Conversation: The conversation between human and AI assistant.
[|Human|] My 88 year old father in law recently had mitral valve replacement, one stent, and a pacemaker procedure. He only has one functioning kidney and has had a minor stroke several years ago. He is currently taking Plavix and suffering from extreme fatigue, nausea and nose bleeding. His PA has prescribed Effient; however, he is refusing to take it because of the side effects. Thank you!
[|AI|]  Hello. I myself would not advise to change to effect as it is a more Putnam blood thinner than Plavix. It also depends on the time elapsed after the angioplasty. If it is more than 6 months you can stop one blood thinner (considering he is on esprit and Plavix), for about 5 days. Other things apart you have to get his stomach checked for active bleeding because he is on blood thinners, having omitting, dizziness and fatigue. (bleeding can cause low hemoglobin and lead to above symptoms. A complete blood count will help for a start. If the hemoglobin is lower than his usual hemoglobin, we have to find a cause for the bleed, if any. Otherwise he can be safely on either esprit 150 mg or Plavix 75 for 5 days and then restarted as soon as bleed settles. An ENT opinion will also help. Thank you best wishes