I called Cleveland Clinic....

[barbwil]

yesterday to express my concern about being taken off warfarin for 3 days before my heart cath. (next Thurs.). I told her I was taking it for A-fib and she put me on hold to ask someone (in the surgeon's office) about it and she came back and said, "you SHOULD be okay". She said they would address the 5 days I'm to go off it before my mitral valve surgery July 25th when I am up there next week for my pre-op tests. As it stands now according to all the instructions I received I will have no bridge therapy and be admitted the morning of the surgery (5:15 a.m. GROAN!!!!).

Two weeks ago my INR was 1.8, kept on same dosage: I am anxious to see what it is Monday at my PCP's office.

I'm anxious to see what they find in the echocardiogram Wed. I'm wondering how many of the numbers come from the operator's observations as opposed to them registering on the machine itself. The last four years the same fellow did the tests.

Praying for all of you in the wake of Dennis!!!! Barb

 

[geebee]

Barb,

I had a cath while on Coumadin because I was having problems with TIAs. My cardio was concerned I would die if he took me off or lowered my coumadin.The nurses in the cath lab had fits when the blood test showed my PT (before INR was used) at 25. They told me, before my cardio came in, that the cath would need to be postponed. My cardio told them in no uncertain terms that the cath would be done. They refused to handle the post cath aterial pressure bags so my cardio spent the time with me putting pressure on the artery.

It might cause a disturbance but caths CAN be done while on Coumadin. If you feel strongly about it, I would make some waves.

 

[bvdr]

Barb,

I was put on warfarin just a few months before I had mitral valve replacement. I had been in atrial fib on and off for maybe a year and a half before I was put on warfarin. I was taken off warfarin 5 days before my MVR at Duke but admitted the day before surgery for a heparin IV drip. Maybe they plan to do something similar in your case.

How long have you been on warfarin? It can be a little frustrating at times can't it!

 

[ALCapshaw2]

I would call your Cardiologist and/or PCP and tell them you are VERY CONCERNED about going OFF Coumadin without Bridge Therapy. Ask them to intervene with your surgeon on your behalf, or do directly to the surgeon (or at least his primary nurse) with your concerns.

YES, going OFF Coumadin is one of my biggest concerns. I have yet to do it but after reading about the number of people who have had strokes OFF Coumadin, I'm pretty sensitive about this issue. Bridge Therapy is a MUCH safer approach, even if it is a PITA for everybody, including the managing physician. It's YOUR LIFE. Make them earn their $$$.

'AL Capshaw'

 

[perkicar]

I would call your Cardiologist and/or PCP and tell them you are VERY CONCERNED about going OFF Coumadin without Bridge Therapy. Ask them to intervene with your surgeon on your behalf, or do directly to the surgeon (or at least his primary nurse) with your concerns.

YES, going OFF Coumadin is one of my biggest concerns. I have yet to do it but after reading about the number of people who have had strokes OFF Coumadin, I'm pretty sensitive about this issue. Bridge Therapy is a MUCH safer approach, even if it is a PITA for everybody, including the managing physician. It's YOUR LIFE. Make them earn their $$$.

'AL Capshaw'

Make sure that when you do your pre-op teaching you let them know how concerned you are. And it was Dr Petterson's nurse who you talked to, or someone else. Do you see a cardiologist at CCF? They were so particular about my PTT and INR both being therapeutic (one with heparin drip and the other with coumadin) before they'd let me leave, somehow it seems like they'd be equally as fussy before surgery if it's an ongoing thing.

If you're still in hospital when I'm there on the 19th we'll come see you!! My appointment is at 1:30 with Dr Griffin (rolling my eyes, like we'll really see him that early LOL).

 

[barbwil]

Gina, Betty, Al Capshaw, and Carolyn,

I will have to answer you together because I'm not that well orientated to the world of computers to bounce back and forth without losing what I've written.

I imagine I spoke with someone lower on the totem pole in the surgeon's office because she put me on hold and went to tell someone of my concern. It was Friday afternoon and if the surgeon weren't operating he probably had left the hospital. I really don't know, just speculating!

I've been in A-fib since having a nephrectomy for renal ca two and one half years ago. My PCP has been taking care of keeping me regulated but it hasn't been easy because of the other meds I am taking for thyroid, and especially since I was taken off Amiodarone last Dec and it is probably just now out of my system so that would mean another change in warfarin. I squacked (I didn't squack; I squawked-- obviously I don't use spellcheck)plenty about being on that drug and the EP finally took me off of it because when she interrogated my pacemaker she could see it wasn't working.

Monday I will be getting my INR checked so I will express my concerns with him and I will try to get ahold of my cardio in the morning but there isn't much chance of getting him then (He is here in town, not with the CCF).

(I don't expect to be there at the Clinic on the 19th, Carolyn, but I wish you well in your appt. I was there two years ago when my hubby had a heart cath. done so I know what you mean about seeing him on time. That place is like a Zoo, everyone sitting around in their hospital gowns dragging their IV poles with them!! They threatened to cancel his procedure because of his INR and he had been off his warfarin as directed but they finally did it.)

Thanks for your support, all. I'd better go crawl back in bed for a couple of hours of sleep or I'll be snoring in church!!

Barb

 

[ALCapshaw2]

I had a brief period (a few months) where I was going into Atrial Fibrilation with exertion. My Cardiologist put me on a low dose of Sotalol (generic form of BetaPace) and it kept my A-Fib under control. It did take a few weeks to adjust to some the side effects (some slight dizzyness at first). It might be worth discussing this approach with your Cardiologist. I don't blame you for not wanting to be on Amiodarone!

'AL Capshaw'

 

[barbwil]

I had a brief period (a few months) where I was going into Atrial Fibrilation with exertion. My Cardiologist put me on a low dose of Sotalol (generic form of BetaPace) and it kept my A-Fib under control. It did take a few weeks to adjust to some the side effects (some slight dizzyness at first). It might be worth discussing this approach with your Cardiologist. I don't blame you for not wanting to be on Amiodarone!

'AL Capshaw'

We'll have to cross that one off because my EP tried Sotolal on me when I was in the hospital getting my pacemaker implanted and wouldn't you know that is one of the things to which I am allergic, broke out in a nasty red rash. Then after I had my kidney removed they put me on the Amiodarone because it is the only antiarrhythmic that isn't processed by the kidneys, instead it invades all the cells in your body and stays there after you are taken off the drug until all your cells are replaced by new ones. My liver enzymes started going up when on the deadly Amio.

 

[barbwil]

nursing cont'd ed. on anticoagulation

nursing cont'd ed. on anticoagulation

http://www.medscape.com/viewarticle/504601?src=mp

Interesting that this should come to me in an email from Medscape today. Thought you might be interested to see what they are teaching nurses about warfarin, whether it should be stopped for dental, GI, etc procedures and how to "bridge" preoperatively.

 

[cocoalab]

quite intresting.

quite intresting.

http://www.medscape.com/viewarticle/504601?src=mp

Interesting that this should come to me in an email from Medscape today. Thought you might be interested to see what they are teaching nurses about warfarin, whether it should be stopped for dental, GI, etc procedures and how to "bridge" preoperatively.

As a parent of a child on warfarin for 9 yrs i can vouch for much that has been said. Now that we are off the coumadin (at least for as long as this valve lasts) I am so gla dto have abreak from this.

We always were bridged to heparin for proceedures- catherizations/ surgery. He had a INR range goal of 2.5 to 3.5. sometimes we were even there.
After his last heart cath in April they loaded him a little fast, and as I predicted we way over shot. I had expressed my concerns but to no avail. Praise God we never had any bleeding incidents but being off always caused anxiety and often changes in plans for the day-week.

last Wednesday ur two weeks ago Wednesday Andrew received a bovine valve. hopefully he will get at least 10years out of it. His p/t nurse told me oh good there goes my worst patient. she receives about 8 INR results per day too. i always wondered how many she followed there.

andrew often fell sometimes to 1.2. god was keeping him then too.

heart hugs,
Wendy, mom to Andrew (15 L-TGA,A/V tricuspid valve replaced with
> > bovine valve 7/1/05, myocardiac infarction, mild ebsteins anomoly)

 

[barbwil]

Hi Wendy!

Hi Wendy!

As a parent of a child on warfarin for 9 yrs i can vouch for much that has been said. Now that we are off the coumadin (at least for as long as this valve lasts) I am so gla dto have abreak from this.

We always were bridged to heparin for proceedures- catherizations/ surgery. He had a INR range goal of 2.5 to 3.5. sometimes we were even there.
After his last heart cath in April they loaded him a little fast, and as I predicted we way over shot. I had expressed my concerns but to no avail. Praise God we never had any bleeding incidents but being off always caused anxiety and often changes in plans for the day-week.

last Wednesday ur two weeks ago Wednesday Andrew received a bovine valve. hopefully he will get at least 10years out of it. His p/t nurse told me oh good there goes my worst patient. she receives about 8 INR results per day too. i always wondered how many she followed there

andrew often fell sometimes to 1.2. god was keeping him then too.

heart hugs,
Wendy, mom to Andrew (15 L-TGA,A/V tricuspid valve replaced with
> > bovine valve 7/1/05, myocardiac infarction, mild ebsteins anomoly)

I just went back and read all of your previous posts to familiarize myself with Andrew's condition. That is such a lot for a 15 year old and his family to go through but it is amazing how young people bounce back from such major surgery. I join you in praising God for what He has done in your lives, how He has helped you to deal with what would seem impossible if you sat down and dwelled on it!
Sounds like Andrew is doing fantastically well; I expect you are pretty exhausted from all of this. God bless you all, Barb