Bonbet
Well-known member
Hi folks. I've been gone awhile-long story. So I was doing pretty fine with my On-X valve which I got May 24, 2017.
Back at gym, INR freakishly stable. This January I received a diagnosis for invasive ductal cancer and I am headed for a likely lumpectomy in a couple of weeks. The bridging for my biopsy was badly botched by the surgeon who I subsequently fired.
Since it all happened so fast, I was a bit slow on the uptake of information. (btw-have ordered a home monitor but it is a lot of red tape to get one here in the USA.) I have a consult tomorrow at the Knight Ca Center at OHSU tomorrow and have inquired about their bridging protocol - which hopefully they will address tomorrow.
In the meantime, I contacted my cardiologist form Mayo with this question that I have been asking all providers to no avail.
If my therapeutic range is 1.5 to 2.5, couldn't I dose down to 1.6 or so and avoid bridging altogether? This occurred to me when the biopsy DR. said that even though I was bridging with Lovenex they would not perform the procedure unless my INR was below 1.9
Well couldn't I have just brought the INR down to 1.6 or so and have been in range therapeutically and reduce the risk of bleeding form the Lovenex. (Which I did. A hematoma formed at the biopsy site and that ended up obscuring the MRI that I had the following week making it inconclusive.)(If you ever have to do this then be sure that they do the MRI before the biopsy!)
Not to mention my abdomen was a huge purple and red hematoma by the time the bridging was completer.
Anyway, my cardio said that as a low risk person with a Mech valve - meaning no previous strokes and no Afib - I don't need to bridge at all. I can just stop the warfarin for 1-3 days before the procedure and the same after the procedure. He said being off of warfarin for 5-7 days is considered safe. He said that if the surgeon wanted to do the procedure with my "low range" INR that is basically up to the surgeon. He also said to NEVER stop the low-dose ASA.
So, what do you think about that??!!
Bonbet/or McBon I am not sure what they call me these days.
Back at gym, INR freakishly stable. This January I received a diagnosis for invasive ductal cancer and I am headed for a likely lumpectomy in a couple of weeks. The bridging for my biopsy was badly botched by the surgeon who I subsequently fired.
Since it all happened so fast, I was a bit slow on the uptake of information. (btw-have ordered a home monitor but it is a lot of red tape to get one here in the USA.) I have a consult tomorrow at the Knight Ca Center at OHSU tomorrow and have inquired about their bridging protocol - which hopefully they will address tomorrow.
In the meantime, I contacted my cardiologist form Mayo with this question that I have been asking all providers to no avail.
If my therapeutic range is 1.5 to 2.5, couldn't I dose down to 1.6 or so and avoid bridging altogether? This occurred to me when the biopsy DR. said that even though I was bridging with Lovenex they would not perform the procedure unless my INR was below 1.9
Well couldn't I have just brought the INR down to 1.6 or so and have been in range therapeutically and reduce the risk of bleeding form the Lovenex. (Which I did. A hematoma formed at the biopsy site and that ended up obscuring the MRI that I had the following week making it inconclusive.)(If you ever have to do this then be sure that they do the MRI before the biopsy!)
Not to mention my abdomen was a huge purple and red hematoma by the time the bridging was completer.
Anyway, my cardio said that as a low risk person with a Mech valve - meaning no previous strokes and no Afib - I don't need to bridge at all. I can just stop the warfarin for 1-3 days before the procedure and the same after the procedure. He said being off of warfarin for 5-7 days is considered safe. He said that if the surgeon wanted to do the procedure with my "low range" INR that is basically up to the surgeon. He also said to NEVER stop the low-dose ASA.
So, what do you think about that??!!
Bonbet/or McBon I am not sure what they call me these days.
