Survived Hip Procedure, now back to Warfarin...

[Maryka]

Well, I had my Cortisone shot in my hip today (Tuesday) and it is back to my regular anti-coagulation. For the next couple of days, however, I am ordered by my cardiologist to take those Lovenox shots twice a day while taking a double dose of the warfarin. On Friday morning I will go into the cardiologist for my first PT test since the procedure. I hope it does not take long to get back up to my happy once-a-month testing routine!

Now, I hope this procedure helps my pain and that the pain does not come sneaking back too soon. I really do not want hip replacement very soon.

By the way, when the radiologist (who did the procedure) asked if I had any questions, I asked when I could start taking the Coumadin again. He asked why I was taking the drug and I said, "because I have an artificial heart valve." The radiologist looked shocked. Apparently no one told him I had an artificial heart valve previously and all of the "rules" placed on me about anticoagulants and the procedure were pure officious supposed "policy" spouted by the administrative assistants in the ward. Hmmm....

 

[tobagotwo]

all of the "rules" placed on me about anticoagulants and the procedure were pure officious supposed "policy" spouted by the administrative assistants in the ward.

Not surprising at all. Sometimes you really have to stand up to staff, or ignore them and go straight to the doctor to plead your case.

I'm merciless about it, because I've seen this sort of thing happen too often, both to my wife and myself. I'm not mean, just adamant. My entire goal with medical procedures and doctors is to get through any dealings with them alive.

Best wishes,

 

[catwoman]

Maryka:

Glad this is over and you're back to taking warfarin. Soon you'll be back to normal.
I've learned to be very assertive (i.e., whine) about my mechainical heart valve and the fact that it's in the mitral position.

 

[Ross]

They're doing it wrong. I swear, if those people ever understand how to do it, I'll die on that day.

Doubling your dose and taking Lovenox too is not only going to overshoot your range, but make you about 4 times more likely to bleed. Lovenox alone is much worse then Coumadin could ever hope to be. If I listened to the Doctors that fixed my mouth, I'd still be in the hospital bleeding. They wanted to do what they're having you do now.

I had a stand in for my PCP come in and tell them to stop the Lovenox and leave it at normal dose of Coumadin only.

While it irritates the crap out of me how they're having you do this, the bright side is, you aren't going to clot! It's just that it's the equivelent of stomping on the accelerator to get your INR up, then they'll want to slam on the brakes because it's too high and set you up to yo yo.

 

[AgilityDog]

Ross, darlin, you took the words right out of my mouth! Idjits! Double dose my Hiney! with Lovenox on top, she'll bleed/bruise like a sumbitch, and have an INR of 6 in 3 days.
Idjits!

 

[Maryka]

Well, I just now checked in here. I took double Warfarin last night. Then I took my first shot this morning. Maybe I should stop here or take another shot tonight and not do the last two shots? When I first went on Warfarin it took forever to get my level up, but I think I was not careful with my vitamin K. (For one thing, I was taking a combo vitamin that had vitamin K in it. What was I thinking?) I am sure that my PT reading cannot be that high yet.

My crazy money-saving side says that I paid over 70 dollars out of pocked for each and every one of those syringes, so why not use them. That is crazy, huh?

By the way, the night before my procedure I gorged myself on luscious brocolli and spinach, some things I ordinarily do eat much of these days. It was heavenly!

 

[Maryka]

By the way, my PT yesterday was below 1.5 or they would not have done the procedure.

 

[Ross]

How much Coumadin do you normally take per day?

P.S., I have 3 syringes of Lovenox left from the last round. Darn straight I'll hang on to them until the expiration date, in case I need them again. Mine were just a little cheaper at around $55 a pop.

If you love those greens, eat them and adjust your dose for them. Don't be depriving yourself of those much loved greens.

 

[Bina]

If the warfarin dose was doubled last night, I would not double it again today....the Lovenox will protect you for 12 hours anyway.

 

[Maryka]

The idea of taking both the Warfarin and the Lovenox for a few days was to have some anticoagulant coverage while the Warfarin built up again to close to a therapeutic level. I am really not as afraid as you all are about blooding to death on this regime. I think I will take the Lovenox tonight again because I do not see any signs that the Warfarin has hit the right level. (It probably points out that I have bad gums, but I always get some bleeding when I brush my teeth when my PT is at the right level. I had absolutely no bleeding today when I brushed my teeth. When I was only on the Lovenox I got the barest tinge of blood when I brushed my teeth.)

I take at least two MG (is the measurement MG?) a day of warfafin. Two days a week I take 4 MG (or a double amount). That was keeping me in the right zone. When the cardiologist told me to take double she meant 4 MG a day. I will go in to have my PT read Friday morning. Based on my tooth-brushing test today, I do not really feel uncomfortable doing as the cardiologis suggested.

 

[karen14]

Best wishes for you Maryka! No pain is where it's at! ~Karen

 

[Maryka]

Well, this morning I awoke to a little bit (but noticable) of blood oozing from one of holes in my abdomen. So, I have changed my plans again. I AM NOT going to take any Lovenox today. (I think the tiny-bit of bleeding is coming from a place where the radiologist injected something during the hip procedure. I will call a doctor today if it oozes more.)

Could my gums be improving? No bleeding again today.

The hip pain is almost non-existant! I still do not plan to dance a jig, however!

 

[Ross]

If your INR is still a little low, don't fret it. Your not likely to develop a clot in a day or two until therapeutic again. Yeah, it's a risk, but honestly, the Lovenox will make you bleed far more then Coumadin. Why the Doctors don't get this is beyond me.

My new opinion, and it is only my opinion since I don't hold a medical degree is, when bridging is necessary, Start Lovenox when INR hits 2.0 and continue until 12 to 16 hours before the procedure to be done. Once the procedure is done and bleeding is under control, resume the Coumadin and forget the Lovenox. Test in 3 days to see where the INR is at.

Hopefully you'll get at least 3 months respite from the pain. Chris has been taking them for his mangled ankle that is severely arthritic. He gets about 2 months of relief when he has them. Hasn't had any in a while because the last time, they botched it and he was in tremendous pain afterwards. Sort of scared him away from it. Can't exactly replace a foot though. You can replace a hip.

 

[Maryka]

Your plan sounds good, Ross. I think my doctor's orders followed your suggestions up through the day after the procedure. Then I did the one day of with both Lovenox and the 4 mg of warfarin. That led to my discovering the blood ooze the morning. Now I believe you all! The ooze seems to be done for now and tomorrow I have my PT test again.

I think I discovered part of my pain today. I spent most of the day cane-less, but was in KMart swinging my big old purse into place over my bad right hip. Wow, pain again! I started carrying the big old heavy purse since just before the hip pain began. I wonder if I do not carry that purse anymore if things will improve??? It is worth a try.

Thanks for everyone's input! I certainly have learned a lot from all of this!

 

[Ross]

I'm sure it would help lessen the pain, but do away with it, I think not. Don't know exactly what's going on in your hip, but it really sounds like replacement is the only sure fire method of relieving the pain permanently.

 

[Maryka]

Yow! I am on a rotten COBRA health insurance. I keep seeing bankruptcy on my horizon!

 

[Lynlw]

Would it be possible to get the replacemtn before your cobra is up? We were on COBRA when Justin neeed one of his heart surgeries and told the docs to get it as soon as pssoible since we weren't sure how long we would be able to afford the COBRA (it was 1300 a month, which is hard when you aren't working)
I hope the shots help. I get them in my back a couple times a year, sometimes just 1 helps and other times I need a 2nd one to get relief. like Chris they usually help for a couple months

 

[Ross]

Yow! I am on a rotten COBRA health insurance. I keep seeing bankruptcy on my horizon!

Hon, I'm there, there are ways and means. You just have to fight and fight and fight. Some days, I just wanna throw up my arms and scream.

Just like today, I sent an application in 2/15/10 for a sliding fee scale program. I got all the paperwork back TODAY with a note to correct the date and send it back. WTF.

 

[COLLEEN S]

Mary, you have a PM from me. Sorry to hear you have been going thru this , the pain must have been horrible from the shots much less from the cysts in your hip socket. FYI, Cobra sucks and is the highest insurance I have ever had.

 

[Maryka]

Well, if no fulltime job comes through in the next couple of weeks, I will be stuck with COBRA for the full 18 months, I suppose. No one, including my kids, wants to take care of me while I am in recovery mode from hip surgery. I guess I have a few months to sort some of this out!