When Nicole was 28 years old and fighting off what she thought was the flu, she suddenly became incredibly unwell.  Her body ached, her head pounded and she was extremely thirsty and nauseous.  Nicole’s GP made a house call and, as soon as he took her temperature and listened to her heart, called an ambulance. It turned out the flu she thought she was fighting was actually bacterial endocarditis and she had a severe infection attacking the mitral valve of her heart. 

Nicole was in the early stages of heart failure and needed open heart surgery to repair the valve.  She spent the next 10 weeks in hospital fighting infection and having mitral valve replacement surgery.  The consequence of this was having to be on warfarin for the rest of her life to prevent clots forming on the artificial valve. 

Since the surgery Nicole has had blood tests as often as three times a week to monitor her INR level (International Normalised Ratio), used to measure the time taken for blood to clot and to monitor blood-thinning medicines. This ensures she is taking the right dose of warfarin to keep her blood in the correct range. 

In May 2015 Nicole had what is called a Transient Ischemic Attack, or a mini-stroke.  Her INR had dropped below therapeutic levels. She had to have Clexane injections in her stomach for 14 days until her warfarin levels stabilised and she was back in the therapeutic range. 

Nicole was referred to Professor Baker who added aspirin to her medication regime as this works on a different part of the clotting process than warfarin does, and would better protect her against the risk of future clots.

“I’m incredibly lucky to have Professor Baker as part of my team of doctors as I know they will keep me safe” Nicole 

As a consequence of being better protected against clots forming on her valve, a new problem was created.  Nicole was no longer able to take the contraceptive pill as it increases the chance of stroke, and she was taking two anti-coagulants.  Heavy menstrual bleeding left her extremely lethargic and anaemic.

After speaking with Professor Baker and a gynaecologist Nicole decided the best option for her was to have an endometrial ablation and to have her fallopian tubes removed.  The surgery went well and Nicole was recovering when, nine days later, she haemorrhaged.

It took three trips to surgery and some ingenious techniques from her doctors to control the bleeding.  It was a tricky balancing act to keep her INR level thin enough to keep her safe from stroke but thick enough so she would stop haemorrhaging.

Nicole didn’t realise when she had the heart surgery years ago that so many issues would arise as a result.  She has essentially been made a ‘bleeder’ in order to keep her safe from clots and a stroke, but keeping her safe in this way presents its own set of issues.  However Nicole is grateful that, each time something has happened, she has come through with the support of her medical team. 

“I would like to acknowledge the expertise of Professor Baker and the support of the Perth Blood Institute in the care of people with blood disorders” Nicole