Protocol for suspending coumadin prior to OHS

[Michaelena]

Can anyone comment on pre surgery (maybe this should be posted in pre surgery) transition from coumadin to heparin. My surgeon said that I should suspend coumadin for 5 days prior to admission to the hospital to start heparin therapy, prior to the cardiac cath and the following day surgery. Is this the normal protocol? The thought of stopping the coumadin frightens me, as I too am concerned about blood clots and possible stroke.

Thanks for any experiences and/or comments.

Michaelena

 

[geebee]

I do not think this is the normal "safe" protocol.

I was admitted to the hospital 2 days before my last 2 OHS. I think I stopped Coumadin one or 2 days before my admission. I was started on IV Heparin as soon as I was admitted.

5 days sounds like a stroke chance to me.

 

[ALCapshaw2]

Why is it that DOCTORS never seem to get Coumadin management right?

 

[tommy]

Michaelena,

Your concern is valid. I've had Lovenox "bridges" several times for various procedures. The longest that I was unprotected was 24 hours afterwards. Since Lovenox dissipates in 12 hours, my last dose was 12 hours prior to the procedure. The half life of Heparin is very short and can be stopped very soon prior to surgery.

 

[Michaelena]

Thanks everyone, my sentiments exactly, sometimes I think that I over analyze everything the doctors say. Consultations with 3 surgeons all said the same thing. Perhaps I was not assertive enough, one of my many drawbacks. Scary , the doctors are the experts? Do you think this may be restrictions by my medical insurance plan? I will definitly pursue this further with my cardio and the surgeon I choose.

Your feedback is very valuable.

Michaelena

 

[Michaelena]

I do not think this is the normal "safe" protocol.

I was admitted to the hospital 2 days before my last 2 OHS. I think I stopped Coumadin one or 2 days before my admission. I was started on IV Heparin as soon as I was admitted.

5 days sounds like a stroke chance to me.

Gina,
Yes, this is what I thought would be more reasonable. I even offered to start heparin therapy at home, (during my pregnancy I gave myself heparin injections), the surgeon said no, it would be better this way. I am not so sure.
Many thanks for your input.
Michaelena

 

[catwoman]

Gina,
Yes, this is what I thought would be more reasonable. I even offered to start heparin therapy at home, (during my pregnancy I gave myself heparin injections), the surgeon said no, it would be better this way. I am not so sure.

Michaelena:
Wonder what the surgeons would do if they were the patient and at risk from a stroke w/out warfarin? Would they be comfortable going w/out the drug? If so, I wonder how much long-term disability insurance and long-term care insurance they have to keep themselves and their family comfortable for many years?