If you are on warfarin, consider the chance that you might face emergency surgery some day.
I went through that last weekend.
I had a colonoscopy June 7. Became nauseated during prep night before, vomited for 6 hours, developed pain. When I reported for c-scope (my 3rd), I mentioned the 6 hours of nausea and the pain and didn't think they should do the c-scope, and was told they'd tell the staff. All the GI doctor was told was that I had been nauseated.
Scope report was good. But I didn't feel well. Slept 4 hours. Took temp and I had a fever, plus the pain the right side. Called the phone # on the discharge papers and was told to go to the hospital ER for a CT scan, that I probably had an infection.
After nearly 6 hours at the ER, I was told I had appendicitis (at 62???????) and needed surgery ASAP. They started calling surgeons and then worked to get my INR down to 1.5. My INR had been 2.3 when I tested Thursday. Had soups (my choice) Wednesday, clear fluids Thursday, no foods or drink Friday, so my INR was up to 3.4 on a blood draw late Friday. Got shot of vitamin K, 4 units of fresh frozen plasma.
They got my INR down to 1.5 and I went into surgery at 10AM Saturday.
Unlike elective surgery, I had no say in how to handle reversing anticoagulation. My GI doc had approved doing the c-scope with INR in range.
I told every RN and doctor who saw me that (1) I had my own INR monitor and (2) adjusted my own dosage, using an evidence-based algorithm chart. Gave them my dosing regimen. We discussed how to restart the warfarin (by then I had been on some heparin and then Lovenox shots).
I had never used low molecular-weight heparin. Before leaving the hospital, I asked my RN to let me give myself the last in-hospital shot, and he gave me 105 on the "test." The shots have been a breeze, no pain, no bruising whatsoever.
Because the appendix had ruptured, I was on IVs of antibiotics in the hospital and am on antibiotics at home for 1 week. I am quite upset at the endoscopy center staff for allowing the procedure to continue as scheduled and will discuss that with my family doctor Tuesday.
Would I have chosen a mechanical valve 10 years ago knowing an emergency like this would occur? You bet!! This is a small price to pay compared to knowing that I would probably undergo another MVR in my lifetime. I was 52 at the time of my MVR. My grandmothers were 99.5 and 96 when they died and my parents are now 84 and 86. In all likelihood, I would have required a re-op had I gone tissue. This isn't to say I won't with a mechanical, but the likelihood is very much reduced.
Those who have chosen tissue valves made that decision for various reasons. I respect their decision.
I am happy with mine. AND I LOVE MY HOME MONITOR!!!! I kept telling medical professionals, "I am so glad I have my own INR machine!!"
I went through that last weekend.
I had a colonoscopy June 7. Became nauseated during prep night before, vomited for 6 hours, developed pain. When I reported for c-scope (my 3rd), I mentioned the 6 hours of nausea and the pain and didn't think they should do the c-scope, and was told they'd tell the staff. All the GI doctor was told was that I had been nauseated.
Scope report was good. But I didn't feel well. Slept 4 hours. Took temp and I had a fever, plus the pain the right side. Called the phone # on the discharge papers and was told to go to the hospital ER for a CT scan, that I probably had an infection.
After nearly 6 hours at the ER, I was told I had appendicitis (at 62???????) and needed surgery ASAP. They started calling surgeons and then worked to get my INR down to 1.5. My INR had been 2.3 when I tested Thursday. Had soups (my choice) Wednesday, clear fluids Thursday, no foods or drink Friday, so my INR was up to 3.4 on a blood draw late Friday. Got shot of vitamin K, 4 units of fresh frozen plasma.
They got my INR down to 1.5 and I went into surgery at 10AM Saturday.
Unlike elective surgery, I had no say in how to handle reversing anticoagulation. My GI doc had approved doing the c-scope with INR in range.
I told every RN and doctor who saw me that (1) I had my own INR monitor and (2) adjusted my own dosage, using an evidence-based algorithm chart. Gave them my dosing regimen. We discussed how to restart the warfarin (by then I had been on some heparin and then Lovenox shots).
I had never used low molecular-weight heparin. Before leaving the hospital, I asked my RN to let me give myself the last in-hospital shot, and he gave me 105 on the "test." The shots have been a breeze, no pain, no bruising whatsoever.
Because the appendix had ruptured, I was on IVs of antibiotics in the hospital and am on antibiotics at home for 1 week. I am quite upset at the endoscopy center staff for allowing the procedure to continue as scheduled and will discuss that with my family doctor Tuesday.
Would I have chosen a mechanical valve 10 years ago knowing an emergency like this would occur? You bet!! This is a small price to pay compared to knowing that I would probably undergo another MVR in my lifetime. I was 52 at the time of my MVR. My grandmothers were 99.5 and 96 when they died and my parents are now 84 and 86. In all likelihood, I would have required a re-op had I gone tissue. This isn't to say I won't with a mechanical, but the likelihood is very much reduced.
Those who have chosen tissue valves made that decision for various reasons. I respect their decision.
I am happy with mine. AND I LOVE MY HOME MONITOR!!!! I kept telling medical professionals, "I am so glad I have my own INR machine!!"
