Bridge questions

[William]

Hi Folks, I got my INR (good at 3.1) yesterday and talked to the tech about my hernia operation sometime in May. She relayed the words to my Cardio Doc and things came back that were different from what the surgeon told me. Mainly, I can't use Lovnox (spelling ?) at home and have use Heperan (spelling ?) at the hospital to bridge the Coumadin. The tech and myself were not sure if that meant being admited into the hospital days before the surgery or just going there for the shots. I'll see the surgeon in a month to sort this out, but does anyone have any insight into this kind of situation? Will

 

[Barry]

When I got my pacemaker installed, they admitted me to the hospital 2-3 days (can't remember) before the operation and put me on Heparin.

 

[Nancy]

Joe has had Heparin IV in the hospital for bridging. It's a pain, but a good way to go. It does mean that you will be admitted to the hospital early and will have to wait until your INR gets to operative level, while the Heparin keeps you safe.

He has also had Lovenox bridging once that was OK, and a second time which was a total disaster.

He will never use Lovenox for bridging again, Fragmin either.

I am glad your doctor has decided on Heparin for you.

 

[tommy]

William,

I had an inguinal hernia repair using Lovenox Bridge. Now in 3rd week of LB for conoloscopy. Just can't get the bleeding to stop. Not significant blood loss, just preventing me from going back to Coumadin. I'm curious why your doc doesn't want you to use Lovenox?

Nancy, what was Joe's Lovenox disaster?

 

[Nancy]

Joe had gallbladder surgery, and had a TOTAL bleedout requiring 33 units of blood products to save him. He was on a Lovenox bridge prior to surgery, and we believe Lovenox contributed to the bleed, might not have caused it, but kept it going uncontrollably. Right after, his cardiologist's office stopped using Lovenox for bridging.

He had a second surgery two days later to clear his abdominal cavity of excess blood and fluid because it was pressing on his heart. He was hospitalized for a couple of weeks, he came very close to dying. His recovery was extensive and lasted the better part of 6 months. He was sent home in very "shocky" condition, with extremely low blood-pressures, and had to have visiting nursing care.

Sylvia Yasgur's dad had a similar thing happen, just recently. Look up her posts.

Also Al Lodwick had some excellent insight on kidney function and the use of Lovenox.

For those who are interested, you could do a search on Lovenox and will probably come up with all of these posts. Do a search on gallbladder as well, and you might pull up some of my ancient posts on Joe's problems as they occurred.

 

[William]

Wow, that was a disaster that Joe went through! Tom, it had something to do with a possible "relapse" to go with the Heparin. I'm not sure what the Cardio Doc is talking about, but when I meet with the surgeon next month, I'm make sure they talk to each other about this. Will

 

[Lisa in Katy]

I had a Lovenox bridge prior to Hysterectomy and my recent wire removal with no problems. In fact, the morning of surgery, my INR was only 1.1 and a weeks later after finishing the Lovenox and going back on Coumadin, only 1.5. We had to boost a little to get it back where it needed to be.

 

[Guest]

The odd thing about going to the hospital and getting a heparin drip as bridge therapy is that there has never been a study done to prove that this is safe and effective. Heparin is so old that doctrors assume that it is tried and proven safe but it has not been.

Fragmin and Lovenox have been tested and shown to be effective, but not to the level of "proof" that the FDA wants.

No type of bridge therapy is approved by the FDA.

The bottom line is that some doctors feel safer putting you in the hospital and doing a "by guess and by golly" treatment than using a somewhat more tested procedure as an outpatient.

 

[Granbonny]

I am at my 3rd year..Ann. with my valvereplacement...and just now thinking at my age What if?..What if, I need some type of surgery? Still have most of the Female parts Just 1 ovary gone at age 20...and they told me I may not be able to have babies..DUD, 2 in 2 years WRONG. That 1 other ovary was working overtime ....Back to needing surgery..I think I would want to go into the hospital for a heparin..IV(Hoping that it will never happen, tho)..... Would it depend on your surgeon's decision, Insurance????or My decision?....Bonnie