Lovenox

[Joe]

As a new registered user, I want to thank Hank for getting me to where I can post. With a St. Judes mechanical aortic valve since Jan. 2001, my concern at the moment regards coumadin. Anytime any surgery is performed one has to get belly shots of lovenex as you all well know. I recently had a prostate biopsy and had to inject 2 shots per day for 5 days prior (60 mg). Now they want to implant 3 markers in my prostate for external raditation. First I was told I would not need to get off coumadin for this procedure. Now they say I will!Anyone out there have much experience with lovenox?
Please let me know your thoughts and experiences. Joe in Missouri

 

[geebee]

Welcome, Joe. Glad you found us and are now a posting member.

Sorry to hear of your problems. I have never had experience with Lovenox as my cardio is very conservative and uses the "in-hospital heparin bridging IV" procedure for anything I have needed.

Not sure about the markers but I would question them again and find out if they really could do them without you coming off coumadin. I have had a few procedures where the initial response was "come off coumadin" but ended up not doing so. These included a lumpectomy (followed by targeted radiation therapy), colonoscopy and tooth extraction. Many times doctors just find it easier to deal with no ACT but really can perform many procedures while you are fully anticoagulated.

Best of luck to you.

 

[WayneGM]

Unfortunately I can't provide any insights on your question as I'm not a coumadin taker (had a mitral valve repair), but I just wanted to welcome you to the VR community. Glad you found us.

 

[Susan BAV]

Hi Joe -

Welcome to the site; glad you found it! I have very little experience with Coumadin so I can't offer any intelligent reply to your specific question but there are many here, including geebee, who have much experience.

This question (this thread) might get moved to the anticoagulation forum where more members may see it there; although the administrator/moderater, Ross, is in the hospital right now, and he's usually the one who would move a thread if necessary.

Take care and post again.

 

[BackDoc]

a few years ago I experienced a DVT. For seven days I self injected 2x daily with lovenox, until my INR reached theraputic levels.

Don't be afraid it it. Lovenox is short acting that's why you inject 2 daily, at 12 hour intervals.

There is no reason to be stuck in a hospital on an IV drip when you can do it yourself.

It's a momentary pinprick, nothing more. They come pre-filled. You simply uncap and inject.

Diabetics do this everyday, multiple times a day.

The drug must be injected into a fatty tissue in order to be absorbed. That is why the abdomin is the preferred site. You can use the front of your thigh, but it is easier in the abdomin. BTW: it can cause intense brusing along the injections sites.

http://www.drugdigest.org/DD/DVH/Uses/0,3915,232|Lovenox,00.html

http://nursing.about.com/od/education/ht/heparininj.htm

 

[Harrybaby666]

I just want to chime in and say Welcome Joe...

I just want to chime in and say Welcome Joe...

Even though I haven't had a valve replacement as of yet, whenever I go into the hospital, they put me on Lovonox as a precautionary measure, and I have done really well with it. I know not everyone is the same, but I just thought this might help in some small way....Harrybaby

 

[hensylee]

Hi Joe. Glad to see you are finally 'legal'. Again, welcome to VR. Backdoc gives excellent info - as do all our other members.

 

[tommy]

Hey Joe. Glad you found us. Welcome!

I've had several Lovenox bridges since AVR in 2000
Dental crown
Wide area excision (about the size of a hen's egg)
Inguinal hernia repair
Several colonoscopies
Small area excision (about the size of a quils' egg - the suregeon must like eggs)

My dosage is set by my body weight. At 200+, my dose is 90-100 mg. My cardio always consults with the doctor by phone. The prescription for Lovenox comes from my cardio.

Also, we finesse the process, by not starting Lovenox until my INR gets below 2.0. Also, after the procedure, we stop Lovenox after the INR gets above 2.0. No guessing that way. Home testing helps. Lab test with a day's delay doesn't work.

Their are several variables in the world of Lovenox brdiges. it is not an exact science.

1. The therapy is not officially approved. But it is the best available.

2. There is a movement afoot (perhaps being led by members of this board) to stay anticoagulated for as many procedures as possible. The thought is that the bridge therapy is often an unecessary risk with the benefit being convenience for the doctor and patient. You can search out other posts for more information. For example, for my latest small area excision, the nurse reminded me to "go off Coumadin 5 days prior". I said "no", and told here that the doctor would understand, but if he objects to call me back. I showed up fully anticoagulated, and it went fine. (Okay, I cheated and halved a dose the night before and had a huge salad for lunch. My INR the next day was 2.5 on the nose!)

3. Many docotors do not seem to understand the risks of going off warfarin. As patients, we must advocate for ourselves. PS....advocacy seems to be more and more important for all medical activites.

4. I personally believe that my Lovenox dose is too high. My GE wanted to put me on 45 mg does, but the cardio insisted on 100 mg. It just seems like I ooze for a long time after colonoscopies.

Hope this help, and again, welcome!

 

[afraidofsurgery]

Lovenox bridge

Lovenox bridge

Hi Joe,
Welcome to the site! I was sent home from the hospital on lovenox after my AVR because my INR hadn't risen quite high enough, but the docs were OK sending me home on Lovenox vs having me sit around in the hospital for no other reason.

I am very squeamish about needles but found the Lovenox shots to be no big deal. Didn't really hurt, and was kind of cool to know I could stick myself with a needle (OK I'm a little weird that way).

As to the acceptance of this therapy and its effectiveness, I'll defer to the experts on those issues. I had no problems but I was taking coumadin while on the Lovenox, took about 4 days for my INR to go up enough to get off it. Apparently the coumadin dose can only be ramped up so fast, so thus the bridge therapy.

Patty

 

[Joe]

Lovenox

Thanks to all that gave me information and support! Its nice to be able to communicate with those who have or had similar concerns.
geebee, I agree with you that the docs want to err on the cautious side and tend not to think about the patient!
backdoc, I am not new to lovenox ,as I took it on two different occasions in 2004. However at that time I was instructed to inject 100 mgs once daily for 5 days prior and none afterwards . Maybe i was lucky but i came through fine with that both times. Same primary doc and coumadin administrator as at that time. weighing in at only 150 lbs. i don't have much fat around around my middle. Brusing is big time and 2 a day injections, i seem to run out a place i have't been. Fortunately my wife of 45 years does the injecting,I don't think I could do it.
Tommy, I was going to say something to you, but I can't remember what, so goes old age.

Again thanks to all for their thoughts and I look forward to much communication in the future.
P.S. I am in line to get a coumadin monitor through QAS, if it ever gets shipped, which will help as I now make a round trip of 150 miles for testing.
I like the idea of testing weekly and will be inquiring more info on self testing in the future. Sorry, I am so long winded today.
My best to all, JOE