Going off warfarin for 5 days. Scared!

[Nancy]

Hi Gina-

We decided a while ago that Joe will have the Heparin drip also. No Lovenox, even though he has had it before. He really can't take any chances on anything. He's had too many dicey things happen.

But for those who feel OK with Lovenox, and find the Heparin a major inconvenience, Al's idea is a very reasonable choice.

 

[LUVMyBirman]

I am with you Nancy. Yes, your Joe has been though too much. Why take the chance.

Coming so very close to death with the birth of our daughter. Complications 3 weeks after surgery..... proceeding with caution. My daughther and husband need me to hang aroud. As I feel fortunate to have the opportunity.
So, here we go around the IV pole. .

 

[cookie]

Lovenox

Lovenox

Gina & Nancy,
I read the article about Lovenox and it seemed to be pointing directly to pregnant women. I know I have read articles on Lovenox and this was mentioned but also that the only cases that resulted in death were pregnant women. I'm confused!
I have an appt. with my Gastro Doc and will discuss with him also. So far though, both Pcp and anti-coagulation doc say it is okay! What to do, what to do!

 

[Nancy]

It sure is confusing, Cookie. If Joe hadn't had so many, many serious problems along the way, I guess I'd think differently about it. But I feel he's got to have a high risk management plan, no matter how inconvenient. He can't have too many more brushes with fluttering wings.

I have to admit that going into the hospital the day of surgery was very nice, as opposed to going in a couple of days ahead of time.

No easy choices here.

 

[Robt Z]

Lovenox shots for me

Lovenox shots for me

My cardiologist wants me to go off warfarin on sat. sun and monday for tues 2pm surgery to remove a small lipoma on my left front side near rib cage. She wants me to take am and pm shots of lovenox on sunday and am shots on monday. After surgery I am to take shots x2 on wed and thurs and fri am only and then get inr check. I have never given myself a shot before. I guess it is a good precaution. Oh well. Without this web site I would not have known this. Do I need to worry about taking lovenox? I still plan to go thru with the surgery, out patient, but I wonder if I should not have even got into this mess. The lipoma does bother me at times and I am looking forward to getting it removed. It has grown over the last few years. RZ

 

[Ross]

Robert as long as they at least have you doing the Lovenox that is a good thing. Just follow their directions for it's use and you should be fine. The idea is for the Lovenox to act as a bridge while your Coumadin levels fall and while the rise again, preventing clotting and danger. I'm glad to hear that they aren't asking you to just stop the Coumadin and go to surgery. You need to do what they are having you do.

 

[Nancy]

Hi Robt-

I too am very happy that you aren't going without some protection. Lovenox is easy to inject. Make sure you rotate your sites like they probably will instruct you. It leaves a nasty and large bruise, no matter who does the injections, so don't be alarmed.

 

[Gnusgal]

lovenox

lovenox

Yes, lovenox DOES leave a bruise. (I ended up playing connect the dots with my bruises.) After my emergency surgery last Feb. we were having a hard time getting my INR back up, so I had to get on lovenox to be releassed from the hospital. It was fine with me! I hate needles of any kind, but didn't want to be in that hospital one more minute. I made my husband give them to me because I hate to watch needles pierce ANYONE'S flesh (he's studying to be a nurse anyway). But one day he left to go to school without giving me my morning shot, so I had to give it to myself. It wasn't as bad as I thought it would be. Except I kept scaring myself... They do tend to sting as the med gets pushed into your body and for a little while after, but it sure is better than the alternative...

 

[Ross]

You ever notice how sometimes it stings and other times it doesn't? I wonder if it's just the placement of the needle?

 

[Nancy]

We're finding that with Joe's Procrit shots too (which I do), sometimes they sting and sometimes not. They are also subQ. I'm getting a complex, I feel like Nurse Rachett.

 

[Guest]

One thing that helps cut down bruising is to not blow the bubble out of the syringe. Use the premixed syringes - not one somebody took out of a large vial. The reason is that that you do not want any Lovenox on the outside of the needle. You will get less bruising (eggplant belly - one person called it) if it is all inside the needle. The bubble is 0.01 ml of nitrogen it is inert and not enough to cause any problem.

There is no right answer here. Next month at out anticoagulation professionals convention we are probably going to ask the FDA to do away with this unfounded statement. Then everybody will be able to use it again. Until then you have to do what you are comfortable with.

 

[Gnusgal]

I use the ones that are premixed. The syringe is really pretty neat. When you depress the plunger all the way, then release, the entire casing pulls into itself and the needle is no longer exposed. It's spring actioned. So you don't even have to pull the needle out of your skin, just let go of the plunger. The first time we used one of these syringes my husband got all excited trying to figure out how it did it. He's a bit odd (and would fit right in here at VR). Anyway, even with the premixed ones, I bruise. Little purple dots all over my belly. I look like I've contracted some strange disease. especially with all the scars surrounding them as well (pacemaker, open heart, gall bladder, ovarian cyst...).

 

[ALCapshaw2]

I would ask an EXPERIENCED nurse to instruct you in how to do the Lovenox injections.

'AL'

 

[BECKY]

Hi there,

I have had a second heart surgery and I was told by the surgeon to go off my coumadin for 3 days and that freaked me out. I was put on Heprin right after I got settled in my room on Sunday. I was to have my catherization on Monday surgery on Tues. They took me down to have the catherization but my INR never dropped low enough. They had me there for hours..took me back to my room and gave me a shot of Vitamin K and did the catherization and surgery on the same day. Everything turned out fine.

Another experience was I had a Dr. who was going to do two breast biopsies on me out patient. Not to worry he could do it without me going off my coumadin. I was thrilled because I had prcedures in the past and I had to go off the coumadin no ifs ands or buts and I was in for a week waiting for my level to go back up. I was so happy I could have this done this way untill the next morning when I was so swollen. Called the Dr. and he had me go right to emergency and he had to do emergency surgery for internal bleeding and I had to stay in the hospital this time, so I had two anesthesia's in 24 hrs....lost alot of blood and couldn't return to work for another week because I was too weak.

It is really nothing to play around with. Always get your cardio's advise.

BECKY

 

[Gisele]

Lovenox & colonoscopy

Lovenox & colonoscopy

Kim & Cookie

My colonoscopy is tomorrow and I am not looking forward to it. I just finished one of my drinks and my next one is tomorrow morning at 6:00 AM--euch!!!

I stopped my coumadin this past Sunday and went onto my Lovenox. Tonight I will give myself an injection at 11:00 PM and will wait for the OK after my procedure to resume Lovenox and coumadin. This certainly beats being glued to a heperin drip for days on end. The only thing my cardiologist did mention if the GI specialist removes anything, I might end up staying one night in the hospital for heperin. The beauty about heperin is that it leaves your body within one or two hours (not sure of the exact time frame) whereas Lovenox stays for twelve hours. Therefore if there were any bleeding problems after the procedure and Lovenox was given it could present a bit of a problem.

They say the prep is the worst part of the procedure--I think the not eating anything solid isn't too good either.

Gisele

 

[Kim]

Gisele,

Good luck on your colonoscopy tomorrow. I had one three years ago and remember how horrid the prep was! I see a new PCP in 2 weeks and will ask him about the virtual colonoscopy. I thought, though, that I read it wasn't as accurate as the traditional, invasive procedure and with my father having colon cancer, I don't know if that will work for me.

I think the Lovenox is probably the way to bridge from the Coumadin and then back on again. 5 days seems an awful long time to be off the Coumadin before the procedure. My INR would drop drastically within 24-36 hours of no Coumadin!

 

[Gisele]

Thanks Kim

Thanks Kim

I am looking forward to having this over with. That prep tastes absolutely horrible (esp. at 6:30 am). The taste is so horrible that fortunately I have no appetite.

My INR drops rapidly also. I can normally drop 1.5 or a bit more if I hold for one day. On the other hand it takes me forever to bring my level back up to range. Lovenox does beat going into the hospital.

I have heard of the virtual colonoscopy but I don't know a whole lot about it other than reading one or two articles.

Good luck with your new PCP and let me know how you make out.

Gisele

 

[cookie]

Gisele,
Am waiting patiently to hear how your colonoscopy went on the Lovenox injections. Haven't seen you posting lately. Do hope everything went well for you.
I have talked to my PCP, my anti-coagulation manager and gastro doc and all three recommend Lovenox for bridge therapy although I had a new person at my anti-coagulation clinic this last time and she said there is still a chance of a clot! I don't understand. Isn't that the whole purpose of the bridge therapy? To prevent that? As you can see, this procedure is consuming me with questions and decisions. I have very bad bunions on my feet and would love to have them fixed but I don't know if it's worth all the grief and anxiety. The downside of coumadin I guess. I have an appt. with my cardio in 2 weeks and will see what he thinks. I personally don't trust a lot of docs when it comes to coumadin management. Three weeks after valve surgery I ended up in the hospital with coumadin induced tamponade and had to have a chest tube put in for drainage. That was more painful than the surgery! I really like having my levels monitored by someone who's job it is to know how to do this. They even offered to do the whole monitoring thing through this procedure. Anyhow, the procedure isn't until Aug. 4 so I have plenty of time to agonize over this! I did ask my gastro doc about virtual colonoscopy and he wasn't for it because of cost to the patient and the fact that if they found something you have to go the regular route anyhow. He said it doesn't find the small polyps that need to be taken care of. They have to be a certain centimeter to be picked up. Oh well!

 

[Gisele]

Cookie

Cookie

I am so sorry. I posted somewhere about my procedure and for the life of me--I don't remember where! I will find my posting and refer you to it, or I will update you on this thread.

Don't worry, I did survive the procedure and the lovenox! I think you will be fine on the Lovenox. I think my reaction to Lovenox is unusual and now I cringe at the thought of needing an injection-which happened just this morning as my INR was 1.8

My difficulty is when I do 60mg bid for an extended amount of time. I was on the 60mg injections for about 1.5 weeks before I dropped down to 30mg bid for my colonoscopy.

I will search for my posting and get back to you.

Gisele

 

[Gisele]

Cookie I found it!

Cookie I found it!

http://www.valvereplacement.com/forums/showthread.php?s=&postid=37177#post37177

Hmmm, I wanted to insert a link, but I am not as talented as Ross, so if the above doesn't work, go to Coumadin/ New home test program thread/page 2


Don't ask me how I ended up posting it there