DEAR DR. GOTT:
I am facing a dilemma regarding medication. Following a diagnosis of atrial fibrillation, my internist and cardiologist very strongly say I must be on Coumadin to reduce my chance of stroke.

I am not interested in doing this if there is any other possible alternative. I would appreciate your thoughts on this matter.

DEAR READER:
Many studies have proven that atrial fibrillation (an erratic, fast pulse rate) can cause a stroke if a clot forms within the heart, breaks off, and is carried to the brain. Warfarin (Coumadin) appreciably reduces this risk. Therefore, I advise you to follow your doctors’ recommendations.

Coumadin is available in pill form, is inexpensive and easy to monitor. To my knowledge, there are no other inexpensive substitutes. Plavix is another pill, but is expensive and may need to be combined with aspirin for optimal effects. Other anti-coagulant drugs (such as heparin) are given by injection, are expensive and are not suitable for home care.

I suggest you take the Coumadin. With proper dosing and monitoring, it is safe.

To give you related information, I am sending you a copy of my Health Report “Coronary Artery Disease”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.