Showing posts with label warfarin. Show all posts
Showing posts with label warfarin. Show all posts

Monday, August 10, 2020

Vanilla Plant's Coumarins, Flatwood Pandemic Plant Medicine & Stunning Wildflower

Vanilla plant, Carphephorus odoratissimus spring basal rosettes

Plants give us so much and ask so little in return.  There is really no mystery as to just what plants offer and how they are best used.  One need simply pay attention to the fruit, scent, color and growth habit of the plant then read about or discuss traditional ethnobotanical uses with those knowledgeable of the plant’s identification and history.  There is an abundance of information available today concerning ethnobotanical uses, safety and efficacy of most described plants in our surroundings, including those available through nurseries.  Simply put, good excuses don’t exist for not integrating plants and their benefits into our lives today. 

For example, a common perennial native, Vanilla plant, Carphephorus odoratissmus, is one of those plants we really should get to know, for many reasons.  Unless in bloom, vanilla plant, also known as vanilla-leaf, is one of those herbs we may be aware of on a subconscious level but never pay close attention to except when in bloom. Those brilliant, late summer purple flowers almost always catch our eyes and turn our heads.

Vanilla plant's leaves contain coumarins


I say vanilla plant is one of those plants most of us are aware of on a subconscious level because of personal experience.  Judy and I spend as much of our time as possible out in nature absorbing inspiration, health and enjoyment.  Nature and wildflower immersions are some of my most effective stress relief therapies.   Walking through nature builds stamina too in addition to relaxing my mind.


Preserving stamina is important to me because I know future surgeries will be required to repair additional portions of my still torn aorta.  When out on a nature walk, whether it’s a premonition or maybe my sense of smell is working extra-well, I will usually know when and where a colony of vanilla plant is growing long before coming into view of the leafy plants.

Vanilla plant is about ready to bloom in this August photo


That’s because vanilla plant leaves contain coumarins, substances that drift across breezes and evoke thoughts of freshly mowed lawns and a touch of sweet spice.  Yes, I always know the vanilla plant is growing along the trail long before I ever see its foliage. The plant’s sweet spice fragrance usually surprises me in the most unexpected of natural areas, those where the dirt is sandy and nutrients under the pine canopy are limited.


On my hikes I’ve come over time to know where the trail side vanilla plants grow; in the dunes, between clumps of saw palmetto and up through fallen flatwood pine needles.  Sometimes my thoughts are elsewhere and I’m not expecting the aromatic, breeze laden spice emitted by the plant but mostly now I look forward to waves of fragrant pleasure around the bend where vanilla plant grows.   It's not just me either; for many people unknowingly acknowledge vanilla plant’s presence with surprised and whispered words such as, ‘the air smells so fresh out here today’.

Vanilla plant about to bloom


Once one becomes familiar with vanilla plant’s foliage (it is easy enough to identify the plant)  the enjoyment begins to take on even more intensity as we begin to look for the herb so as to crush the alternate stem clasping leaves and release novel breezes of spicy freshness.  Some say the odor is strongest when the leaves are dry, yet to my sense of smell even the green leaves emit powerful notes of freshness.  Written and oral history both have documented many ethnobotanical uses of the vanilla plant.  Dried leaves have been used to make teas and on a much more economically significant scale, vanilla plant has been harvested by the ton to blend with tobacco as a spicy flavoring.  


Vanilla plant’s sweet scents also offer clues to the herb’s medicinal importance. The plant's fresh aroma is attributed to it's hefty coumarin content.  Synthesized in the plant from sunshine, water, CO2 and dirt, coumarins possess anticoagulation properties in mammals and the aromatic substance may prevent vitamin K factors from completing blood clotting.  Plants such as sweet clover, cherries, tonga beans (the bean used to make Mexican vanilla), and others contain coumarins too.


The potential for bleeding from larger amounts of coumarin ingestion has led to FDA warning statements being associated with its culinary use.  Vanilla plant’s coumarin content makes this plant’s use for human consumption potentially problematic from a governmental regulatory perspective.  But if there were ever a societal breakdown t where pharmaceuticals were off the market then the respective governmental regulatory perspective would be meaningless.


Fermented sweet clover, Melilotus spp. is another plant rich in coumarins and the actual basis for the invention of the anti-coagulant pharmaceutical, warfarin.  Cattle dying from blood loss in Wisconsin were discovered to have been eating fermented sweet clover. Ultimately, warfarin, an important anticoagulant medicine was developed from the fermented clover coumarins.   Sweet clover, Milelotus spp., however is classified in a different genus than the common red clover, Trifolium spp. Yet red clover too contains coumarins and has been the documented cause of bleeding issues in humans.  Most importantly here is the fact that nature does provide us with coumarins, the basis for modern day anticoagulants, from a variety of different plant species, including vanilla plant, Carphephorus odoratissimus.


Today most anticoagulants are synthetically created in laboratories around the world.  Yet plant phytochemicals can also offer an alternative approach if necessary.  Unfortunately plant extracts are also difficult to standardize for concentration and may lead to harmful dose administrations.  Personally, I believe we humans taking pharmaceutical medicines should understand the basic chemistry behind the drugs we ingest, including the ethnobotanical history of the plants from which the drugs were first isolated.  Part of that understanding involves the realization, like the recent losartan recall and trade embargos, manufactured drugs may not always be available.


Many people depend on anticoagulants to treat stroke, arrhythmias and to maintain and care for manufactured heart valves.  A sudden stoppage of warfarin availability could be catastrophic from a health perspective for a large population segment.  Of course the chances of a class of widely used pharmaceuticals becoming unavailable are relatively small.  Yet with the uncertainty we’ve seen emerge from the Covid 19 pandemic and the aforementioned drug recalls, there does exist a very real level of stress associated with the worry of ‘what will I do if my warfarin is no longer available’.


I probably will never turn to vanilla plant for answers to an anticoagulant shortage.  More than likely warfarin will always be available to pick up from the local pharmacy.  But for me, a ‘type A’ individual who always is analyzing risk management issues, simply encountering the fresh scent of vanilla plant coumarins on my nature walks, affords me hope that if I was faced with a lack of anticoagulants for my artificial heart valve, vanilla plant may be a hope in time of crises.  Nature always offers answers to most questions.


Vanilla plant’s scent and coumarin content are usually the strongest in late summer, when blooming occurs and as leaves begin to dry on the stem.  Swaths of bright purple blooms cover the plant with resplendent royal hues typically found on late summer flowering plants.  The color purple is often associated with summer time flowering. In addition to vanilla plant, plants that bloom summer purple include; the closely related deer tongue, blazing star, purple coneflower, clematis, passionflower, ageratum, verbena, chaffweeds, spotted beebalm, thistles and salvias.


Purple blooms are also interwoven into the schedule of shortening days and lengthening twilight.  As the summer daylight hours begin to diminish in length, purple wildflowers seem to proliferate across the landscapes.  Moreover, purple wildflowers find a place in mythology with unicorns, fairies and various traditional priests, gods and priestesses expressing royal themes cloaked in purple.  Of course the supple, rich hues and textures of vanilla plant’s blossoms call out to be an eye-catching part of any floral arrangement. I have picked my share of Carphephorus flowers over the years, even if just to hang on our SUV’s sun visor for a short time.


There are also many good reasons for leaving vanilla plant’s flowers in the flatwoods.  Butterflies, moths, bees and other pollinators are attracted to vanilla plant in search of nectar.  Though the species is lovely and I may be tempted to plant around the home garden (and I may yet), Carphephorus grows best in a fire impacted ecology.  Botanical studies have shown how vanilla plant, along with other Carphephorus species, actually flower longer when growing in wildfire impacted habitat.


Vanilla plant is just one of the many important native wildflowers and plants found in most of our local forests and conservation areas.  Because of the plant’s strong coumarin leaf fragrance and striking wildflower beauty, vanilla plant is easy to recognize.  I am grateful for the coumarins in this plant, its functional beauty and special place in our surrounding ecology.


I may never have to turn to vanilla plant to extract coumarins for anticoagulant use, however just knowing I could if I had too makes me appreciate this marvelous scented and beautiful flowering species even more.  Hope is always nearby in the flatwoods.


Saturday, August 10, 2013

Coumadin Lifestyle, Bruising and Bleeding with Marfan Syndrome

Coumadin, is just a dreaded anti-clotting drug that just needs to be understood (yeah, right!).

Bruising and Bleeding with Coumadin
Even though I've been taking Coumadin for twenty one months now there are times when life's normal activities appear to be doable, but wishful illusion quickly fades away with bruises, bleeding and orange skin.

The other day Ruairi and I replaced spark plugs and wires in the car.  Leaning over the motor I braced myself with my right arm, something I'd done many times before during my pre-Coumadin life era.

Three days later I still have a large and quite painful arm bruise, many other small bruises and lots of nicks and cuts scabbing over.  So predictably, I have to periodically remind myself, 'therapeutic Coumadin life has its own set of requirements that must be adhered to or there will be painful consequences'.

I think I can do something I used to be able to do.  Nope.  Not anymore.

So score another for the great drug that keeps me alive, keeps blood clots from forming around my St. Jude mechanical heart valve but also is responsible for all the nasty little
side effects.

And it helps me to go back and re-read this post about Coumadin from time to time because I quickly forget what the drug actually does to keep me alive and of her side affects.  So here is my Coumadin post...

----------

It happened again.  Out of nowhere comes a slow steady dripping, bright red blotches Jackson Pollock style across the open book page, table or as it was with yesterday's event, all over the shiny white bumper of the Lincoln.  The unmistakeable metallic scent of fresh blood fills my nose but as usual there is no pain, no twinge of a prick or sting of a slicing cut.  The ever increasing amount of afternoon sun brilliant, lipstick red blood splatter now has my explicit attention.

Warfarin and St. Jude Aortic Valve #Marfan
After being on warfarin, also known as Coumadin, Jantoven, Marevan, Lawarin and other brand names, for going on a couple years I now know and am familiar with the whole drippy routine.

First task is to find the source of the flowing blood.  Usually the best places to look are the toes, feet, fingers or head, depending upon where one is in the house or yard at the time the red splots start appearing.  Chances are if I am in the kitchen then the blood will be forehead presenting and a sharp cornered cabinet door probably open.  Yet kitchens too are notoriously awful places for the feet if the teens are in a hurry sweeping up glass shards of an accidentally dropped ceramic mug.

However if I am in the yard, I can expect the red alert will be the result of a garden utensil hiding in the grassy paths. 

Blood in the bathroom is primarily indicative of a head wound from the shower door frame and so forth and so on.

The key to this entire blood thinner/anti-coagulant lifestyle is to find the cut or poke quickly, before you loose a quart of life's thirst quencher.  So yesterday when the red blotches started covering the rear bumper of the Lincoln I headed for the bathroom sink, mirror, hydrogen peroxide and band aids. 

A big mirror will usually tell you right away about the blood's origin without an unnerving shriek the teens or my spouse usually emit as I walk by covered in red.

Laughingly I can honestly say, life on anti-coagulants is not really as bad as it sounds.  When I first started taking Coumadin I heard all kind of negative or bad comments like 'OMG!" and 'I can't believe you have to be on that horrible drug the rest of your life!'.  Other words of encouragement included statements like 'my mother's skin turned bright orange!' or 'my Uncle bled out before' and (really heard this one) 'Shit!  That stuff is rat poison!'.  Even a TEDx talk I watched about aortic aneurysms decried the blood anti-coagulant I was taking.

Understandably, Coumadin and I had a not too happy introduction.

But perception can be quickly changed once one acquires hands on experience.

Yes, it is true Coumadin, the anti-coagulant I was and still am taking, is used as rat poison.  However the more I researched this plant-based miracle drug, the less uncomfortable I became.

Don't get me wrong.  I  wish I never had to take any of the many medications I have to take.  But in reality the Coumadin scare was mostly hype.

Warfarin allows my St Jude device to function without clotting

Again, please don't get me wrong.  I am sure some people have bled and coded out from the drug's use, but a quick meal of fresh garden collard greens or broccoli should stop any bleeding as vitamin K is the antidote for Coumadin overdoses.  I am also sure that there are some Coumadin taking bright orange people walking around out there too.

But what was really interesting was finding out why Coumadin is used as a rat poison and the history behind the drug's discovery!

Back at the beginning of the twentieth century there were incidences of cattle dying after being castrated or dehorned, bleeding to death, their bodies unable to develop and implement the normal clotting and healing process.

Researchers at the University of Wisconsin, including Karl Link and clinics suspected that there was something in the cattle's diet was responsible for their inability to clot when wounded and bleeding.

Studies showed that there was a compound in the fermented clover the bulls were ingesting which interfered with prothrombin, the substance responsible for clotting action.  Further tests isolated a coumarin compound called dicoumarol.  Interestingly, though the clover produced the basic coumarins it was the fungi responsible for the moldy clover that actually converted the coumarins into the dicoumarol.

Without a medical use apparent, scientists and industry looked at and began using the dicoumarols as rodent poison.  When the rats ate the drug they bled out.  The substance interferes with vitamin K metabolism and as we know, vitamin K is essential for our blood clotting process.

One of the first human applications was Dwight Eisenhower when he was provided the drug after a heart attack in 1955.

Coumadin's other name, Warfarin, is actually derived from a combination of the words found in the phrase 'Wisconsin Alumni Research Facility' and the word 'coumadin'.

Coumadin or Warfarin is important to me and many others because the anti-clotting effects allow for foreign objects in our body to function with reduced risk for the potential of blood clot formation.  For me this means warfarin allows my St. Jude aortic valve to open and close for many years without sticking due to clot formation (that could be fatal).  Disconcertingly though, data shows that Warfarin use has its risks and mortality due to hemorrhaging does occur.

Yet to date my bleeding has been manageable.

I do wear a bike helmet when cycling and always take a cautious approach when participating in activities with potential for serious trauma, carrying a variety of tape, band aids and antibiotic ointments in my backpack.  Backpack and band aids go where I go, be it for a short walk or trip to the store or even over to a relative's house.

Checking my PT/INR is easy.  INR stands for 'international normal ratio' and PT is 'prothrombin time' and both are used to calculate the body's clotting time efficiency.  Usually I will ask my daughter or wife to take me to the neighborhood medical laboratory, about a mile away for my once a month PT/INR test.  The lab sends the results to my primary care doctor who reviews the results and then either adjusts my dosage or says 'all looks good' and I wait until next month for another test.

I take on average about 5 mg Coumadin each day.

And I've learned to type on the IPad with a band aid or two on my fingers, though this feat is not an easy one to become accustomed to.

Rest assured, I am not super excited about being on anti-coagulants for the rest of my life.  Yet Coumadin is not as bad as I first imagined.

I am super happy the obnoxiously loud St. Jude aortic valve in my chest is still working as designed, and appreciative that Coumadin helps keep the device from clogging up with fibrous clot material.

And the frequent red splots don't surprise me now as much as they once did.  Thank goodness for fermented cover.

Tuesday, May 28, 2013

Warfarin Lifestyle, Aortic Dissection and a St. Jude Device, #Marfan Syndrome

It happened again.  Out of nowhere comes a slow steady dripping, bright red blotches Jackson Pollock style across the open book page, table or as it was with yesterday's event, all over the shiny white bumper of the Lincoln.  The unmistakeable metallic scent of fresh blood fills my nose but as usual there is no pain, no twinge of a prick or sting of a slicing cut.  The ever increasing amount of afternoon sun brilliant, lipstick red blood splatter now has my explicit attention.

Warfarin and St. Jude Aortic Valve #Marfan
After being on warfarin, also known as Coumadin, Jantoven, Marevan, Lawarin and other brand names, for going on a couple years I now know and am familiar with the whole drippy routine.

First task is to find the source of the flowing blood.  Usually the best places to look are the toes, feet, fingers or head, depending upon where one is in the house or yard at the time the red splots start appearing.  Chances are if I am in the kitchen then the blood will be forehead presenting and a sharp cornered cabinet door probably open.  Yet kitchens too are notoriously awful places for the feet if the teens are in a hurry sweeping up glass shards of an accidentally dropped ceramic mug.

But if I am in the yard, I can expect the red alert will be the result of a garden utensil hiding in the path.  Blood in the bathroom is primarily indicative of a head wound from the shower door frame and so forth and so on.

The key to this entire blood thinner/anti-coagulant lifestyle is to find the cut or poke quickly, before you loose a quart of life's thirst quencher.  So yesterday when the red blotches started covering the rear bumper of the Lincoln I headed for the bathroom sink, mirror, hydrogen peroxide and band aids.  A big mirror will usually tell you right away about the blood's origin without an unnerving shriek teens or a spouse usually emit as I walk by covered in red.

Laughingly I can honestly say, life on anti-coagulants is not really as bad as it sounds.  When I first started taking warfarin I heard all kind of negative or bad comments like 'OMG!" and 'I can't believe you have to be on that horrible drug the rest of your life!'.  Other words of encouragement included statements like 'my mother's skin turned bright orange!' or 'my Uncle bled out before' and (really heard this one) 'Shit!  That stuff is rat poison!'.  Even a TEDx talk I watched about aortic aneurysms decried the blood anti-coagulant I was taking.

Understandably, warfarin and I had a not too happy introduction.

But perception can be quickly changed once one acquires hands on experience.

Yes, it is true warfarin, the anti-coagulant I was and still am taking, is used as rat poison.  However the more I researched this plant-based miracle drug, the less uncomfortable I became.

Don't get me wrong.  I  wish I never had to take any of the many medications I have to take.  But in reality the warfarin scare was mostly hype.
Warfarin allows my St Jude device to function without clotting

Again, please don't get me wrong.  I am sure some people have bled and coded out from the drug's use, but a quick meal of fresh garden collard greens or broccoli should stop any bleeding as vitamin K is the antidote for warfarin overdoses.  I am also sure that there are some warfarin taking bright orange people walking around out there too.

But what was really interesting was finding out why warfarin is used as a rat poison and the history behind the drug's discovery!

Back at the beginning of the twentieth century there were incidences of cattle dying after being castrated or dehorned, bleeding to death, their bodies unable to develop and implement the normal clotting and healing process.

Researchers at the University of Wisconsin, including Karl Link and clinics suspected that there was something in the cattle's diet was responsible for their inability to clot when wounded and bleeding.

Studies showed that there was a compound in the fermented clover the bulls were ingesting which interfered with prothrombin, the substance responsible for clotting action.  Further tests isolated a coumarin compound called dicoumarol.  Interestingly, though the clover produced the basic coumarins it was the fungi responsible for the moldy clover that actually converted the coumarins into the dicoumarol.

Without a medical use apparent, scientists and industry looked at and began using the dicoumarols as rodent poison.  When the rats ate the drug they bled out.  The substance interferes with vitamin K metabolism and as we know, vitamin K is essential for our blood clotting process.

One of the first human applications was Dwight Eisenhower when he was provided the drug after a heart attack in 1955.

The name warfarin is actually derived from a combination of the words found in the phrase 'Wisconsin Alumni Research Facility' and the word 'coumadin'.

Warfarin is important to me and many others because the anti-clotting effects allow for foreign objects in our body to function with reduced risk for the potential of blood clot formation.  For me this means warfarin allows my St. Jude aortic valve to open and close for many years without sticking due to clot formation (that could be fatal).  Disconcertingly though, data shows that warfarin use has its risks and mortality due to hemorrhaging does occur.

Yet to date my bleeding has been manageable. 

I do wear a bike helmet when cycling and always take a cautious approach when participating in activities with potential for serious trauma, carrying a variety of tape, band aids and antibiotic ointments in my backpack.  Backpack and band aids go where I go, be it for a short walk or trip to the store or even over to a relative's house.

Checking my PT/INR is easy.  INR stands for 'international normal ratio' and PT is 'prothrombin time' and both are used to calculate the body's clotting time efficiency.  Usually I will ask my daughter or wife to take me to the neighborhood medical laboratory, about a mile away for my once a month PT/INR test.  The lab sends the results to my primary care doctor who reviews the results and then either adjusts my dosage or says 'all looks good' and I wait until next month for another test.

I take on average about 5 mg warfarin each day.

And I've learned to type on the IPad with a band aid or two on my fingers, though this feat is not an easy one to become accustomed to.

Rest assured, I am not super excited about being on anti-coagulants for the rest of my life.  Yet warfarin is not as bad as I first imagined.

I am super happy the obnoxiously loud St. Jude aortic valve in my chest is still working as designed, and appreciative that warfarin helps keep the device from clogging up with fibrous clot material.

And the frequent red splots don't surprise me now as much as they once did.  Thank goodness for fermented cover.