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Submitted photo Phaedra McDonough

Coumadin (also known as Jantoven or warfarin) is a common medication used to prevent blood clots and strokes. Unlike many other drugs, however, it requires careful monitoring by the prescribing medical provider to keep it in a target range. When well managed, Coumadin is a safe and very effective medication.

Coumadin is an antithrombotic, or "blood thinning" medication. Medical reasons for prescribing treatment with Coumadin include:

• A trial fibrillation (when rapid, disorganized electrical signals cause the heart's two upper chambers to contract very quickly and irregularly),

• Mechanical heart valves

• Stroke

• Pulmonary embolism (the sudden blockage of a major blood vessel in the lung, usually by a blood clot)

• Deep vein thrombosis (when a blood clot forms in the deep veins of your body, usually the leg).

Most patients are prescribed the generic form of Coumadin known as warfarin. Because the management of conditions that require the use of Coumadin can be complex, Coumadin Clinics have been developed at health care facilities across the country to monitor and adjust patients' Coumadin doses as needed. The Brattleboro Memorial Hospital Coumadin Clinic opened in February of 2014 and currently serves over 150 people in our community.

When a patient's medical provider refers them to the BMH Coumadin Clinic, they set the parameters for monitoring the concerns they would like us to watch for. Patients are seen quickly, and the results of their testing are communicated immediately to them.


At the first visit, each patient receives comprehensive education on the various aspects of taking Coumadin. At each subsequent visit, which usually lasts 10-15 minutes, we evaluate the blood levels of Coumadin using a finger stick blood evaluation, rather than the needle that is typically used in standard laboratory venous blood draw. We use a standardized chart to adjust the dosage as needed, and assess any possible drug interactions. We work very closely with each patient's medical care provider, who also is able to see the results immediately address any adverse effects from taking Coumadin.

The clinic is staffed by a trained medical assistant, Tonia Smith, under the supervision of Phaedra McDonough, APRN and the Director of Cardiovascular Services, Dr. Mark Burke. Patients enrolled in the clinic become familiar with our staff, which helps to decrease the anxiety that can be associated with taking a medication that requires close monitoring.

Our office is located in the Richards Building in the Center for Cardiovascular Health and is open Monday through Friday 7:30 a.m. to 2 p.m. For more information call 802-275-3699.