Is it time for me to ease up on Eliquis? What say you?

I’ve followed this group for many years and value all of your advice. (Perhaps there is someone who is in my same situation, but even if you’re not, I’d love to hear your thoughts). Here is my status and question:

Had a Quad By-pass in 2016. On Eliquis (5mg twice daily) for 2 years, then my doc took me off and put me on baby aspirin. Then about 2019 I had an Afib episode, and since then, have had 5-6 total in 3 years. (They start in the evening and last till the next morning). So my doc put me back on 5mg Eliquis in 2020.

About 2020 I got Macular Degeneration in my right eye. (FYI - Macular is caused by bleeding of blood vessels behind the retina). (FYI - while there doesn’t appear to be direct proof that anticoagulants cause Macular, there are many folks that are pretty sure they don't help it, and perhaps help make it worse).

MY question is, is it time for me to go to a lower dose of Eliquis (2.5mg), to help lessen the chances of getting Macular in my other eye, AND to lessen its (possible) on-going damage to my right eye?

Eliquis states that if you are over 80 and have a “serum creatinine” level of 1.5 or higher, the correct dose is 2.5mg. I am 83 and my creatinine is 1.2.(So I fail to meet the exact conditions, so I should remain on 5mg). But my understanding is the whole reason anyone with Afib is on anticoagulants is to help prevent strokes.

But I also had an “AtriClip” in that 2016 operation (my understanding is that an “AtriClip” serves the same purpose as the “Watchman” - it helps prevent strokes while in Afib.). Given all this, I am going to see if my doc thinks I can go down to 2.5mg, but I’m curious what you all think?

Hmmm... tough call, but given your age and the history you've given us, you're at least a CHADS-Vasc 3, which normally would mean Eliquis for sure, but the Atriclip changes that calculation and puts you back to 0 or 1. Although anticoagulants don't cause bleeding (so they don't cause MD), they do prolong bleeding so they can make MD worse.

Dropping to a half-dose is probably a good idea but I think I'd get an ophthalmologist's opinion on that.

My understanding is that Atriclip is a substitute for either thinners or a device like Watchman -- so if you have the Clip or Watchman, why add thinners? I guess it will decrease stroke risk more, however there is the bleed risk on the other side of the occasion. Yes, strokes can come from other than the LAA, but on the other hand, he LAA itself can harbor clots so which AtriClip would take care of. Some argue they cancel each other out with stroke risk with the advantage to the clip over thinners, because again, less bleed risk. Have you discussed this with whoever put in the clip?

Jim

The chairman of the Cure AMD Foundation believes AMD is linked to seed oil consumption and has spent years researching it.

[www.youtube.com]

AMD specific - [www.youtube.com]

I watched it. It was interesting regarding the affects of diet on one’s vision. Thanks for sharing.

All I can say is it could be either good genes vs bad, or what food choices are available where one lives.

I had a cholesterol test done in June-my score was 123. They repeated it yesterday and it’s 133…which is a high score for me. I’m sure it’s due to my new diet. The food labels are not in English but I’m consuming a thicker almond base almond milk, and on rare occasions foods containing palm oil and soy milk and I increased my salmon to 1-2 servings a day of the fattest fish I could find with white fat stripes. No yolks, no wheat (I’m gluten free), no dairy. I eat chicken breast that is 98% fat free and no meat nor gravy. However, against the advice of my Cedar Sinai former cardiologist on consuming coconut oil, my dairy free no sugar added yogurts contains coconut cream by necessity because almond based yogurts do not exist. I buy whatever I can that is not perishable at iherb and get it delivered.

My double vision is horrible now. I have to spend up to 45 minutes trying to type and correct my typos writing this. I’m always type one keystroke to the left. Maybe it’s diet related as the YouTube video discusses.

Have you looked into a condition resulting from weakened eye muscles, called Adult Strabismus?

[aapos.org]

My wife developeled it after cataract surgery at age 80, which somehow weakened the muscles around her eyes, probably from the anasthetic.

The treatment she received at UCSF was a head MRI resulting in specialized glasses. There are surgical options as well.

Get to a specialist before your eye muscles become accustomed to their new settings.

There are two types of MD. Wet , caused by leakage of fluid or blood into the retina, and Dry , which is age related. I have Wet MD and have been on eye injections for 3 years. I have very poor vision in my right eye and am very nervous about my left. Wet MD is the leading cause of blindness. My MD came on suddenly, one minute I could see clearly, the next I couldn’t. I’ve had three haemorrhages in my right eye, and I get random pain in my left.
Needless to say I have mixed feelings re Apixaban which I should be taking but am using as a PIP currently. ( my AF has returned )
I don’t want to have a stroke but I also don’t want to be blind.
I think the risk is less if MD is age related.
I’ve never consumed seed oils. Only pure Olive Oil.

Quote
JoyWin
I’ve never consumed seed oils. Only pure Olive Oil.

Interesting. Dr. Knobbe in the video details the progression from dry to wet.

The Q&A was interesting at the end where he drew a blank about children with AMD.

Sometimes we can't over come the genetic tendency.

Quote
PavanPharter
I’ve never consumed seed oils. Only pure Olive Oil.

Interesting. Dr. Knobbe in the video details the progression from dry to wet.
Sometimes we can't over come the genetic tendency.

Could you summarize the progression from dry to wet, and any commentary on the benefits of taking supplements like PreserVision AREDS2 which my ophthalmologist says does a lot to halt progression?

Did you watch the 2nd video?

Dr. Knobbe discussed AREDS vitamins and the dry to wet progression.

[www.cochrane.org]

People with AMD may experience some delay in progression of the disease with multivitamin antioxidant vitamin and mineral supplementation. This finding was largely drawn from one large trial, conducted in a relatively well-nourished American population. We do not know the generalisability of these findings to other populations. Although generally regarded as safe, vitamin supplements may have harmful effects. A systematic review of the evidence on harms of vitamin supplements is needed. Supplements containing lutein and zeaxanthin are heavily marketed for people with age-related macular degeneration but our review shows they may have little or no effect on the progression of AMD.

[www.youtube.com]



Edited 2 time(s). Last edit at 08/07/2023 05:20PM by PavanPharter.