ANDREWS AFB, Md. –
The Coumadin clinic here at Malcolm Grow Medical Center has brought life changing differences to its patients.
Coumadin is an anticoagulant or blood thinner that is prescribed to patients who suffer from deep vein thrombosis, pulmonary embolism, atrial fibrillation, atrial flutter, myocardial infarction, patients who have heart valve replacements, and those with blood factor deficiencies.
"This medicine extends the amount of time it takes the blood to clot, therefore preventing future clots and sustaining present ones," said Licensed Practical Nurse KaShawna Jones, Malcolm Grow Medical Center Coumadin clinic.
According to Ms. Jones, the pharmacists who work in the clinic have to be credentialed.
"They have approximately 20 hours of on the job training and most of them have been doing this for years, so they are very experienced," said Ms. Jones. "Our nurse practitioners who work in the clinic specialize in cardiology and possess a great deal of experience as well."
The Coumadin clinic is open to active duty military, retirees and their dependents. In order to been seen in this clinic, there are certain criteria.
"Patients must be under the age of 65, their primary care managers must be enrolled at MGMC and they must have at least six months of therapy," stated Ms. Jones.
"We are an anticoagulation clinic and we monitor patients taking anticoagulation medication such as Coumadin. We basically monitor how long it takes a patient's blood to clot and how thick or thin a patient's blood is," she said. "Our goal at this clinic is to assist the PCM with managing their patients' therapy, and providing the best care to these patients."
About eight months ago, the Coumadin clinic took in Bobby Jones, a patient who was suffering from an atrial fibrillation or an irregular heart rhythm.
"Before an official diagnosis, I went to the ER," said Mr. Jones. "There, a cardio version was performed on me to shock my heart back into a normal rhythm pattern."
According to Mr. Jones the effects of the procedure were short term, so his doctor immediately prescribed him Lomax - an anticoagulant or blood thinner.
"I administered it by needle injections into the fleshy part of my abdomen for about two weeks. Then they put me on Coumadin tablets, which I now take once per day," said Mr. Jones.
The treatment of Coumadin has greatly influenced his diet.
"Because vitamin K decreases the effectiveness of Coumadin, I have to watch my intake of foods that contain this source," said Mr. Jones.
Consuming foods such as liver, broccoli, brussels sprouts, spinach, and most other leafy green vegetables, which are a sources for vitamin K, can adversely affect Coumadin patients' International Normalization Ratio.
INR is the standard unit for reporting the clotting time of blood.
In general, the higher the number, the longer it takes the blood to clot. The target set by a physician for an individual patient is also called the therapeutic INR range, and is dependent upon the condition being treated and the risk of clot formation.
Frequent and consistent testing is required in order to make proper adjustments to maintain the effectiveness of the medication, which helps to prevent serious side effects. While the typical patient has their INR tested every four to six weeks at a clinic, studies now show that more frequent testing significantly reduces complications by helping to keep patients in range.
According to Mr. Jones the treatment is as simple as taking the medication as prescribed and overall, he's glad that this clinic exists here.
"I really didn't want to be placed on this medication," he said. "But I can easily make adjustments to my daily regimen if it means living a more normal life."