If you have to..............

[RandyL]

If you have to have another operation (lets say OHS for example) and your INR level on Coumadin was therapeutic what would the Doctor's tell you to do, if anything before surgery. Do they give you something in surgery to counteract the coumadin. How do they operate on you when your INR is therapeutic, once they made the first cut wouldn't you continue to bleed? I am curious how this is done if anybody knows.
Thanks

 

[geebee]

Before my second and third surgeries, I stopped coumadin 2 days before admission, went into the hospital where IV heparin was started immediately.

Just prior to surgery, they gave me platelets to allow the blood to clot enough to get through surgery without bleeding to death. My understanding is they also cool the system to aid in bleeding prevention.

Heparin and coumadin were restarted right after surgery and I was on the heparin until my INR was above 2.5 and was not released until then. I believe such a routine (or some variation) is pretty normal.

 

[RandyL]

Just prior to surgery, they gave me platelets to allow the blood to clot enough to get through surgery without bleeding to death.

How did you know this? Was it explained to you or were you informed enough to just ask about it?

 

[twinmaker]

I've also had platelets before having my defibrillator inplanted. My coumadin was stopped a day or so before, but since my INR was still too high for the procedure, the doctor ordered platelets. Then they run another INR to see where it's at, and then when the level is comfortable for the doc, the procedure is done. This is all done in the hospital. I did have an allergic reaction the second time they were used. Started having trouble breathing and was itching all over. I had hives raise up also. Not sure about OHS as I wasn't on Coumadin before my 2 OHS. I didn't know about the platelets until the first time they were used, but they've been used on me twice. LINDA

 

[geebee]

Just prior to surgery, they gave me platelets to allow the blood to clot enough to get through surgery without bleeding to death.

How did you know this? Was it explained to you or were you informed enough to just ask about it?

Everything was explained to me as they already knew I am the type of person who has to know everything. I don't know if the detailed explanation is done for everyone or just us nosy folks.

 

[RandyL]

Thanks GeeBee. Is there a way to find this out after the fact? I still have issues with my bleeding during a pericardial window that I know I was at 2.9 INR the night before surgery. It seems nobody knows why I started to bleed internally after the PW. I guess I have a hard time with the answer of " I don't know, never had this happen before" It seems to me there has to be a reason for this occurence.

 

[geebee]

Randy,
If you received platelets it should be in the hospital records or certainly on your bill. They don't do those things without charging for them.
You would probably have know since the platelets are done via IV and in advance (i.e. before you are knocked out for surgery). They look like thin bags of blood.

 

[Nancy]

Here are some things that have been done prior to surgery in Joe's case. He's had lots of surgeries.

Hold Coumadin for X number of days prior to surgery.

Hold Coumadin and then do self-injection of Lovenox at home and then go in for surgery. This is no longer an option for him. He has kidney issues and it is contraindicated for kidney issues.

Go into the hospital several days prior to surgery and go on Heparin drip. This is the most used routine for him.

Go to the hospital and get an injection of Vitamin K which drops the Coumadin level very effectively. This is used for emergency procedures. And the down side of this is that it takes two weeks in the hospital to bring his Coumadin level up to the therapeutic range before he can go home. And during this time he would be on a Heparin drip.

So don't worry, if they want to operate on you there are many ways to do it with Coumadin.

 

[Guest]

Platelets do not affect the INR.

They do help form clots. Just not in the part that is involved with INR testing.

This is a very difficult concept that many doctors fail to grasp.

Clotting time is not the same thing as the prothrombin time.