I really resent it when people force me to defend Hillary Clinton, but they can't seem to stop. In an article dated from yesterday, I read of one Dr. Wolf declaring that Hillary's warfarin (aka Coumadin) prescription is very odd because it's never prescribed to someone who is otherwise healthy and can afford ‘safer’ anticoagulants:
Dr. Milton Wolf, a board-certified radiologist, writes, ‘Coumadin carries a substantial risk for patients, particularly those with fall risk. Spontaneous hemorrhage common, intracranial and elsewhere. I see it commonly, including life-threatening brain bleeds. Normal, healthy patients are NEVER, NEVER prescribed Coumadin.’ There are safer anticoagulants. ‘Coumadin is typically given to those who can’t afford the newer drugs or reserved for cases that are refractory to the safer drugs.’ Wolf speculates that Clinton probably has a hypercoagulable blood disorder. Coumadin would otherwise be given only to patients with chronic atrial fibrillation (like the vets) or with prosthetic heart valves, both of which can cause hypercoagulation.
With apologies to Jay Michaels, the author of this article, this is bullshit. (It's not clear that Dr. Wolf's observations are out of line so much as Michaels' context.) I have two friends who are permanently on warfarin, both of whom are ‘otherwise healthy’ and can afford other anticoagulants. In the case with which I am most familiar, my friend had a stroke and a dvt within short order. Having solved the immediate problems, doctors determined after a short trial that my friend's dosage and results were stable with warfarin (sometimes that's a tough thing to accomplish with warfarin due to its interactions with various food and drink), so that's what they stuck with. On the other hand, neither of my thick-blooded friends requires help getting up a short flight of stairs or from sidewalk to limo, and neither is subject to random faceplants, so maybe the guy is on to something.
Anyway, in the real world, most doctors go with the least expensive effective medicine. The problem is well solved, so why spend more even if the patient can afford it? But that's the real world, not the febrile world of political commentary.