Lovenex as a sub for warfarin during surgery

[Guest]

What have you experienced with Lovenox? My cardiologist recommends getting off warfarin for 4 days, using Lovenox as a "bridge" in preparation for removing a basal cell carcinoma from my nose.

Wondering about the wisdom of doing this.

Thanks for input,
friend

 

[Tbone]

I have heard of this before, some doctors like this & others do not. All is considered using a risk assessment . For more information see website below, or look it up on Google "using lovenox as a bridge to surgery"


http://www.warfarinfo.com/bridgetherapy.htm

Best of luck to you!

 

[Ross]

Actually, you shouldn't have to come off Coumadin for that procedure. It's not that big of deal and won't bleed much at all. I know, I know, arguing with the damn Doctor gets you no where.

Lovenox is the standard approach used when someone must be taken off Coumadin for a procedure or any time when they are going to be below therapeutic level for an extended period of time. It should be noted that even though Lovenox is used, it has never been studied for use for this purpose. It does seem to be effective however, which is why they still go that route.

Here is a link that may better explain:
http://warfarinfo.com/bridgetherapy.htm

 

[catwoman]

If you were having invasive surgery, i.e., hysterectomy, gall bladder removal, etc., going off warfarin would certainly be the way to go.

I haven't had any problems with skin cancers, so I'm not familiar with how much bleeding would be involved.

I believe that Lovenox can also cause bleeding issues.

Let's see if anyone here has had skin cancers removed while on warfarin and can weigh in on their experience.

 

[Herb M]

I have had a basal cell carcinoma removed from my nos and from my chest. In neither case was I told to change my Coumadin dose. There was no significanr bleeding.

 

[mattwisconsin]

Lovenox can cause bleeding issues. When I had it for bridge therapy it caused my gums to bleed for a day and a half. The reason it is used for bridge therapy is because it leaves your system so much more quickly so you can use it up to 12-24 hours before surgery, where coumadin takes days to leave your system.

This is just my understanding. I am sure you can find more accurate info on warfarininfo or from your doctor.

 

[Sierra Bob]

I also have had basal cell carcinoma removed from my nose with no bleeding problem while on warfarin. For two major (8 hour) surgeries involving and repairing my mandible because of osteoradionecrosis from radiation due to head and neck cancer, I have been bridged with Lovenox. Also during my original cancer surgery. I had a severe bleed after the last repair in my chest where my pectoralis major muscle was removed to place in my cheek since the tissue was so badly compromised from radiation, the previous surgery would not heal. The bleed was not caused by the Lovenox. The problem I'm sure was caused by placing me too soon on my original warfarin dosage, without recognizing I wasn't consuming any vitamin K and my presurgery dosage was based on consuming an Ensure (25% K), a V-8
and a salad every day. I'm now scheduled for another repair this month as the screws holding the titanium plate will not hold in the remaining mandible as it also has necrosis at the TMJ end.

Sierra Bob

 

[Guest]

Thanks for the input from all of you.
Friend

 

[ShezaGirlie]

I also had a basel cell removed from my leg while on warfarin. I remember about 8 stitches and absolutely no bleeding. Be sure to have the MOHS method of removal -- more expensive, but you will be guaranteed it's all gone in one visit.

**hey Sierra Bob** How ya doing these days? That silzone valve still clickin' away??

 

[Sierra Bob]

No problems with the model of the recalled valve so far. Wish I could say the same regarding my jaw.

Sierra Bob

 

[Bina]

I also had a basel cell removed from my leg while on warfarin. I remember about 8 stitches and absolutely no bleeding. Be sure to have the MOHS method of removal -- more expensive, but you will be guaranteed it's all gone in one visit.

**hey Sierra Bob** How ya doing these days? That silzone valve still clickin' away??

Janie, what is the MOHS method of removal---?
A few years back I had a small suspicious bump removed from my face. It was done by a plastic surgeon, and I don't have any scarring.

 

[ShezaGirlie]

Janie, what is the MOHS method of removal---?
A few years back I had a small suspicious bump removed from my face. It was done by a plastic surgeon, and I don't have any scarring.

Call me a day late and a dollar short old woman. Forgot to give you an answer... This from the website: http://www.mohscollege.org/

Mohs Micrographic Surgery is the most advanced and effective treatment procedure for skin cancer available today. The procedure is performed by specially trained surgeons who have completed at least one additional year of fellowship training (in addition to the physician's three-year dermatology residency) under the tutelage of a Mohs College member.

Initially developed by Dr. Frederic E. Mohs, the Mohs procedure is a state-of-the-art treatment that has been continuously refined over 70 years. With the Mohs technique, physicians are able to see beyond the visible disease, to precisely identify and remove the entire tumor layer by layer while leaving the surrounding healthy tissue intact and unharmed. As the most exact and precise method of tumor removal, it minimizes the chance of re-growth and lessens the potential for scarring or disfigurement.

Because the physician is specially trained in surgery, pathology, and reconstruction, Mohs surgery has the highest success rate of all treatments for skin cancer - up to 99 percent. The Mohs technique is also the treatment of choice for cancers of the face and other sensitive areas as it relies on the accuracy of a microscopic surgical procedure to trace the edges of the cancer and ensure complete removal of all tumors down to the roots during the initial surgery.

 

[Bina]

Thanks Janie.
After my bump removal, the biopsy did not show cancer, but I always wondered what if? ......