Question about coumadin

[Granbonny]

How soon after sugery..do they give you your first coumadin pill? I know..not in recovery room. Do they have you on a heparin (sp) drip? or Lovenox?..until your INR gets into a safe range..which, I'm thinking it must be the 4th or 5th day...I don't remember having a shot in my arm... Bonnie

 

[EVELYN]

Hi Bon

Tyce says he remembers getting an IV drip of some sort, but I think his coumadin pill was 2-3- days post op. I remember something about his coumadin level being too low, so they really bumped him up before they released him.....wow, talk about being in a fog, I guess we both were. That's about all I can tell ya'll.

Aside from everyone being sick, hope your Holiday was happy.

We spent the day raking and picking up leaves---mostly in the driveway where they all settle.....it will definitely be an early night.

Ev

 

[Creed3]

Hi Bonnie!

Hi Bonnie!

I believe I was started about the same time Tyce was started, 2 to 3 days post op. I'm thinking 2nd day because I was still in CCU.

Take Care!
Gail

 

[Gnusgal]

I don't remember exactly what day I started taking the coumadin, but I'm fairly certain I was on heprin IV until my INR was in-range. That was part of the reason I was in for a full week. Other than that I was feeling pretty darn good and trucking around those hallways like a champ!

 

[Johnny Stephens]

I came out of surgery with a Heparin drip. I stayed on it for 10 days or so until I came out of my artificial coma and was awake enough to swallow the pill without choking on it.

 

[Harpoon]

Sort of echoing Johnny here, though I WISH it was only ten days for me...


I think it really depends on the individual and how quickly their body adjusts to the coumadin. I'm sure there's a period where things fluctuate a lot and heparin is a much more effective way of managing that. I suspect heparin is easier to counteract if there's a need for additional surgery say to control bleeding or install a pacer after you've gotten your valve surgery.

 

[sylviayasgur]

Help!!!!!

Help!!!!!

hi all!
i haven't been on at all lately, miss you all terribly and look forward to having more time to come back more frequently...

funny this should come up about coumadin....
my dad, 71 y.o., in chronic afib and had a st. jude's mech. valve put in
4 1/2 yrs ago, just had hernia surgery done last week. they resumed what i thought was either coumadin or heparin about 12 hours after surgery and sent him home two days later. daily lovenox shots brought his levels up to where they should be...
last night he was rushed to the ER with internal bleeding and BP of 70/44 (didn't even register!), severe anemia and severe dehydration...
it was very touch and go.
today they did a ct scan and found that there is a hematoma in his pelvic area and they have taken him off coumadin and given him frozen plasma to coagulate the blood (they want his inr down to 1.3 ish).
they feel that they want to address the internal bleeding rather than focus on maintaining his coumadin level in order to prevent clotting
(and stroke?).

i have PM-ed al lodwick and would love any feedback that might enlighten me. i rarely read threads pertaining to coumadin since they don't apply to joey, but could use all the help i can get now...

hoping you're all doing well...
sylvia

 

[bvdr]

Hi Sylvia! It is so nice to hear from you again but sorry your dad is having this problem.

First of all, treating a severe bleeding problem would be the priority with your dad. He would, short term, be more at risk loosing his life by actual bleeding that by, at this point, only the potentiality of developing a clot.

Since you aren't all that familar with Lovenox and coumadin, let me just give you a couple of basics. The coumadin and Lovenox both are used to anti-coagulate blood but only coumadin is reflected in the INR. A rather set dose by patient's weight is prescribed to protect a patient while the coumadin has a chance to build back up to the INR appropriate for an individual patient. Lovenox doesn't bring INR up but "bridges" until the coumadin brings it up.

There are several different steps blood goes through to clot and by interupting any of the steps the same effect is achieved. Lovenox and coumadin interupt slightly different places. Lovenox is short acting but coumadin is long acting.

I don't know what happened in your dad's case but I know I bruised much more when I was on Lovenox injections than I ever did even when my INR (reflecting coumadin therapy) was very high.

I'm sorry if this just confuses you. I'm thinking of deleting it but maybe it will help a little. I'm concerned about your dad so please keep us informed on how he is doing, OK?

 

[sylviayasgur]

thank you, thank you, thank you!

thank you, thank you, thank you!

hi betty!
so great to hear from you.
i'm sooo happy you did not delete that post.... i got it.
i understand the basics of coumadin because i am very close to my parents and my dad and i talk a lot about this since he knows it's a big part of my life as well.....
it seems that my dad's bleeding has stopped (even though his inr is 2.3) which i assume is good.... and they have started administering heparin so that he can be "safe" with his valve and afib, hoping he won't start bleeding again (but heparin can be stopped_ like lovenox_ much faster than the coumadin)... am i on the right track????
in any case, they are moving him out of icu and into a room tomorrow.
his stomach is unbelievably distended with air (they finally x-rayed it after 2 days and realized it wasn't blood or fluid that was in there!!!!)..
i hope he tolerates the heparin and then they will start coumadin...
will keep you posted.
again, betty, thank you for your support..
btw, i haven't been on much (college apps, my dad, joey's elderly parents...) how are YOU feeling? did you go to the reunion? we were so sorry to have missed it, but it just didn't work out for us timing-wise.
wishing you all the best, sylvia

 

[EVELYN]

Hi Sylvia

SOOO good to hear from you.....but not glad to hear about your Dad. Please keep us posted. I'm sure everything will be ok. I'll add him to my prayer list. We've missed you on the list.

Evelyn