G
Guest
Yesterday I wrote a new page about the risks of stopping warfarin to have procedures done.
You can read it at http://www.warfarinfo.com/procedures.htm
You can read it at http://www.warfarinfo.com/procedures.htm
Help Support Valve Replacement Forums:
A
ALCapshaw
THANK YOU AL !!
What a GREAT New Year's present.
I've been having some 'issues' and my cardio wants me to consider another Catheterization. This couldn't have come at a better time! I'm inclined to decline, or at least require a better justification and explanation of benefit vs. risk.
'AL'
What a GREAT New Year's present.
I've been having some 'issues' and my cardio wants me to consider another Catheterization. This couldn't have come at a better time! I'm inclined to decline, or at least require a better justification and explanation of benefit vs. risk.
'AL'
MarkU
Well-known member
Thanks for the new info, Al.
I've always had much more fear of strokes than of bleeding. In my mind I always I felt that bleeding was a much more managable risk.
You information helps to confirm my opinion.
Thanks again and happy new year.
Mark
I've always had much more fear of strokes than of bleeding. In my mind I always I felt that bleeding was a much more managable risk.
You information helps to confirm my opinion.
Thanks again and happy new year.
Mark
Marty
Well-known member
"tunnel vision" subspecialists
"tunnel vision" subspecialists
Al, this is an important subject. I see subspecialist "tunnel vision" every day. It is true that most subspecialists do not think of the well being of the "whole" patient. There is a great fear of malpractise litigation. There is almost no risk to doing a test or operation. However if a condition develops subsequently the lawyers search for a test or procedure that was not done.My own specialty ,radiology, has benefited financially from this as we do tests every day that have low yield and little indication and are sometimes quite dangerous . Most of us would like to do fewer of these tests even if it hurt our pocket book a little but we can't seem to tone it down as the internists and surgeons buff up the charts primarily to look a little better for the lawyers. Al,I'd be interested to know the procedure your patient had done. Was it an Xray, a colonoscopy, minor surgery,...? The best protection for the patient is a good knowledgable GP, FP, general internist who knows you and your family well."The secret of caring for the patient is caring for the patient."
"tunnel vision" subspecialists
Al, this is an important subject. I see subspecialist "tunnel vision" every day. It is true that most subspecialists do not think of the well being of the "whole" patient. There is a great fear of malpractise litigation. There is almost no risk to doing a test or operation. However if a condition develops subsequently the lawyers search for a test or procedure that was not done.My own specialty ,radiology, has benefited financially from this as we do tests every day that have low yield and little indication and are sometimes quite dangerous . Most of us would like to do fewer of these tests even if it hurt our pocket book a little but we can't seem to tone it down as the internists and surgeons buff up the charts primarily to look a little better for the lawyers. Al,I'd be interested to know the procedure your patient had done. Was it an Xray, a colonoscopy, minor surgery,...? The best protection for the patient is a good knowledgable GP, FP, general internist who knows you and your family well."The secret of caring for the patient is caring for the patient."
Thanks for the info Al.
I have stopped my Coumadin several times for various procedures and was very concerned each time.
I did insist that the doctor/dentist talk it over with my cardiologist
beforehand.
Each time I stopped for three days.
Fortunately I did not have a problem......so far.
As far as a colon check for instance non-invasive tests do sound like the way to go but I have read that the tests can amount to the same as many,many x-rays.
Has anyone else heard this regarding excessive radiation?
I have stopped my Coumadin several times for various procedures and was very concerned each time.
I did insist that the doctor/dentist talk it over with my cardiologist
beforehand.
Each time I stopped for three days.
Fortunately I did not have a problem......so far.
As far as a colon check for instance non-invasive tests do sound like the way to go but I have read that the tests can amount to the same as many,many x-rays.
Has anyone else heard this regarding excessive radiation?
G
Guest
Rich,
Look at it this way -- what are your options if you bleed?
1. Pressure
2. Ice
3. Suture
4. Cauterize
5. Vitamin K
6. Fresh Frozen Plasma
7. Blood transfusion
What are your options if you clot?
1. Wrecked valve
2. Stroke
I will run INRs up to 5 without making too much of a change because I'm much more afraid of a clot than a bleed.
I had a young man, exactly my son's age in his 30's, who refused to take enough warfarin. He had a stroke. One of the most sickening sights of my life was when a therapist sat him up in bed and failed to support him. He fell over sideways and landed back on his pillow. But he made no attempt to recover and even his face showed no sign that he recognized that anything was wrong. He did artistic type work and lost his job because he no longer had the right brain functions. He went from a quite successful young man to washing pans at Burger King because of failing to take warfarin. Just think how much better off he would have been if his nose had bled at work and he had to spend 15 minutes in the rest room getting it to stop. That is why I lean toward bleeding instead of clotting.
Marty,
It was a colonoscopy.
Rich,
Marty will be the one to tell us about the relative doses of radiation. MAT is (are?) his initials, the XR is because he is a radiologist.
I don't agree with Blaine (Jesse Ventura) in Predator when he says, "I ain't got time to bleed."
Thanks everyone for your nice comments. It took most of the day to write that page. Yesterday it was the 3rd most looked at page on the website -- so I guess lots of people are interested.
Look at it this way -- what are your options if you bleed?
1. Pressure
2. Ice
3. Suture
4. Cauterize
5. Vitamin K
6. Fresh Frozen Plasma
7. Blood transfusion
What are your options if you clot?
1. Wrecked valve
2. Stroke
I will run INRs up to 5 without making too much of a change because I'm much more afraid of a clot than a bleed.
I had a young man, exactly my son's age in his 30's, who refused to take enough warfarin. He had a stroke. One of the most sickening sights of my life was when a therapist sat him up in bed and failed to support him. He fell over sideways and landed back on his pillow. But he made no attempt to recover and even his face showed no sign that he recognized that anything was wrong. He did artistic type work and lost his job because he no longer had the right brain functions. He went from a quite successful young man to washing pans at Burger King because of failing to take warfarin. Just think how much better off he would have been if his nose had bled at work and he had to spend 15 minutes in the rest room getting it to stop. That is why I lean toward bleeding instead of clotting.
Marty,
It was a colonoscopy.
Rich,
Marty will be the one to tell us about the relative doses of radiation. MAT is (are?) his initials, the XR is because he is a radiologist.
I don't agree with Blaine (Jesse Ventura) in Predator when he says, "I ain't got time to bleed."
Thanks everyone for your nice comments. It took most of the day to write that page. Yesterday it was the 3rd most looked at page on the website -- so I guess lots of people are interested.
Last edited:
Z
Zipper
Al,
You betcha we are interested! There aren't enough words to Thank You for this invaluable information. You are just wonderful and giving to be here for us!
To be perfectly honest..my dentist wants me to hold for 2 days for a routine cleaning! I don't do it...and if they ask I lie...LOL! I am more concerned about root canals and am never sure if I want to follow their instructions. I have had two since coumadin and did hold but it scared me!
I also had to have an 'UltraSoundFine Needle' Biopsy due to thyroid nodules...(which, BTW..my dentist discovered...grin) and I ended up holding til I was down to 1.9 before they would do it...took three days. Again, it scared me.
Your articles are so amazingly informative and helpful. I will advise each of my Doc's and Dentist to visit your site..if they don't I'll print the new additions and bring your book to them !!!!!!
I am so upset with my Mom's friends that are on Coumadin....they are older and really do not pay attention to any of this. I've tried to make them read your book...it's futile. The education you offer isn't reaching some of the elderly...such a shame...I'll keep trying, Tho!!!
THANK YOU AL!
Zipper/Joan
Many, Many Thanks Al...
Zip/Joan
You betcha we are interested! There aren't enough words to Thank You for this invaluable information. You are just wonderful and giving to be here for us!
To be perfectly honest..my dentist wants me to hold for 2 days for a routine cleaning! I don't do it...and if they ask I lie...LOL! I am more concerned about root canals and am never sure if I want to follow their instructions. I have had two since coumadin and did hold but it scared me!
I also had to have an 'UltraSoundFine Needle' Biopsy due to thyroid nodules...(which, BTW..my dentist discovered...grin) and I ended up holding til I was down to 1.9 before they would do it...took three days. Again, it scared me.
Your articles are so amazingly informative and helpful. I will advise each of my Doc's and Dentist to visit your site..if they don't I'll print the new additions and bring your book to them !!!!!!
I am so upset with my Mom's friends that are on Coumadin....they are older and really do not pay attention to any of this. I've tried to make them read your book...it's futile. The education you offer isn't reaching some of the elderly...such a shame...I'll keep trying, Tho!!!
THANK YOU AL!
Zipper/Joan
Many, Many Thanks Al...
Zip/Joan
Marty
Well-known member
Xray Dose, ? Colonoscopy
Xray Dose, ? Colonoscopy
Rich, Unfortunately your suspicions of high dose during certain Xray tests like CT, virtual colonoscopy,angiography are well founded. Each situation is different and must be individualized.
However we were surprised when we had physicists
monitor some of our procedures and found in some single tests the annual permissable dose of 5 rads was exceeded! This is a risk vs. benefit decision.
Having said this, we humans are very resistent to radiation and can actually take more than the governament mandated permissable dose without obvious ill effect.
Al, I am distressed to hear your patient stroked just to have a colonoscopy. The almost 100 year old barium enema test is still good. I do three or
four every day....some for failed colonoscopy. It is not rare for us to detect a polyp or cancer missed at colonoscopy. Your patient should not have had her warfarin stopped. If they found a polyp or tumor she could then have been hospitalized, bridged with heparin and then operated.
Xray Dose, ? Colonoscopy
Rich, Unfortunately your suspicions of high dose during certain Xray tests like CT, virtual colonoscopy,angiography are well founded. Each situation is different and must be individualized.
However we were surprised when we had physicists
monitor some of our procedures and found in some single tests the annual permissable dose of 5 rads was exceeded! This is a risk vs. benefit decision.
Having said this, we humans are very resistent to radiation and can actually take more than the governament mandated permissable dose without obvious ill effect.
Al, I am distressed to hear your patient stroked just to have a colonoscopy. The almost 100 year old barium enema test is still good. I do three or
four every day....some for failed colonoscopy. It is not rare for us to detect a polyp or cancer missed at colonoscopy. Your patient should not have had her warfarin stopped. If they found a polyp or tumor she could then have been hospitalized, bridged with heparin and then operated.
Al and Marty,
Thank you very much for the information.
I have stopped my Coumadin once for a tooth removal but never for cleanings or root canals.
If I bleed a little it's no big deal as long as Iv'e taken the anti-biotics.
I have had however biopsies of the prostate taken several times.
Those times(which all turned out negative) they had me stop the Coumadin for three days(stopped on Friday,Sat and Sun)had the procedure done on Mon afternoon and then resumed my Coumadin as soon as I returned home. Sounds like it was actually closer to four days of going without Coumadin since I take my dosage in the late afternoon every day.
They did pump me full of anti-biotics before those procedures were done but no Heparin therapy was considered.
If and when I have to do this again I will have a long talk with these doctors before I agree to it.
Marty I would rather take a chance on a little extra radiation then unnecessary internal bleeding so I will have to look into that one.
Rich
Thank you very much for the information.
I have stopped my Coumadin once for a tooth removal but never for cleanings or root canals.
If I bleed a little it's no big deal as long as Iv'e taken the anti-biotics.
I have had however biopsies of the prostate taken several times.
Those times(which all turned out negative) they had me stop the Coumadin for three days(stopped on Friday,Sat and Sun)had the procedure done on Mon afternoon and then resumed my Coumadin as soon as I returned home. Sounds like it was actually closer to four days of going without Coumadin since I take my dosage in the late afternoon every day.
They did pump me full of anti-biotics before those procedures were done but no Heparin therapy was considered.
If and when I have to do this again I will have a long talk with these doctors before I agree to it.
Marty I would rather take a chance on a little extra radiation then unnecessary internal bleeding so I will have to look into that one.
Rich
A
ALCapshaw
My Dentist had his hygenist use an Ultrasonic Cleaner for my semi-annual cleanings. Also had a 'deep cleaning' without stopping Coumadin. INR was around 2.5+ . No problems.
'AL'
'AL'
G
Gisele
Al-great article!
Al-great article!
I have always been in the belief that a high INR is a heck of a lot better than a low one. I am too busy enjoying life to have a stroke! I would rather deal with a bleed. The hard part is trying to convince my doc who is trying so hard to keep me stable. He worries about me going too high, and doesn't want me getting too low either. It is like walking a tightrope. Still searching for that perfect dose. Thank goodness for Lovenox!
Al keep up the great work and thanks so much for all your support and your imput.
Al-great article!
I have always been in the belief that a high INR is a heck of a lot better than a low one. I am too busy enjoying life to have a stroke! I would rather deal with a bleed. The hard part is trying to convince my doc who is trying so hard to keep me stable. He worries about me going too high, and doesn't want me getting too low either. It is like walking a tightrope. Still searching for that perfect dose. Thank goodness for Lovenox!
Al keep up the great work and thanks so much for all your support and your imput.
G
Guest
Thanks everyone - the good comments are what keeps me going.
Last year I had 87,153 visitors who read 204,123 pages. They have come from 101 different countries.
I guess some people are learning something.
One of my friends said, "Not bad for a non-porno site!"
Last year I had 87,153 visitors who read 204,123 pages. They have come from 101 different countries.
I guess some people are learning something.
One of my friends said, "Not bad for a non-porno site!"
Thanks Al!
This came at just the right time. I tried to make my first appt., since my surgery, for a dental cleaning. My dentist wouldn't make the appt. until I had the ok from my doctor. My dentist said that he has several patients on coumadin and that some stop their coumadin or lower the dose before cleanings and others just continue to take their normal dosage before cleanings. I called my doctor and I'm curious as to what he will tell me. If he wants me to stop my coumadin, I can now show him some information and discuss the options.
Thanks & Take Care!
Gail
This came at just the right time. I tried to make my first appt., since my surgery, for a dental cleaning. My dentist wouldn't make the appt. until I had the ok from my doctor. My dentist said that he has several patients on coumadin and that some stop their coumadin or lower the dose before cleanings and others just continue to take their normal dosage before cleanings. I called my doctor and I'm curious as to what he will tell me. If he wants me to stop my coumadin, I can now show him some information and discuss the options.
Thanks & Take Care!
Gail
