TEE & Herina surgery

SHerrin Hutt · Nov 17, 2006

I am supposed to have a Tee on mon. Does warfine need to be stoped? And on dec. 1 I am hernia repair. I have been having a hard time with the nurse about the bridging , I tood her none of my Dr's would agree with what she wanted to do, Which was to stop warfine four 5 days before surgery. She didn't want to hear what I had to say I told her to call My cardiologist because it wasn't going to happen her way. I'm very high risk because of my three strokes and a blood clot. And a new disorder they found in the last bunch of blood tests they did. They say tou get from one of your parents and it effects you clottting factor, I wish I could remember the name of it

DrAllan · Nov 17, 2006

Sherrin,

There is no need to stop Coumadin for a TEE. As far as your surgery goes, even with proper bridging, you are at significant risk because of your past history. There is no way you should let the nurse control your life. If the doctor will not speak directly to you and allow you to make the point, then get another surgeon. You need to get your cardiologist involved. Politically, don?t put the burden on the cardiologist directly. Let his/her office know that you are instructing the surgeon to contact them. Then TELL the surgeon that he has to speak to the cardiologist directly. The magic phrases to use age that the plan being proposed for you is MEDICAL MALPRACTICE. You understand the risk of bridge therapy and have to accept that as an absolute minimum, but that his plan amounts to gross negligence. Even if he agrees, you want the cardiologist or a hematologist managing the bridge therapy especially the part of when to resume Lovenox. True, this depends to a great degree on the surgeon and the surgery as well as how things go post-operative, but you do not need a timid surgeon delaying the resumption.
Be aggressive,

SHerrin Hutt · Nov 19, 2006

Tee

Tee

Thanks for your input. THey told me just don't take it the morning of the TEE.

geebee · Nov 19, 2006

Sherrin,

The only way coumadin could be a problem with a TEE is if the cardio jabs the probe hard enough to cause bleeding. Sine the probe is not sharp, I have never heard of that happening. I supposed it is possible but not something I would worry enough about to stop my coumadin.

One other thing, not taking the coumadin the morning of the TEE will not make a bit of difference for the TEE as it won't show up in the INR for a couple of days. Maybe they just don't want you taking anything by mouth that morning.

Absolutely do not have the surgery without bridging. The nurse is wrong, wrong, wrong and, if she is giving instructions from the doctor, he is wrong also. Please insist on bridging and find another doctor if the answer doesn't change.

Best of luck to you.

Guest · Nov 19, 2006

Sherrin - with your history of strokes you are at very high risk for another. Your doctor's attitude is, "well it is too much work to bridge her, besides if she has a stroke that is somebody else's problem."

We tend to lose sight of doctors functioning just like the rest of us - pressed for time - unable to keep up with the latest developments or as my mother is fond of saying, "Well, somebody had to be last in the class."

Some years back the person who finished last in his class at West Point was from the town where I was living. He was asked if anyone who finished last in his West Point class had ever became famous. His reply, "Yes sir, George Armstrong Custer!"

Granbonny · Nov 19, 2006

Sherrin

Sherrin

Best of luck to your ongoing surgery..Hernia repair....My son=in-law had one...Turned into a nightmare..He followed the doctor's orders..yet, when he went home..the bleeding continued..where he had to be readmitted for another repair.

I know, because I had to stay with him..daughter off on business trips, ect.).....I was there to make sure, he didn't lift anything, ect.and to be there with him..when he had to clean that gaping hole.repack bandages, ect...I cannot not image having one done while on coumadin..

.....It took a long time for him to return to work..When he did..it was only a month later that they flew to Russia to first visit our now precious Russian Grandchildren .We were all worried ..but he did fine.

Not an easy surgery for him.....Hope all turns out well for you. Bonnie

Sherry · Nov 19, 2006

Sherrin, I just had a tee this summer and didn't stop the coumadin. I actually got checked within a day of the procedure, and it was a tad high (4 point something). No bleeding whatsoever unless the doc is pretty rough with the scope, which I'm sure he won't be.