are getting better. Today I barely had an upset stomach and while I still had that urge to go to the bathroom, my bowel movement wasn’t as “loose” shall we say. I will continue to tweak things until I get these side effects under control.
Aside from those side effects, it’s been pretty uneventful so far (thank God). I still constantly think about bleeding out or getting into a bad car accident. And I still constantly wipe my nose checking for blood. I realize this is ridiculous but I’m just wired to worry, I guess.
I should point out that while I worry about stuff, it doesn’t necessarily consume me. I don’t get depressed nor do I alter how I live because of those thoughts. Worry probably isn’t the right word to use. It’s more of having on and off thoughts about these things throughout the day.
There is one major change I have made, however. I quit drinking all together for now. My heavy drinking days are long gone but I still enjoy my nightly vodka/7-up cocktail so I wasn’t looking forward to giving that up. I don’t want to be drinking at all during the three month recovery period after the ablation so I thought I would stop now. I figured what the hell, I’m taking blood thinners now I might as well quit drinking too.
While I miss not having my nightly cocktail, quitting drinking turned out not to be such a big deal either. Like the blood thinners, I know it’s only temporary and I know it’s the best thing for me right now.
I can’t wait until June when this is all over and I can enjoy a cocktail in the warm summer sun.
I am astounded at the cost of Eliquis that you people are talking about, my ten prescription drugs cost $5.20 australian per month each under our pharmesuticals scheme. Anyway I have heart failure and have a biventricular pacemaker. I have afib and take Eliquis to reduce the clotting risk with no specific side effects yet.
Hi, I’m Tania. I was diagnosed with afib a year ago. It seems like a month ago, with the doctor visits, ambulances and firetrucks arriving at my house, for all my neighbors to see, before I have even met them. I don’t worry about warfarin. I worry about the metoprolol. It’s first side effect is heart disease! And the longer afib goes on, the harder it is to have a successful procedure.
My cardio told me to take all that stuff for 3 months then we’d see if the blood clot in my left atrium has dissolved so we could proceed. I’ve seen him 3 times in this past year. August 6 I will definitely be in his face because the way I see it, he is treating the SYMPTOMS not the PROBLEM. Any comments on the different kind of ablations (I’d have to have TEE test first right?) and should I get an EP?
Thanks
Tania:
I totally hear about you about the “embarrassment” of having ambulances come to your house. When I was first diagnosed with afib I was carted in an ambulance to the ER as well. It sucks.
You definitely should be seeing an EP. These are cardiologists that specialize in arrhythmias such as atrial fibrillation. Not only do you want to find an EP but you want to find the best EP you can find – especially if you’re considering having an ablation.
Having a TEE done before an ablation isn’t always automatic. For example, when I had my ablation I didn’t have to have one done. Having said that, my guess is you’ll likely have to have one given your history with a blood clot. Don’t fret, however. From what I’ve been told by people who have had them their not a big deal. By no means are they fun but they’re not painful.
It is true that the longer you have afib the harder it is to treat with or without having an ablation. If you’re going to have an ablation it’s always best to have it sooner than later.
Keep in touch and I wish you well!
Travis
Hi Travis,
I just got done reading your blog about the tradeoffs b/n the different NOAC’s:
https://www.livingwithatrialfibrillation.com/1369/choosing-noacs/
and then came across this blog wherein you mention that Dr. Natale’s office has you on Eliquis as a prep for your ablation.
Did they suggest Eliquis in particular, or… did they say any of the NOAC’s (eg, Xeralto) would be fine? The reason I ask is that I’m currently on Xeralto (I was just cardioverted 2 weeks ago, and my local EP’s protocol is for me to stay on Xeralto for 30 days after the cardioversion), and was contemplating asking my Dr. to switch to Eliquis, if Dr. Natale had found it to be better.
By the way, I came across a June 2015 paper by Dr. Natale (and colleagues), comparing Eliquis to warfarin, regarding effectiveness in protecting against embolisms during an ablation, found Eliquis to be equally effective:
http://www.heartrhythmjournal.com/article/S1547-5271%2815%2900248-9/abstract
The abstract doesn’t say why they chose Eliquis instead of one of the other NOAC’s, or if they consider their results to be equally applicable to the other NOAC’s (eg, Xeralto).
Cheers,
-Ted
Ted:
Dr. Natale usually prescribes Eliquis based on his patients’ experiences with it. He said of the new anticoagulants, Eliquis is one where he sees the least issues (i.e. side effects). However, he told me if I wanted to take Xarelto, that was fine too. I chose Eliquis and I’m glad I did because I had such a good experience with it that I didn’t even know I was taking it as I had zero side effects.
I’ve read in some forums that people have GI issues taking Xarelto. I’m told that’s the most common side effect of it. If you’re not experiencing any side effects with Xarelto then I’d just stick with it. Everyone responds differently to these drugs. The good news is you have choices so if you do have issues, you can always switch to Eliquis.
Travis
Great blog, thanks for sharing. I had a cryo-ablation in November 2014 at Mayo Clinic Jacksonville. From the beginning I was told it may need to be done twice to fully “corral all the horses”. I started having afib episodes a few weeks after the procedure so I will be undergoing another ablation in May 2015.
Just wanted you to know that Eliquis has a “360 support program” where I got 30 day supply free and a discount co-pay card that will save me a lot of money. You can contact them at 855-354-7847 to see if you qualify too.
Renee:
Glad to hear you’re enjoying the blog. I’m sorry to hear you have to have another ablation. That stinks…although they do tell you to expect two procedures so I’ve prepared myself mentally for that.
Thanks for the great information on the Eliquis 360 Support offer. I have provided a link to the offer for others that might be reading this:
https://www.eliquis.com/eliquis/support-offers
Best of luck to you, Renee, on your second procedure. Do stop by and let us know how it goes!
Travis