Post hernia Op bleeding-Coumadin/lovenox

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djexec

My dad (76yrs young) had a hernia operation Monday 8/14. He has a St Judes valve & has been on coumadin for the past 10 years. Prior to surgery he was advised by his cardiologist to supplement his coumadin with lovenox injections. Approximately 5 days later we brought him to the hospital because of significant swelling & obvious signs of bleeding. He has now been in the hospital for four days & according to his Hematocrit labs is still bleeding. The surgeon wants to operate again to tie off the bleeder & to remove part of the hematoma. We are concerned that it is too soon after his surgery last week for him to undergo another one. You guys here at vr.com were incredible to me prior to my surgery & I hope that someone in here can give me some advice on this situation. Thanks.

Deane:confused:
 
I think you should follow your surgeon's advice on this one. I know when I had an internal bleed after surgery my stomach blew up like I was having twins with blood.My surgeon told my wife if he didn't operate to stop the bleed I would bleed to death. Thats all my wife had to hear and I went directly to the operating room. Of course I was a sleep the whole time and didn't find out till later what had happened. You could always get a second opinion but your father could be in danger while you figure out what to do.
Good Luck
 
The surgery shouldn't be long enough to be of any major consequence. The bleed must be stopped.
 
Joe had a similar thing after gallbladder surgery and a Lovenox bridge. Older folks have to be careful with Lovenox and also those with kidney issues. It can build up in their system and cause over anticoagulation.

Joe alsmost bled to death. He had a complete bleedout. His cardiologist wanted him to have an immediate resurgery since he thought the large amount of belly fluid was pressing on his heart and could cause something bad to happen. And the bleeding had to be stopped. The surgeon did not want to go back in (possibly fear factor), but wanted to allow the fluid to absorb on its own. That never would have happened. Common sense prevailed and he had surgery a second time to remove clots and extra fluid. I think it saved his life.

However, he still needed 33 units of all the blood products they could pump into him to keep him this side of the dirt.

It took him probably 6 months to recover from that fiasco.

And they had to hold all anticoagulation for many, many days, at least over a week. That in itself was scary.

I can't tell you what a tense time that was for us.

Joe will NEVER have Lovenox again or Fragmin either.
 
hi deane,
something very similar happened to my father (71 at the time) about two years ago, in fact, it sounds like the same story. he takes coumadin (st. jude's valve), went in for a simple hernia operation, the surgeon was not familiar with bridging and after the surgery immediately put him back on the coumadin and added lovenox shots at home. he nearly bled to death and was rushed back to the hospital. he was given coagulants, i think about 5-7 units of blood, and developed a hematoma the size of a football in his abdomen.
it took almost a year for it to dissolve itself.
it was a total nightmare.

if the docs think that they can locate and stop the bleeding, i say do it.
hopefully you trust your docs more than we did the ones who were in charge of my dad.

al lodwick and others here (nancy's joe had had something similar) were very very helpful to me.
please let us know how things go.
all the best,
sylvia
 
Deane

Deane

I hope your Dad is in a good hospital (Atlanta)?....I know my S/I/L had a hernia operation that went bad..and he had to have a re-do...Not on coumadin but still. it looked awful..with the gaping hole, ect.:eek: ..bleeding..and he stayed in bed for the first few days. Yet, it still bled.did well after 2nd one..but still had to have bed rest..no lifting, ect. for several weeks....Let us know..Bonnie
 
Unfortunately, this illustrates why I am less enthusiastic about Lovenox bridging. Especially with abdominal surgery it carries a large risk of bleeding. Still, going in to suture the bleeder is usually less serious than having a stroke. I didn't say that I was against bridging, just less enthusiastic.

Hope your Dad recovers quickly.
 
djexec said:
Prior to surgery he was advised by his cardiologist to supplement his coumadin with lovenox injections.
Perhaps you meant to say replaced Coumadin with Lovenox bridge. If he doubled up, that would be wrong.

I laid real low after my inguinal hernia repair before the bridge back to Coumadin was complete. I had constant oozing "down there" during the bridge. Here's my thread on "collateral discomfort" http://www.valvereplacement.com/forums/showthread.php?t=5135&highlight=collateral
 
Update

Update

Once again, I send you all huge thanks for your quick replies & sharing experiancial data with me. Sylvia, I actually found your story & printed it off for my mom to read...it was incredibly helpful for both her and my dad to read about your fathers experience. He even asked if I thought your dad would speak to him over the phone? To everyones surprise, the doctors released my dad from the hospital on Saturday. The internal bleeding seems to have stopped & the kind folks at St. joe's hospital bode him a healing farewell. Since he has been home, he has had several dizzy spells which the doctors believe to be related to the blood loss. The home nurse arrives tomorrow which will be a relief to us all...having his INR checked daily at this point is quite important. Otherwise, he is doing fine but frusterated as to the length of time his recovery will entail. THanks again for the help & I'll let you know how things progress.
 
Daily INR checks are ok if used for reference only, but don't let them start changing his doseages with every test! It takes 3 days for a dose change to show in the test, so actually, testing everyday is over kill.
 
Ross said:
Daily INR checks are ok if used for reference only, but don't let them start changing his doseages with every test! It takes 3 days for a dose change to show in the test, so actually, testing everyday is over kill.[/QUOTE]

You mean like they do in the hospital, you would think somebody at a hospital woud know that.
 
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