Gotta Do the PRE- Colonoscopy Diet...how do you get any Vitamin K anyways?

[coffeelover]

Hi valvers! In 2.5 weeks I'm having my first colonoscopy post AVR, so I'll be doing the Pre-op Low-Fiber Diet, as well as anticoagulant med adjustments. It sounds like I have to follow a Low-Fiber Diet 3 days before and also 2 days before the Colonoscopy, then a Clear Liquid Diet the Day Before. How does one get any kind of Vitamin K those days 3 days before the Colonoscopy? I generally eat a salad and veggies , blueberries everyday. BTW, I don't have a home INR monitor. Any advise? Thanks for your help!

 

[pellicle]

How does one get any kind of Vitamin K those days 3 days before the Colonoscopy?

the human body is based on an age old design where food wasn't always a conveyor belt on the hour. You'll be fine.

sadly we've probably all done it ...

The bigger issue is managing your INR down during the procedure, as bleeding risks are higher during a colonoscopy. Discuss with your provider, but mine was happy to have me down to INR=1.4

PS: I just read you don't have a home monitor, so that makes things less than ideal (like driving a car with no speedo). I would suggest that you consider what I did and you can probably assume it will follow a similar pattern (what is your daily dose?)
http://cjeastwd.blogspot.com/2017/12/perioperative-management-of-inr.html
I would suggest that you make a few changes though:

1. simply cease warfarin not "lead in" with a half dose that I did (I can offer no logical reason why I did that)
2. you can see I went 4 days without warfarin and that it was slower to return after I essentially "ran out of it" in my body. So I would suggest that if you cease 2 or 3 days before that you'll be something like 1.5 at procedure
3. I would resume your dose with at least 2 doses of 50% more than you normally take
4. if you are concerned about your thrombosis risk then consider heparin 24 hours after your procedure. If you are otherwise healthy, under 60 and have as your only issue the mechanical aortic valve then your thrombosis risk is low

Run that plan past your medical professionals.

Best Wishes

 

[pellicle]

oh, should I have added I'm not a doctor? (cos if I was, I wouldn't be wasting my time here, I'd be billing your medical insurance system $500 for your advice)

 

[coffeelover]

Hi Pellicle, Thank you for sharing your experience! Since I'm on lifelong anticoagulants I'm not very excited about doing this Colonoscopy, but I'm going to get try to manage it all and just get the dang test over with. Thanks for your help!

 

[Kathmack]

Coffee lover: It’s been about six months since my TAVR procedure and I am scheduled to get a colonoscopy sometime soon - just waiting for a checkup prior to. I haven’t had a colonoscopy since thirty years ago and it was fine so I ultimately forgot about getting another but decided that was stupid since I am turning 80 at Christmas time. I am nervous about it since I take a blood thinner (forever). I see that just about everyone on this forum keeps close track of INR about which I know nothing as my doc never mentions it.

 

[Keithl]

I stopped about 5 days before colonoscopy then you check INR and bridge with Lovonox shots 2x a day once INR drops below 2. You do not take a shot the morning of. If they did not remove polyps then resume warfarin that day and I do at least 50% more for 2-3 days as it take s me 9 days to get back in range, by upping dose for 3 days I was back in range in 6. I have had 3 colonoscopies since AVR. 2 within a week due to a bleed after the first one.

 

[Mister_James]

You need to be able to check your INR otherwise you are flying blind.

 

[Keithl]

Correct this is all based on you being able to home test.

 

[coffeelover]

Thank you everyone for sharing your experience with colonoscopy prep and warfarin management. Your information is very helpful!

 

[pellicle]

2 within a week due to a bleed after the first one.

Yes this is my concern with them. A fellow I know in town nearly died from his bleed and he isn't even on warfarin (or any drug). Getting a good practitioner is important, he went public hospital.

PS, what is your daily dose if you don't mind.

 

[pellicle]

ultimately forgot about getting another but decided that was stupid since I am turning 80 at Christmas time.

Personally I think that's a sound decision unless you are a high risk patient. It it's just to see then I suggest don't.

 

[Juli]

I had two colonoscopies this year. bridging worked well - followed the instructions and used Lovonox only for a few days. I measured my INR every day - but be aware that the measured INR only reflects the Warfarin response, not the Lovonox. Right after the procedure and the following day I took 2x my normal Warfarin dose and then continued with regular daily dose. Was back at my lower INR range 4 days later and could stop the injections. Went even faster the first time. In my experience the process was not as bad as I thought.

 

[pellicle]

In my experience the process was not as bad as I thought.

I gotta say the lead in to the colonoscopy and my time on the throne was the worst part of it.

 

[Keithl]

Yes this is my concern with them. A fellow I know in town nearly died from his bleed and he isn't even on warfarin (or any drug). Getting a good practitioner is important, he went public hospital.

PS, what is your daily dose if you don't mind.

He is a great practitioner, I think the 2 polyps he removed were difficult and instead of clips he should have just cauterized the area, but I am sure there was a reason he did not. I actually blame the GI before him as she was lazy and I bet these polyps were there a few years early when she looked, but since they ere all the way at the beginning I bet she di not scope all the way and missed them. That allowed these to grow big and flat, vs. getting them early.


My daily dose lately has been 7.5 for at least 6+ months, back then if was probably 6.75. It takes forever (about 2 weeks) for me to get my INR back after being off. I am supposed to get gum surgery soon and the thought of going off warfarin for it is not appealing. Hoping they can use laser.