Coumadin and post surgical complications_ wow!

[sylviayasgur]

hi all!
finally, he's home!
boy, those hospitals can kill you!
two days ago things started looking better and better_ my dad was awake much more than he had been the previous day and napped less. he was also walking around and sitting in his chair more. i actually thought that he might go home sooner if things kept progressing at that same rate...
however...in came a doctor who felt he had not put out enough urine that night (doc didn't even feel his tummy) and felt that his bladder might have an obstruction. when i called i told them to stop and wait to put in the foley cath until i got there, but they had already done so by the time i arrived.
set him back 3 days!!!! when i got there along with my brother, we gave the doctor a piece of our minds and made him take it out. after that dad was fine albeit sore (they went through flushing it before removing the cath and they pushed it in further because they thought it hadn't been put in properly_ they basically tortured the man)....
it still shocks me to think that if we hadn't gotten private duty nurses for him, my dad would still be in that hospital bed (probably their guinea pig) withering away unnoticed.

nancy,
thanks so much for telling me to get him out of there.... he left as soon as he felt he could handle it_ thank G-d!

marty,
i hope your leg feels better soon. i can imagine how you must be feeling. my dad's only upset is that he won't be able to play golf anytime soon (not that he won't be able to go on our annual family vacation this xmas... just the golf!! no, just kidding!)

everyone,
thanks so much for your wise words and support and concern.
it will be a very slow recovery for my dad, but we'll take it one day at a time.
his inr is hovering around 2.7 ish and they are happy about that. the bleeding finally did stop and now his distended tummy (two huge hematomas that will be absorbed by the body) just has to go down.

hoping none of you ever has to go through what he did these past two weeks.
i might have convinced him to join this site...he has so much to offer.
thanks again,
sylvia

 

[Karlynn]

Sylvia, I'm glad to here your Dad is home and on the road to mending - despite the hospital's best efforts to complicate things. I hope he has a smooth and quick recovery now that he's home.

 

[Nancy]

Hi Sylvia-

I'm glad he was able to go home. I don't know if he was sent home with a drain or drains, or has any wound dressings on his belly, I know that Joe had a drain (they used an ostomy bag as a drain) and several wounds from the laparascopy scopes, after his bleedout. They had to be changed often, and he has an allergy to tape. The sores from the tape were almost worse than the drain areas. I think he still has some scars from them. After a while even paper tape did a number on him, tore his skin right off.

The wound dressings are very expensive. I finally covered the wound with a thin pad of non-stick sterile dressing and then used feminine napkins cut down to absorb the drainage. Much cheaper.

Hope your dad doesn't have to many wounds to heal.

But that fluid takes a long time to resorb.

Tell your dad, he's quite a survivor.

Joe had a terrible experience with a Foley also, he ended up bleeding, but in his case there were no options. This wasn't when he had the bleedout. It was another dicey time.

Keep reminding your dad that Joe's wounds all healed up, and can hardly be seen, and his belly is flat. It just takes time.

 

[tommy]

Sylvia,

Sorry your dad has had to go through this. Glad that you have been there to help.

I sympathize, having three Lovenox bridges in the last few years. Wide area excision (forearm), colonoscopy, and inguinal hernia. The most critical time is those few days when the Coumadin and Lovenox are acting together. Lovenox does not effect the INR, so as the INR approaches 2-2.5, you have 2 anticoagulatants at work. The hernia was the latest and the worst. It was several months before the discoloration finally went away.

Hope your dad continues to get better. Please tell him to hang in there.

 

[ALCapshaw2]

SO, Sylvia, what is your dad's surgeon saying NOW?

Is he sticking by his telephone prognosis of NORMAL?

What did the Doc who put in the Foley have to say?

"Curious minds want to know"...

'AL'

 

[Marty]

Sylvia, How are they handling your Dad's anticoagulants now? Is he back on Coumadin. What's his INR and how often do they test him? Is he on Lovenox or heparin? Just curious ,in case a similar problem comes to my attention at the clinic.

 

[catwoman]

Sylvia:

So glad your dad is back home! Give him a big hug for me. Sounds like he's a wonderful man.

 

[sylviayasgur]

hi all!
thanks so much for your responses and support. it has meant everything to me.

marty,
my dad's inr was about 2.7 when he left the hospital (they started the coumadin "loading" while he was in the hospital, because of his awful experience with lovenox at home).
they kept him on 5 mg until his inr dropped to 2.2 and then upped it to 7.5, i think, for a few days. he was tested yesterday and i'm sure he'll tell me what his inr is today and he'll adjust accordingly. i would love to buy him a coagucheck (along with my brothers and mom) for the holidays, but he swears that they are not accurate_ he can be very stubborn.

i think the problem arose when my dad was reintroduced to his coumadin after his surgery along with lovenox to get his inr up to an acceptable level.
there was NO monitoring and he simply started bleeding inside....
thank God my mom took matters into her own hands and saved his life.
i think that is why they are being conservative with him (no lovenox at home for now).

things are progressing slowly as nancy said they would... he tires easily.
he is walking and alert and looks more like himself to me. still, i leave him heartbroken because he looks so much weaker than my dad, so much older. in fact, he said that this is the first time in his life that he has felt old.
we are so fortunate that he is on the mend and progressing. as the minister in the next bed in the hospital said "God is good" (and he was having a mass removed from his brain!!!).

thanks for all your help and kindness. i hope these posts have helped others.
be well, sylvia

 

[catwoman]

Sylvia:

71YO is young!
Perhaps your dad feels "old" because of what he's gone through. He's had some serious jolts to his system.

 

[MitralMan]

Sylvia, your dad is lucky to have you.

Sylvia, your dad is lucky to have you.

My thoughts are with you and your dad.

 

[Marty]

Sylvia, Glad to hear Dad is making progress if slow. I have been assured by hematologist professor Jack Ansell in Boston and other authorities Coaguchek, Protime, etc. and other monitors are as good sometimes better than central labs. I have relied on my Coaguchek for six years and it has never failed. I think if you got Dad one he would learn to use it and love it. My vascular surgeon told me to keep my INR between 2.0 and 2.5 until my leg is completely normal and then I can think about going back to 3.5-4.0 which is supposed to be good for mitrals.I doubt that I ever will however. Its interesting that none of my doctors prescribed Lovenox or heparin for me.

 

[sylviayasgur]

thanks all!
each day is a little better for my dad... it is VERY SLOW though, this recovery.
i think that's why he says he feels old_ he must mean he feels weak and not like himself (active).

my entire family usually takes a trip to aruba where my parents have a house and my brothers, niece, nephew, my parents and joey and i and our girls all stay in this house together. this will be the first december holiday that we won't be together.
still, i count our blessings that he is well enough for us to go, knowing he is stable at home.

i hope everyone here has a happy, healthy and wonderful holiday and new year_ only good things to come.

be well and thank you all for holding my hand throughout this rough patch.
all the best, sylvia

 

[Granbonny]

Hi Marty

Hi Marty

I have tried several times to post to you..but computer dies when I preview..Will try it again... I'm so sorry to hear of your fall on the golf course... I hope your leg is feeling better... I have been extra careful the last few days in rain, ect...just goes to show, how relaxed we coumadin takers get. My little dog wants to go outside in early pre-dawn..and I'm extra careful going down the steps... My last few INR's were a 3.0..but I'm like you..I think I would rather see it at 2.8... Take care...so you will be back on the golf course soon..and stay out of the Kitty Litter Box. Bonnie

 

[sylviayasgur]

the saga continues...

the saga continues...

hi all,
i can't believe i'm writing this.... my dad was doing really well all week long at home. even got to the point where he could get in and out of bed all by himself... walking up and down stairs, sitting in his rocker for a bit, alert, reading (he LOVES to read), watching golf..he was SLOWLY (nancy you were so right, this is SLOOOOW recovery).....
until tonight when he vomited (he can;t seem to eat too much and when he does, he sometimes vomits.... he has this abdominal hematoma that makes him feel full quickly)...after vomiting, his pulse dropped to 40 (low for him these days when he's not stable yet) and he felt "weak"...
we immediately rushed him to the "good_heart hospital" (as opposed to the one he was in these last few weeks (horrible!!!! shame on them)....
we spent 5 hours in the er, did tests, ct scan, etc. and finally put him in a room on a monitor......
his pulse is now back to normal and he is stable.
the nurse (we had a private duty nurse helping him out at home, she was the one who picked up on it all) thought it might be a vasal/vagal response (which i think i heard the cardio say it was_ he was on call and immediately met us in the er).
we'll have to find out what is causing these drops... his bp (which has been 140/80-90 these days since he' s not on all his meds yet) was 140/60.
just thought i'd keep you all up to date..
i'll try and post as soon as i know more... i'm exhausted for now..
thanks all for your support.
please stay well,
sylvia

 

[Karlynn]

So sorry to read that your Dad is still having problems. We went through the same thing with my Dad. We thought he was all fixed and then something else would pop up to cause concern, or put him back in the hospital. It is very exhausting so please take time to take care of yourself. Make sure you are eating well and getting as much rest as you can -even if it's a little nap here and there.

 

[Nancy]

Sylvia-

I felt so sorry when I saw your post. I can only say once again, to tell your dad not to give up hope. Joe had many dicey and difficult days over the course of the year of healing. He thought he would never get there, but he did. It's clear that your dad is still a little unstable, and I am so glad that you have a nurse there for him.

After Joe's bleedout, he had to have a second surgery to remove some of the big clots and also some of the accumulated fluid. It was pressing on his heart area, and his cardiologist was concerned that it might impair his heart function. The surgeon really, really didn't want to do this, and even tried to talk us out of it even right up to the surgical suite. He wanted to let it resorb over time, but I believe the cardiologist was very right. It was after hours and not too many people around, just the surgical nurse, the surgeon, the anesthesiologist, Joe and I. We had a very earnest discussion, but perservered with getting the second surgery done. It was a nerve-wracking time. But after the surgery, Joe's stomach and chest were considerably less swollen.

So, I would guess your dad will have some uncomfortableness in these areas until the fluid and clots start to disappear.

Never, never give in or give up. It will get better, but a very tough road.

My best to your dad.

 

[sylviayasgur]

thank you all for your support,
my dad came home yesterday and seems to be much stronger and more alert.
while in the hospital they consulted with a gastro doc who said that the hematoma seemed to be breaking up_ good news.
they never figured out why his pulse rate dropped suddenly and he is now stable and on his meds again.
we took him to a great hospital (where tyce, evelyn's hubby had his avr), st. francis the heart hospital which made all the difference. his cardio was there every single day and really took charge (this must be his place!)

so for now he is doing very well, trying to eat and build up some strength (he lost 14 lbs!!!). he is drinking something called BOOST to add some weight. i've heard that some of these drinks are not good when one is on coumadin... anyone know about this?

in any case,i'm resting more easily as is my mom. i hope his recovery continues smoothly from here on in...
thank you all for all your help, your ears, and your concern.
it helped so much.
wishing you all a happy and healthy holiday.
be well, sylvia

 

[Nancy]

Boost contains a large amount of vitamin K, so it can interfere with Coumadin. Make sure your dad's INR is checked frequently while he's on Boost, and even if he decides to go off it. We've found that doctors, nurses and even nutritionists don't have a clue about the vitamin K content of Boost or Ensure.

You don't need to have him yinging and yanging with his INR while he's in such precarious condition.

Glad to hear that he's feeling better and things seem to be breaking up clot-wise.

 

[Karlynn]

Sylvia, I'm glad your Dad is doing better. Will continue to keep him (and you!) in my thoughts and prayers.

 

[Guest]

I'm glad that my predcition seems to be coming true - that he would make a good recovery.

I second the motion that he needs frequent INR checks while on Boost and after he stops it. It is loaded with vitamin K.