J
JeanneImp
and please excuse my mistakes! I didn't check before sending... lol
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K
Karlynn
Wow, I'm really confused. 
This other parent you quoted is giving information that I have always understood to be somewhat opposite. Many doctors will prescribe Lovenox for bridging prior to a surgical procedure but feel that it makes bleeding a risk post surgery much more likely than using a Heparin drip. But the Heparin drip required hospitalization because it is giving IV in a drip. I'm wondering if Lovenox keeps your blood at a higher level of anticoagulation than the target ranges for warfarin. The information you shared that 'less Lovenox is required with contiued usage' also doesn't make much sense. The reason Lovenox is used as bridging prior to surgery is because it leaves your system very quickly, within hours. I don't see how a drug that leaves your system very quickly would allow for any type of reduction in dose with continued use. This is saying that your system gets used to being anticoagulated and begins to anticoagulate on it's own somewhat - would that were true!
I hope I don't sound critical (since this is inflectionless writing) - it just sounds like you've been given some really odd information that I have never heard and I think we need to make sure this gets checked out thoroughly. I googled "long term Lovenox usage" and other various forms and found articles referring to it's use for "bridging" for procedures but I only found 1 sentence in an article that said it may be used for those who have hard time regulating Coumadin. This, however, doesn't mean the information isn't out there to be found.
With Al as our esteemed anti-coagulation member and pharmacist/registered anti-coagulation specialist extraodinaire, I will wait for his reply. He has his pulse on the anticoagulation "world" and will be able to weigh in much better on this "new" information on Lovenox vs. Coumadin.
If Matt's INR continues to be low, they need to give a little bigger bump in his dose. It's usually 10% increase of the weekly dose.
This other parent you quoted is giving information that I have always understood to be somewhat opposite. Many doctors will prescribe Lovenox for bridging prior to a surgical procedure but feel that it makes bleeding a risk post surgery much more likely than using a Heparin drip. But the Heparin drip required hospitalization because it is giving IV in a drip. I'm wondering if Lovenox keeps your blood at a higher level of anticoagulation than the target ranges for warfarin. The information you shared that 'less Lovenox is required with contiued usage' also doesn't make much sense. The reason Lovenox is used as bridging prior to surgery is because it leaves your system very quickly, within hours. I don't see how a drug that leaves your system very quickly would allow for any type of reduction in dose with continued use. This is saying that your system gets used to being anticoagulated and begins to anticoagulate on it's own somewhat - would that were true! I hope I don't sound critical (since this is inflectionless writing) - it just sounds like you've been given some really odd information that I have never heard and I think we need to make sure this gets checked out thoroughly. I googled "long term Lovenox usage" and other various forms and found articles referring to it's use for "bridging" for procedures but I only found 1 sentence in an article that said it may be used for those who have hard time regulating Coumadin. This, however, doesn't mean the information isn't out there to be found.
With Al as our esteemed anti-coagulation member and pharmacist/registered anti-coagulation specialist extraodinaire, I will wait for his reply. He has his pulse on the anticoagulation "world" and will be able to weigh in much better on this "new" information on Lovenox vs. Coumadin.
If Matt's INR continues to be low, they need to give a little bigger bump in his dose. It's usually 10% increase of the weekly dose.
G
Guest
That reply sounds like it is from someone who is a warfarin-hater and will never be convinced otherwise. Don't fall for this ridiculous statement.
1. Lovenox has never been considered by anyone to be safer.
A. It causes a lot of osteoporosis - she is setting her child up for brittle bones at a young age.
B. It has never been studied to show that it is effective for mechanical valves -- even in short term such as bridging.
C. Only a few years ago the FDA had a ban on its use with mechanical valves. (The ban was wrong and was lifted but it demonstrates how little is known about it for people with valves.)
"Actually once you have been on it for awhile you are able to reduce your dose and keep the same level." This is absoulte 100% fictitious nonsense. There is no drug known that you can reduce the dose and keep the same level. It makes as much sense as saying that you can eat fewer calories and not lose weight. Or you can buy less gas and go just as far as if you filled the tank. Cut off correspondence with that person immediately. She is worse than a waste of time her "advice" will lead to Matt's destruction. Her hematologist probably just took the easy way out and prescribed Lovenox to get her off his/her back. It was probably easier to bend the facts to fit what she wanted rather than waste time trying to convince her otherwise. Her misplaced "looking out for her child" will end up doing the child no good. There are lots of other websites where you can find this kind of venom but thankfully there is little of it here.
I have been managing warfarin full-time for over 8 years and have seen over 2,000 people, at over 30,000 office visits and I have never seen one that we could not get regulated -- or we found a valid reason why they could not be regulated. Here are some reasons that you have to rule out before you give up on warfarin.
1. Antiphospholipid antibody syndrome
2. Lupus Anticoagulant
3. Budd-Chiari Syndrome
4. All of the things that lead to poor absorption from the stomach and intestine.
5. Erratic intake of vitamin K.
6. Things to fool Mom such as not swallowing the pill, getting an extra from the medicine cabinet once in a while, etc etc etc. If there is anyone on this site who never tried to "get away with something" concerning their parents, please do not publish your biography, it would be very dull.
1. Lovenox has never been considered by anyone to be safer.
A. It causes a lot of osteoporosis - she is setting her child up for brittle bones at a young age.
B. It has never been studied to show that it is effective for mechanical valves -- even in short term such as bridging.
C. Only a few years ago the FDA had a ban on its use with mechanical valves. (The ban was wrong and was lifted but it demonstrates how little is known about it for people with valves.)
"Actually once you have been on it for awhile you are able to reduce your dose and keep the same level." This is absoulte 100% fictitious nonsense. There is no drug known that you can reduce the dose and keep the same level. It makes as much sense as saying that you can eat fewer calories and not lose weight. Or you can buy less gas and go just as far as if you filled the tank. Cut off correspondence with that person immediately. She is worse than a waste of time her "advice" will lead to Matt's destruction. Her hematologist probably just took the easy way out and prescribed Lovenox to get her off his/her back. It was probably easier to bend the facts to fit what she wanted rather than waste time trying to convince her otherwise. Her misplaced "looking out for her child" will end up doing the child no good. There are lots of other websites where you can find this kind of venom but thankfully there is little of it here.
I have been managing warfarin full-time for over 8 years and have seen over 2,000 people, at over 30,000 office visits and I have never seen one that we could not get regulated -- or we found a valid reason why they could not be regulated. Here are some reasons that you have to rule out before you give up on warfarin.
1. Antiphospholipid antibody syndrome
2. Lupus Anticoagulant
3. Budd-Chiari Syndrome
4. All of the things that lead to poor absorption from the stomach and intestine.
5. Erratic intake of vitamin K.
6. Things to fool Mom such as not swallowing the pill, getting an extra from the medicine cabinet once in a while, etc etc etc. If there is anyone on this site who never tried to "get away with something" concerning their parents, please do not publish your biography, it would be very dull.
G
Georgia
Al, since you mentioned it - what do folks do who need coumadin and have had gastric bypass surgery? My daughter is currently pregnant due to poor absorption of birth control pills - she had gastric bypass a year ago.
Would this cause a problem with use of coumadin?
This is just curiosity - given the rate that people are having gastric bypass it'll sure be an issue in the future.
Would this cause a problem with use of coumadin?
This is just curiosity - given the rate that people are having gastric bypass it'll sure be an issue in the future.
G
Guest
Fortunately a low INR is easier to deal with than the EPT turning blue!
All you have to do is test the INR and adjust the warfarin dose if necessary.
All you have to do is test the INR and adjust the warfarin dose if necessary.
jeffp
Well-known member
Wow, that warfarin can do anything! I'm gonna' go out and put 10mg in my tank right now!allodwick said:
K
Karlynn
I think this thread proves the idea that the biggest problem with warfarin management today is the lack of knowledge of SO MANY medical professionals that manage it. Off hand I can't really think of any other medical issue that continues to have so much mishandling due to the refusal of some medical professionals to begin practicing in the 21st century.
