Interviews
Q&A with Diana S.
Monday, April 28, 2008
PTINR.com Staff
Diana S. comes to us as a PT-INR.com visitor. Diana is an accomplished professional who, while being relatively new to Coumadin, has a lot to offer other patients and professionals.
Question: Tell us a little bit about yourself?
Answer: I’ve been a medical publisher for over 30 years, beginning specifically with books for physicians but gradually moving to an emphasis on books for laypeople, with an emphasis on managing specific medical conditions. I originally trained as a biochemist.
Q: How long have you been on warfarin (Coumadin ®)?
A: Three years.
Q: Why are you on warfarin?
A: I have an atrial fibrillation that developed following surgery to correct a birth defect I had lived with for many years without knowing it existed. The AF caused a stroke – which fortunately was minor as I was on Plavix at the time, but I’m now on Coumadin® for life.
Q: How do you currently test your INR?
A: I am tested every six weeks at a nearby hospital, which has a large Coumadin®/warfarin clinic. It’s done by finger-prick.
Q: Is home INR monitoring something you would consider?
A: Yes, it’s been recommended to me that I’m a good candidate for home monitoring. (I’m not sure about the insurance issues – my insurer covers it, only uses CoaguChek, but I’m not sure whether they cover AF)
Q: We've learned you're coming out with a book? Is this your first?
A: I’ve developed over 500 books, and edited several very technical neuroscience books ‘way back when, but this is the first lay book I’ve authored myself.
Q: What drove you to write a book for patients on warfarin (Coumadin)?
A: After I began taking Coumadin®/warfarin, I found that many friends and a few relatives were also taking it. Most of them did not receive the good information I had, and they were having trouble keeping their INR steady. One of them - a nurse who you’d expect to be given detailed information – was not told anything about diet and drug interactions, another firmly believed that she could not eat anything green, etc.
Q: When will the book be available and where can consumers buy it?
A: The book will be most readily available through online bookstores such as Amazon.com and BarnesandNoble.com, but should be in the chain and independent bookstores within a month or so after publication as well. People can visit our website at www.diamedicapub.com and, we’re pleased that they can also purchase it through www.ptinr.com as well.
Q: Is the book written for patients new to Coumadin or patients who have been on warfarin for some time?
A: It’s really for both. It’s a good introduction for people who have just begun taking Coumadin or warfarin, and we hope that physicians and clinics will recommend it to their patients. There’s a lot of information on the Internet, but the last thing people want to do when they’ve just been given a diagnosis of one of the conditions for which the drug is prescribed is to try and hunt for information. Also, the available information can be both confusing and off-putting.
People who’ve been on the drug for a while will also hopefully find it to be a useful reference, and the resource list will help them answer specific questions they may have.
Q: What have been some of the most valuable lessons you’ve learned about being on Coumadin?
A: The main thing is to be consistent. The dosage can be adjusted to accommodate anyone’s lifestyle, but only if there are no major fluctuations in diet or medications. So, for example, I have one leafy green every day. EVERY day. When I was in Mexico recently, I switched to guacamole (most definitely not a hardship!).
The other is to be careful to monitor any changes in medication, including herbal preparations. The nurses at my Coumadin clinic tell me the number one cause of INR fluctuations is in people who decide to take a recommended herb without checking to see if there might be a problem.
It’s especially important to be sure that all physicians and other health care providers – including dentists – know that you are on Coumadin, and to ask whether interactions might be a problem for any new medication.
Q: What are your dreams for The Coumadin (warfarin) Help Book?
A: I’m hoping that will be recommended by physicians and nurses to their patients at the time they are first prescribed Coumadin or warfarin, to help them manage the drug with minimal problems from the start.
Diana’s book is forecasted to be available in July 2008. PT-INR.com will feature a book review shortly before the book is officially released and announce the actual date patients and professionals can order.