missnutz
New member
I am due to have carpal tunnel op on both hands soon, had replacement aortic valve 6 mths ago. Do I have to go in 5 days before as drs say, and why? can anyone advise me? missnutz
surgery while on warfarin
- Thread starter missnutz
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Most surgeries (although NOT an ordinary tooth extraction) require going off Warfarin so you do not bleed too much. I had to do that for an injection of cortisone into my bad hip (which is done in a hospital). I had to be tested two times while building up to the surgery. I had to "bridge" to taking Lovenox over the 5 days. Lovenox offers anticoagulation while you are off Warfarin. Lovenox leaves the body in 12 hours, so you will not be bleeding during your procedure.
The bad parts of Lovenox: 1) You have to give yourself an injection twice a day. This turned out to be not as bad as I (terrified of needles) anticipated because the needles are tiny and there is almost no sensation when you poke yourself in the belly area. 2) Lovenox is extremely expensive if you must pay for it all out-of-pocket. It was so expensive for me that my creditcard company telephoned the drugstore a minute after the card passed through the drugstore's reader. Then the creditcard people called me two more times to make sure it was not a hoax. Yow! 3) Be careful as you go back onto Warfarin. I was erroniously advised by my Cardio to take both Lovenox and Warfarin the two days after the procedure. People on this forum warned my to not do take both at the same time. I took both for 24 hours, then awoke with red bloody areas/stains through my nightclothes and onto my bed from the most recent shot sites. I immediately stopped the Lovenox, despite the bad advice from my cardio.
It is doable, as others will advise you on this forum.
The bad parts of Lovenox: 1) You have to give yourself an injection twice a day. This turned out to be not as bad as I (terrified of needles) anticipated because the needles are tiny and there is almost no sensation when you poke yourself in the belly area. 2) Lovenox is extremely expensive if you must pay for it all out-of-pocket. It was so expensive for me that my creditcard company telephoned the drugstore a minute after the card passed through the drugstore's reader. Then the creditcard people called me two more times to make sure it was not a hoax. Yow! 3) Be careful as you go back onto Warfarin. I was erroniously advised by my Cardio to take both Lovenox and Warfarin the two days after the procedure. People on this forum warned my to not do take both at the same time. I took both for 24 hours, then awoke with red bloody areas/stains through my nightclothes and onto my bed from the most recent shot sites. I immediately stopped the Lovenox, despite the bad advice from my cardio.
It is doable, as others will advise you on this forum.
By the way, you or Ross might want to move this question to the Anticoagulation section.
Ross
Well-known member
I don't see any reason for you to have to come off Coumadin for Carpel Tunnel surgery. It's not that bloody.
ALCapshaw2
Well-known member
Maryka -
Actually, the advice your Doctor gave you was NOT-necessarily Incorrect regarding taking Lovenox and Coumadin AFTER your procedure.
There is NO Standard Protocol for Bridging.
Some Surgeons do NOT Bridge, either Before or After invasive procedures.
Some Surgeons Bridge Before but NOT After invasive procedures.
Some Surgeons Bridge Before AND After invasive procedures.
Bridging AFTER invasive procedures necessarily requires a Balancing Act between the Risk of Bleeding vs. the Risk of Stroke.
Some of our members have mentioned that their Surgeons recommended waiting 24 to 48 hours before resuming Lovenox Injections AFTER their invasive procedures to allow time for the treated area to heal.
Ross had Serious Bleeding Issues after having ALL of his Teeth Removed and had to go OFF anticoagulation to allow his gums to heal. I'm thinking some sutures were either not done properly or were missing.
Note that It is NOT uncommon for patients to take Coumadin / Warfarin AND Lovenox while they wait for their INR to reach 'Theraputic Levels'.
'AL Capshaw'
Actually, the advice your Doctor gave you was NOT-necessarily Incorrect regarding taking Lovenox and Coumadin AFTER your procedure.
There is NO Standard Protocol for Bridging.
Some Surgeons do NOT Bridge, either Before or After invasive procedures.
Some Surgeons Bridge Before but NOT After invasive procedures.
Some Surgeons Bridge Before AND After invasive procedures.
Bridging AFTER invasive procedures necessarily requires a Balancing Act between the Risk of Bleeding vs. the Risk of Stroke.
Some of our members have mentioned that their Surgeons recommended waiting 24 to 48 hours before resuming Lovenox Injections AFTER their invasive procedures to allow time for the treated area to heal.
Ross had Serious Bleeding Issues after having ALL of his Teeth Removed and had to go OFF anticoagulation to allow his gums to heal. I'm thinking some sutures were either not done properly or were missing.
Note that It is NOT uncommon for patients to take Coumadin / Warfarin AND Lovenox while they wait for their INR to reach 'Theraputic Levels'.
'AL Capshaw'
AgilityDog
Well-known member
Hey guys, see that new study I posted on continuing warfarin, rather than bridging, before during and after pacemaker implantation surgery. Trust me, having had 2 implants, that's a lot bloodier building a pocket under your skin than doing carpal tunnel surgery.
Ross
Well-known member
I had tendon surgery on my hand, and was surprised to find that they tourniquet the limb before surgery. There's darn little blood there when they operate, assuming they will do the same for you. It's almost dry. I would guess the concern is for when they let the blood back in.
There is mounting evidence that continuing Coumadin is the best course of action for most procedures, while trying to bring INR to its most reasonable low point. However, most surgeons are not up to date on Coumadin. Just make sure that whoever is guiding the bridging (or whatever course is chosen) is well experienced in it, and not just looking it up in his or her paperback copy of Anticoagulation for Dummies, thinking it's one-size-fits-all.
I wish you great results from your surgeries. However, if I understand your first post correctly as both paws at once, before the surgery, you may want to figure out how you're going to use TP during a two-hand recovery...
Best wishes,
There is mounting evidence that continuing Coumadin is the best course of action for most procedures, while trying to bring INR to its most reasonable low point. However, most surgeons are not up to date on Coumadin. Just make sure that whoever is guiding the bridging (or whatever course is chosen) is well experienced in it, and not just looking it up in his or her paperback copy of Anticoagulation for Dummies, thinking it's one-size-fits-all.
I wish you great results from your surgeries. However, if I understand your first post correctly as both paws at once, before the surgery, you may want to figure out how you're going to use TP during a two-hand recovery...
Best wishes,
Well, I would never again take warfarin with Lovenox at the same time again, if I had any control of the situtation! I guess it does not take me too much time to get up to my therapeutic level of warfarin!
missnutz
New member
Thanks for the reply Maryka, I checked back with the Cardiology team, The drs here are insistent that I go in to stay, and they say it must be two hands, too risky to do a second op. But then again, I am 65yrs old, so maybe I was expecting too much. Also I have something called syndrome x, (pretty rare here in new zealand,) and I still get angina a lot. The valve was o.7 when I had it replaced, but i was fine. Bounced back good. they told me I will be given the tummy jabs, it is called heparin, I have had it lots when I go in to Hosp So much drama, I once forgot to take my warfarin for a few days, and boy what a telling off. To be honest, I am so over warfarin, lol. Cheers from NZ, missnutz. ps, never thought about the tp. yikes !!!!
