Several years ago, John Coen learned he had atrial fibrillation (AFib), which occurs when the top two chambers of the heart, known as the atria, quiver or flutter instead of fully contracting which produces a rapid, out-of-sync heartbeat.  During a routine checkup, John’s primary care physician detected an irregular heartbeat and ordered an electrocardiogram (EKG) to determine if John had AFib.  The condition is not always easy to detect because many patients, including John, experience no symptoms. 

The irregular heartbeat caused by AFib can lead to blood collecting in the heart and forming a clot that may travel to the brain, cut off the oxygen and blood supply, and cause a stroke.  To prevent blood clots from forming, John was prescribed Coumadin (warfarin) – an anticoagulant, or blood thinner, that requires careful monitoring for patient safety.  The most common side effect of Coumadin is bleeding in tissues or organs.  It is important for patients to have a prothrombin time (PT) and International Normalized Ratio (INR) blood test regularly to help the physician determine the blood clotting rate and whether the dosage should change.  The testing is vital and must be accomplished at recommended intervals in order to keep the PT/INR result in the safest range for the medical condition.

After his diagnosis, John was referred to the Licking Memorial Hospital (LMH) Medication Therapy Clinic.  The Clinic works with the patient to create a treatment plan, and teaches the patient and their family members about correct dosing and signs and symptoms of complications.  “At first, I was upset and worried about having to take medication, but the Medication Therapy Clinic staff explained why I needed it,” said John.  “They were very helpful because the information can be difficult to understand.”  John visited the clinic frequently until the PT/INR was properly regulated.  Now, the visits are scheduled every 4 to 5 weeks in order to ensure the proper blood clotting rate.

The Medication Therapy Clinic is a service directed by a physician and staffed by clinical pharmacists and registered nurses with specific knowledge of anticoagulation therapy.  Blood testing and other laboratory studies generally are performed on-site in the clinic.  Regular communication with the patient’s primary care physician occurs throughout the patient’s care.  “The nurse greets us when we arrive at the Clinic, discusses my current state of health and notes any changes, including my diet,” John explained.  The pharmacist then visits with John and reviews all the information to decide if adjustments are needed in the dosage.  John also is required to regularly meet with his primary care physician, Nina P. Hourmouzis, M.D., of Licking Memorial Internal Medicine, for follow-up care.
 
For patient safety, the Medication Therapy Clinic staff coordinates with other Licking Memorial Health Systems (LMHS) providers when procedures or other types of testing are required.  Since John is at risk for colon cancer, he recently was scheduled for a colonoscopy and had to stop taking Coumadin for five days to lower the risk of bleeding during the procedure.  The Clinic staff made adjustments to John’s dosage to prepare him for the colonoscopy.  “I was concerned about how much of my medication I was supposed to take, and the Clinic staff made sure I was on the right dose,” John said.  “Everyone at LMHS has always been very attentive and caring.”  A week after the gastroenterologist removed several small polyps, John returned to the Medication Therapy Clinic to check his blood clotting levels and readjust his dose of Coumadin.

John has been a barber for 49 years, and continues to work part-time at a shop in Heath located on Route 79.  His wife, Ruth, was a registered nurse and retired from LMHS in 2005.  She continues to volunteer at Licking Memorial Hospital.  The couple has been married for 54 years and have two daughters.  Polly Prouty is a teacher in Johnstown, and Deborah Savage is a Regional Vice President for AVI Food Systems, Inc.  John and Ruth enjoy spending time with their daughters and their granddaughter, Alyssa Savage.