I (John), being raised in Pennsylvania, took a college class about the geography and history of my home State. One region we learned of was “The Land of Milk and Honey,” also known as the Wyoming Valley in the northeastern part. Honey implies bees and bees need blossoms, and blossoms need, what else, Sweet Clover. [The Wyoming Valley played an important role in the Revolutionary War, including an early battle and later providing food for soldiers.]
Down through the years from the time of settlement sweet clover has been used as a cover crop (for green manure) and as a hay crop in northern U.S. and Canada. A problem can develop because a component of sweet clover is coumarin. It has a sweet scent, readily recognized as the scent of newly-mown hay. Some say it smells like vanilla. In its succulent stems Sweet Clover hay can harbor fungi, some of which can transform the coumarin into an anticoagulant called dicoumarol.
Anticoagulants can be useful or deadly. Sweet clover was widely used as hay in the early part of the 1900s when a series of wet summers, and lush clover, led to an epidemic of “bleeding disease” in cattle. One such place this occurred was in Deer Park, Wisconsin in the northwest part of that state. In 1933 a farmer from Deer Park showed up at the School of Agriculture and walked into a professor’s laboratory with a milk can full of blood which would not coagulate. In his truck, he had also brought a dead heifer and some spoiled clover hay. He wanted to know what had killed his cow. When the researchers succeeded in isolating the anticoagulant the Wisconsin Alumni Research Foundation (known as WARF) became involved in seeing that the University benefited from the commercial application of the compound. For a name they concocted Warfarin from WARF + (coum)arin. A major early use was for rodent killer. The compound Warfarin Sodium is marketed by the global biopharmaceutical company Bristol-Myers Squibb as Coumadin®.
Coumadin® (Warfarin Sodium) is used to help prevent and treat blood clots in the legs, lungs, and those clots associated with heart-valve replacement or an irregular, rapid heartbeat called atrial fibrillation. Despite its effectiveness, treatment with Warfarin has several shortcomings. Many commonly used medications interact with Warfarin, as do some foods, and its activity has to be monitored by frequent blood testing for the international normalized ratio (INR) to ensure an adequate yet safe dose is taken. The test is used to determine the clotting tendency of blood.
After trial-and-error adjustments over the last couple of months Nancy’s INR has just recently settled into the desired range. Thus, it seems the appropriate dosage for her has been determined given her current diet, exercise, and whatever else is involved.
So yesterday she stopped taking it.
We are in the approach period for the implantation of a cardioconverter-defibrillator. The clotting ability of her blood has to happen faster for the procedure to be safe, that is, excessive bleeding is to be discouraged.
We expect the implantation to be on Tuesday, June 1, mid-morning. One night in the hospital is scheduled and she should be back home by late afternoon on Wednesday.
We’ll celebrate with a warm toasty muffin spread with Sweet Clover honey.