Heparin drip vs injections

[lance]

What have your experiences been with a heparin drip vs heparin injections prior to surgery.

Is one method superior to the other?

I think I heard that injections were totally terrible. Are they?

 

[MarkU]

I've given myself Lovenox injections prior to Colonoscopies. Not too bad except for the bruising - not real painful, but your stomach looks awful for a week or so.

Mark

 

[Johnny Stephens]

I think I heard that injections were totally terrible. Are they?

They weren't for me - I've had to do them twice. The only painful part for me came about a minute after the injection, when there was a somewhat intense burning sensation, which would resolve in about 2 minutes. Oh, yeah, the bruising - WOW.

 

[geebee]

I have never used the injections but I feel the drip is easier. If you are going to have surgery anyway, you will need an IV so why put more holes in yourself than is necessary.

Just my 2 cents.

 

[lance]

IVS and warfarin reduction

IVS and warfarin reduction

I have never used the injections but I feel the drip is easier. If you are going to have surgery anyway, you will need an IV so why put more holes in yourself than is necessary.

Just my 2 cents.

Hi Geebee

Surgery is considered "day surgery" --performed one day and home the next and I think warfarin reduction is done over 5 days or so. Anyway I have lots of time to think it over--surgery is early next year.

Your 2 cents worth is appreciated

 

[RCB]

Drs. have always put me in the hospital for any procedures and on a
drip, so far no injections. I also did not go off warfarin for my colonscopy,
because in most people they find nothing. If they found something that had
to be removed- I would have to go through it again on a drip. I guess it is just a personal choice one has to make. After I saw what happened to WarrenR's father- I'm glad I went the way I did.

 

[geebee]

Hi Geebee

Surgery is considered "day surgery" --performed one day and home the next and I think warfarin reduction is done over 5 days or so. Anyway I have lots of time to think it over--surgery is early next year.

Your 2 cents worth is appreciated

I have had a couple of surgeries where I needed to be off coumadin that, for someone else, would have been a day surgery. I was admitted to the hospital each time a couple of days in advance for heparin therapy.

Maybe that would change now with the use of Lovenox but I have a pretty conservative cardio so my guess would be not.

 

[Mama2Rylan]

I have had heparin injections...but at the time I was very much pregnant so the thought of sticking a needle in my belly sort of freaked me out, so they put it in on my side (more like the side just below my waist) and it didnt really hurt at all...there was quit a bit of bruising but that goes away after a little while...i hate getting any kind of shot but this was really no big deal

 

[lance]

"belly stick and timing"

"belly stick and timing"

I have had heparin injections...but at the time I was very much pregnant so the thought of sticking a needle in my belly sort of freaked me out, so they put it in on my side (more like the side just below my waist) and it didnt really hurt at all...there was quit a bit of bruising but that goes away after a little while...i hate getting any kind of shot but this was really no big deal

I can well understand your feelings at that time, it would freak me out, too.

Glad your experience was positive.

 

[ccrawford]

Lovenox isn't so bad, once you get over the idea you have to do it. I think the morning injection is the worst, but its doable. Lovenox is considerably cheaper than a day's stay in the hospital but still expensive (over $3000 per month). Make sure you tweak it to get the air at the top of the syringe, pinch the skin on the belly, insert the (very thin) needle at a slight angle, pull the plunger out slightly to aspirate (insure you aren't into a small blood vessel) then inject VERY slowly. I take about 15 seconds to inject 85 mg and this will minimize both the burning sensation and the bruising. Make sure you have all of the solution injected, then pull it out slowly and wipe LIGHTLY with an alcohol swab - don't rub hard. Piece of cake, but Coumadin is a whole lot nicer !!!

 

[lance]

"I'd rather be in Philadelphia"--W.C. Fields

"I'd rather be in Philadelphia"--W.C. Fields

Lovenox isn't so bad, once you get over the idea you have to do it. I think the morning injection is the worst, but its doable. Lovenox is considerably cheaper than a day's stay in the hospital but still expensive (over $3000 per month). Make sure you tweak it to get the air at the top of the syringe, pinch the skin on the belly, insert the (very thin) needle at a slight angle, pull the plunger out slightly to aspirate (insure you aren't into a small blood vessel) then inject VERY slowly. I take about 15 seconds to inject 85 mg and this will minimize both the burning sensation and the bruising. Make sure you have all of the solution injected, then pull it out slowly and wipe LIGHTLY with an alcohol swab - don't rub hard. Piece of cake, but Coumadin is a whole lot nicer !!!

Excellent, well given instructions. Thanks.

But Lovenox first think in the morning--I'd rather stay in bed or as W.C. Fields put it "I'd rather be in Philadelphia". Oh boy, what a mess I'm in.

When that surgery date comes up next April I think I deserve to be cut a little slack and I'll scream and yell for a Heparin drip.

 

[Guest]

Actually, if you are using Lovenox, you should not blow the "air" bubble out of the syringe for two reasons.

1. It is not "air" but 0.01 ml of nitrogen put there to keep air from causing the Lovenox to decompose. It is such a small amount that it can be safely injected under the skin. The exact dose is in the syringe, so when you blow the "air" out, you will get less than the desired dose.

2. When the bubble is blown out, some of the Lovenox runs down the outside of the syringe. This gets injected into the skin instead of under it and causes a lot of bruising. If you blow the bubble out and decide to get around this problem by wiping the needle, you wipe the lubricant off and it feels like a harpoon when it goes in - probably causing more bleeding.

I have yet to meet a nurse who read the package insert on the proper injection technique - even the ones who "teach" people how to give their own shots. Just like people believe in bleeding to death with warfarin, most nurses consider injecting the tiniest "air" bubble the kiss of death.

 

[geebee]

Just like people believe in bleeding to death with warfarin, most nurses consider injecting the tiniest "air" bubble the kiss of death.

This is always amazing to me, too. When I think of all the 1 inch or so sections of air in the various IV lines I have had, I would be dead today if tiny bits of air were an issue.

 

[Guest]

I think that it is something like 30 cc of air that has to go into the heart to stop blood flow. It is rare that anyone has ever had an injection from anything larger than a 10 cc syringe.

 

[ccrawford]

Al - you are absolutely correct. I didn't make myself clear. What I meant to say is that the syringe comes in preset amounts of lovenox, and you need to eject some of the liquid in order to get to the amount you are supposed to inject in yourself. Holding the syringe upright, tweak it until the nitrogen bubble comes to the top of the syringe (top meaning the end where the plunger is), then depress the syringe until the level of liquid comes down to your prescribed amount. In my case, I had to squirt 15mg of lovenox to get down to 85mg from the standard 100mg syringe. The liquid is somewhat thicker than water and you sometimes need to tweak it to get the bubble to move to the top. Hope this clarifies.

 

[Guest]

I try to round off to the nearest whole syringe-ful so that people don't have to shoot any out. I think that 1 mg/kg is only an estimate of what people need. But lots of other people see it as a black or white issue - if you need 85 mg by the book, you get 85 mg not 84 or 86. I maintain that there are no studies proving that rounding off if not just as good.