Hi Jake,
It's great to hear from you and there are far more folks who visit the forum and glean good advice and info without posting than there are those of us who post here. So you have been in good company, but I hope you won't make yourself a stranger here now that you are up and running on the forum.
A good question to ask is was the increased pain & swelling more from the stopping your solid anti-inflammatory regime that it was a side effect of Eliquis, which I tend to suspect that a good deal of that sudden increase in pain and swelling may well have been in your case.
Like all drugs Eliquis can have some side effects for sure, but they tend to be more mild and these relatively fast changes in inflammation status I would think would tend to be caused more from stopping certain anti-inflammatory protocols a person may have been taking rather than the Eliquis causing s sudden arthritic changes in the joints which it has not been shown to do in the reports I have seen.
I took 500mg of Meriva while I was on 5mg BID of Eliquis for 9 months right after my Lariat leak caused that modest stroke and after the Amplatzer Duct Occluder II vascular plug was installed to plug the 5mm diameter leak that had formed in the central pucker of my Lariat causing the leak that caused the stroke.
I never had any bleeding issues from the Meriva or pycnogenol and several over anti-oxidant/anti-inflammatory supplements I took along with the watchful guidance of my functional medicine MD as well.
I am NOT suggesting or prescribing that you should resume taking Meriva with Eliquis, as that is your doctors role and I don't know your whole story and such. But you might bring it up to him and see if he knows of any excess bleeding risk from Meriva plus Eliquis out there. Im not the only one who has combined those two without a problem but these is just a small anecdotal report and not to be acted on without the okay and guidance from a knowledgable MD regarding both Eliquis and these anti-inflammatory supplements like Curcumin as Meriva etc. There may well be some added reasons in your case where curcumin might be deemed a higher risk for bleeding that for other folks so don't add it back in strictly on your own initiative. I share my experience here simply as a case history of one so that you might discuss the issue with your doctor.
Best wishes and good luck on the net TEE. Sounds like a good plan to have Natale instruct your TEE cardio's and just what he wants them to do, I have seen a number of locally done TEEs at the 6 month mark in small centers or hospitals in the patients home area post an LAA isolation , and the vast majority of the time Dr Natale has to ask that the scan be redone as even when given a general outline of what he needs to see to assure you its okay to stop OAC long term, is very specific and are not commonly performed aspects of a typical TEE... It takes knowing jsut the right angle of view as well for getting the best and more reliable information from that TEE.
Hence the wisdom, when possible of making one more trek to Austin, San Fran or Scripps La Jolla where for sure the TEE experts at these three Natale institutions are well aware of just how to get a great looking TEE that Dr Natale can feel comfortable with.
A case in point, I saw my friend close friend 'Tony' (not his real name) last week In Honolulu when I was there for a week catching up on some needed errands at my old home town of 38 years, those of you who get The AFIB Report may recall that in the June/July 2014 issue 132, I wrote a case study of my witnessing first hand Tony's index long standing persistent AFIB ablation in which Dr Natale converted him to NSR in around 43 minutes. And Tony has gratefully been in NSR ever since as confirmed by his onboard 24/7 LINQ monitor.
Tony did not yet require full LAA isolation, but Natale did have to delay his LAA a good deal. The odds are very high in this instance with jut an LAA delay and not a full LAA isolation that he is fine and can stop his Eliquis, but due to the extensive nature of his case and that he had had some AFIB-induced bradycardia prior to the ablation too, Dr Natale wanted him to get a 6 month TEE in any event, just to be 110% sure he was safe to stop his Eliquis with his additional cardiac reserve issue.
Tony got all the detailed written instructions from Natale's office in San Francisco sent to his Hawaii interventional cardiologist who follows him there describing exactly how to perform a post-LAA isolation TEE at 6 months after ablation. This written report highlighted that Dr Natale requires clear and repeatable confirmation of an LAA emptying velocity of at least 40mm/sec or higher, plus there must be a consistently robust "beat for beat" positive deflection of his Dopper A-wave leading into the Mitral valve Inflow area.
The third and final requirement that Natale insists on seeing is an actual copy of the TEE CD being sent to him so that he can confirm with his own eyes the first two metrics are accurate and not just depend on some unknown Cardio's interpretation of what he thinks he sees, and also so Dr Natale can verify visually that there is zero 'Smoke' or SEC (spontaneous echo contrast) seen in either the LAA or Left atrium areas. Smoke or SEC reflects more turgid thicker blood that has more stagnant stasis in certain areas of the LA or LAA.
All three tests much be clearly passed, and it takes some experience in looking for these values for the TEE Cardio to get good readings on all three. Tony's local Cardiologist reassured Tony touted how many TEE's (albeit more standard typical TEEs) he had done and that this would be a piece of cake for him. And yet, when Dr Natale got his CD of this Hawaii done TEE scan, only one of the two metrics where clearly and definitively captured! so
As as result Tony is flying to Scripps La Jolla in two months to get a solid TEE from Dr Rubinson there in hopes he can then drop the Eliquis once and for all. He has had zero side effects reported from Eliquis ( as most people do not report much or mild side effects on this class of NOACs, so tony said doesn't much mind the wait but the odds are he may well be able to stop Eliquis since he has not required full LAA isolation yet and he is looking forward to learning if he can do so.
That is why I say, if you can zip down to Austin, San Fran or La Jolla for two days, preferably when Dr Natale is also there and might be able to review the results with you the next day depending on his schedule, that would be the ideal choice.
Shannon