Sir Lance-a-Lot meets Coumadin Patient

[ALCapshaw2]

Today was the day (Friday). My General Surgeon Lanced my infected Sebaceous Cyst while (more than) fully anti-caogulated and I didn't bleed to death. One bloody towel but far from being soaked. Not too bad. He did end up cauterizing around the incision(s).

Backtrack to Tuesday. Surgeon examined the sebaceous cyst, pronounced it infected and prescribed an anti-biotic, Bactrim, to see if it would help reduce the swelling by Friday. My Coumadin Clinic and Pharmacist gave conflicting information on the affect of Bactrim on INR. Another pharmacist (at the same pharmacy) discovered two different references with confilicting information on the SAME drug!

Later, our friend and tutor, AL Lodwick declared that Bactrim does indeed tend to Raise INR and noted that the more powerful (and expensive) antibiotic Levaquin had little effect on INR.

I stayed with the Low Cost approach (which was the only Rx he gave me). Coumadin Clinic scheduled a recheck for the following Monday. Surgeon said he would Lance the cyst on Friday and I would NOT need to go Off Coumadin (Hooray!). Friday comes and I decide to drop by the Coumadin Clinic for a quick INR check. Fancy Finger Stick Machine (with bar code reader and computer interface) says INR=5.5 after a L O N G delay as it processed what looked to me like a HUGE blood sample.

Off to the surgeon. I never knew that Lidocaine(?) could BURN so. The surgeon said that was the worst part. He was right. Surgeon said I could discontinue the antibiotic now that the pus was all squeezed out. I wasn't totally comfortable with that recommendation...
Think I was at least take this evening's dose, just to be safe.

I then went back to the Coumadin Clinic to see what to do about dosing adjustments and juggling the antibiotic. The Nurse Manager told me that whenever they read over 5.0 on a Finger Stick machine they require a retest by veinous draw. Later that afternoon she called to report INR = 3.2 by veinous draw. She explains that sometimes patients on antibiotics register (artificially) high INR on the Finger Stick test but Normal Range INR by veinous draw. (AL Lodwick: Feel free to express your observations in this matter - which reading do YOU believe?).

Surgeon advised laying on my side for an hour on a firm pillow to put pressure on the incision. I gave it an extra half hour. Took ONE pain pill 'just in case' but was never in great discomfort, if you don't count pulling off the tape!

Didn't mean for this to turn into a Novel. Sorry about that.

'AL Capshaw'

 

[lance]

Excellent experience

Excellent experience

Very pleased to learn cyst removal while fully anti-coagulated did not require a raincoat, boots and umbrella.

The absolute worst experience is the lidocane ***.

Cheers

 

[Karlynn]

Boots and a rain coat - love it!

Al - I'm glad it went so well. Thanks for the great report. I'm not totally comfortable with you not taking the antibiotic as prescribed. Don't want any of that junk to have entered your system during the lancing and cause other problems. Antibiotics can be a pain on INR. How long are you supposed to take the antibiotic?

 

[Guest]

Glad that it worked out so well.

This will be important for the people that take warfarin and that surgeon works on again.

Mayo Clinic reports doing prostste surgery on men who are fully anticoagulated.

The person at the anticoag clinic just made up the thing about getting different readings with antibiotics. I have read the abstract of nearly every article written on warfarin in the past ten years and have never seen it reported anywhere. I have also recently tested (and read the instruction manual) for all three fingerstick testers and none of them include this in the cautions. If the person knows that it happens, I wish that they would submit the finding for publication. That way the world would benefit instead of this being their "secret".

 

[geebee]

Al,

Happy to hear all went well. It's nice to have one more thing we know can be done fully coagulated. I think there is very little that cannot be done while on coumadin short of major surgery.

 

[ALCapshaw2]

Bleeding Setback?

Bleeding Setback?

Maybe I was a bit premature saying that ALL went well.

Woke up Sunday morning to find that I had an Ear Bleed. Apparently there is a minor 'injury' inside the ear canal that is STILL bleeding this evening (with a 2X2 gauze pad stuffed inside in an attempt to put some pressure on the bleeding site.

After having the ear checked at a local "Urgent Care" facility affiliated with the major local hospital, I asked the Doc to 'look at' my incision. When he unpacked the 'hole', it began to bleed freely ...again. He put a 'compression bandage' on it and suggested I call / see the Surgeon MONDAY instead of waiting until my scheduled followup on Thursday. Doc was concerned about blood loss if this continued every day for a week.

My ProTime meter indicated an INR of 3.7

Does anyone know if the ProTime units are consistently 'off' to ONE side or the other?
Or can their readings be either high or low
compared with a Lab Draw?

'AL Capshaw'