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My 90 year old mom with no history of aFib or stroke or heart disease went to the ER at midnight. On arrival HR was 65, EKG normal BP normal. She has dementia but this wasn’t documented by person who took her. So her speech was like it always is- repeating, pauses between thoughts,etc. she kept saying she was fine and wanted to go home bc she had trip planned to see her granddaughter get married- which she did and was always packed waiting to leave the next morning. She has anxiety and takes Xanax .025. The day after admission she went into aFib and was given Eloquis. And sent home with a prescription. Now she is extremely tired, no appetite and wants to sleep all day?



Any suggestions?

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Afib gets you on elliquis. For me, it never affected my state but people vary. The afib itself can be exhausting. Is she on a holter monitor or what? BTW, she now has a history of Afib.I felt my Afib. It was like my entire heart went crazy. My mother is in chronic Afib all the time and she doesn’t feel it at all.
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SavingMom2014 Jun 2023
Thank you! She just had a hip replacement 18 months ago and everything was fine. Her cardiac markers were all good too! Worried that she might forget to take a prescription med and that will cause more damage than if she forgets to take an aspirin. So hard making these decisions!
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I have had atrial fib for two decades and my partner for longer. He has a pacemaker, I don't. I am 81 and got first atrial fib when still working as a nurse. Because I have seen so many dire outcomes from anti coags (bleeding) I have chosen to take a baby aspirin daily only for my atrial fib. It's rate is controlled with atenolol once daily.

Upwards of 15% of our elders go into this arrhythmia at some point; it is quite common and I am certain you will have looked it up. Atrial fib, studies show, can make us more prone to stroke due to the erratic heart beats and vessel movement of the blood.

At 95 I would be on palliative care only and my advance directive has for many years reflected my knowledge that we all do die, that I am prepared to die and that I don't want any heroic measures. I would do now very minimal treatments for ANY condition I might face.

There are many types of anti coagulant. As I imagine you are now POA to make health care decisions it is up to you to choose which decisions you believe are best for your Mom with the guidance of her doctors. I surely do wish you the best going forward.
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SavingMom2014 Jun 2023
Thank you for your personal information and advice. Yes I prefer she would be on aspirin therapy without all of the side effects from the other. And she has cats that I worry about bleeding from scratches. Talking to her last night she doesn’t know why she was in the hospital but says since she was there she’s exhausted and wasn’t before she went. I just want her last years to be alert vs groggy and sleeping. That’s no way to live!
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My husband found his own afib with his Apple Watch. His symptoms were mild, but he still did the wise thing and saw a cardiologist for the full work up, ending in being on Eloquis. He doesn’t have symptoms now. I’d say your mother may have something else going on that needs addressing. Take her to primary care doctor and describe her symptoms. Maybe some bloodwork or other tests can shed some light on what’s going on
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SavingMom2014 Jun 2023
Thank you! I gave my mom one of those watches so I can monitor her but she forgets to wear it. I know she takes Xanax for anxiety but she has never had aFib on any dr appointment so I was hoping it was stress induced. Worried about side effects and her forgetting to take the Eloquis. They put her on twice a day. I know it was taken off the market in the past.
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You are still required to follow up with her PCP. It should be listed in her discharge notes. Her doctor will reconsider the new medication or give a cardiologist referral.
My personal experience...
Mom had hers associated with pneumonia. She was switched to baby aspirin.
My father had it and refused medication. He died or a massive stroke within 8 months of diagnosis. The first thing I noticed when he was in ICU was the A fib on the monitor
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In the 42 yrs I have been married to my husband, he has had AFib 3x. From the first time it was 23 yrs till the next, from the the second to the 3rd, 4 years. No reason could be found why. The only thing we could figure out was maybe a stress factor. My husband has never been put on any blood thinner. He takes an 81mg aspirin a day. Thats it. After his and my Moms last visits to a hospital I swore that I would be getting them both to their PCP ASAP.

Hospital doctors do not communicate with the PCP or the patients specialists. I think a lot of mistakes are made because of this.
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SavingMom2014 Jun 2023
I was wondering if stress could be a factor? Her adult son moved in and has friends over and she has said it’s a lot for her. She is used to her quiet home
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My mom has constant AFIB and was put on Eliquis two years ago. AFIB is associated with dementia. I suspect it causes damage to the brain through undetected mini-strokes. I would caution you to take the blood thinners if they are recommended. Eliquis is supposed to have fewer problems than some of the others.
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SavingMom2014 Jun 2023
Thank you. She also has consistently low heart rate around 50. And is extremely tired which I worry about falling. Any suggestions?
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Sorry if you said - why the ER visit at midnight?
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Take her to her PCP to understand why Eliquis was prescribed. My mother is a fall risk and has had Afib. We took her off Eliquis because she had a greater chance of dying from internal bleeding from a fall than from having a stroke. She now has a pacemaker and would have been off it anyway.
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SavingMom2014 Jun 2023
Mine is too! Fell last year and broke her hip. Fell a few months ago and hit her head. She uses a walker and had chronic UTIs. I’m worried about her falling and bleeding and forgets she took her meds and doubling up
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Please don't look to the internet to decide about discontinuing medication. Every time my mom went to the hospital they wanted to change her meds, make sure there is a follow up with a specialist who can take the time to consider her history and needs in a way that an ER doc never will.
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SavingMom2014 Jun 2023
Thanks! She went to cardiologist today and he took her off of her BP meds that she had been on for years to get her heart rate up. I’ve never heard of such a thing. When she was off of it in the ER her BP went up to 185/90.

her pro BNp was 1350 snd he said that’s not a big deal bc she does have any other symptoms- but her chart says bilateral pleural effusions and she is short of Breath and SaO2 is between 90/94
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Saving, just read your response to me. Yes, her son moving in could cause her stress. Any change in her routine. He needs to be told her house her rules. That he is stressing her out.
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