the tooth bleeding again - any quick advice?

[danielgilboa]

I had this tooth pulled on Sunday. I am on coumadine, INR=3.5 (mitral mechanical St Jude). It did not stop bleeding so on Tuesday I went in to the hospital. They reopened the place, messed around in the bone put some coagulating material inside and re stitched it. This procedure was HELL!

For 2 days now it has been OK. 1 hour ago it started bleeding again. They told me to go back to the hospital. I can not think of going through any messing around with the gums any more. What I want to do is to have my INR dropped by vit K shot, let it heal for as many hours as needed and go back on coumadine. Or let the INR down by just stopping the coumadine. I know it will take 2-3 days.

Any opinions? suggestions?
I am leaving home in about 20 minutes but I will try to look up your answers through my mobile before they touch me.

Thanx - at least I have your sholder to cry on...

Daniel

 

[JimL]

I have a product (Bleed-X? I can't remember for sure) which is supposed to stop bleeding immediately, and they should have access to that, although it might not be good for your mouth. A little bleeding in your mouth will not be fatal.

 

[Guest]

I agree with Jim. You can lose about 1 liter of blood before you start having trouble. Think about spilling a liter of oil and cleaning it up with cotton balls. You will not allow that much blood to run out before you go to the hospital. So as long as it is not squirting blood you are probably better off just biting on a handerchief or cotton balls until it stops. This does not run the risk of a major clot for the next two weeks that giving vitamin K would cause.

 

[Barry]

What they said. I wouldn't worry about it. I'd just use gauze and pressure and patience. A pulled tooth is a bloody mess even without Coumadin on board, "excessive" bleeding is rather to be expected. And as Al pointed out, you'd be pretty freaked out from the quantity of blood lost before you'd be at any risk - this is sorta one of those things (there are a number of them) where if you're wondering whether you need to go to the ER that means that you don't.

 

[Guest]

Barry, Well stated.

 

[danielgilboa]

Thanx all, I'm back. They treated the bleeding with Hexa-something, injected localy + soaked perssure pad and seems to have stopped. I also met my surgeon who said not to drop the INR, but he did agree I should let it down to 2.0 for a day or two to assist clotting.

 

[Janetlee]

Extractions are a pain

Extractions are a pain

Hi,

Just had a tooth pulled yesterday. This evening it's still oozing but not a great amount of blood. Went to the oral surgeon for followup today and he said all looked fine--the healing process was progressing normally. If/when bleeding continues, use the cotton in the mouth strategy to (finally) get it stopped. My cardiologist said not to stop coumadin as there is more risk with that than a little prolonged bleeing in the mouth. So I'm going with that and hoping for the best. I hope not to have to go through this again anytime soon.


Janet Richardson
MVR 1999

 

[jeffp]

A week or so ago I mentioned in a post in another thread an oral liquid that aids in fibrin clotting in oral surgery for patients with bleeding disorders. Couldn't remember the name of it at the time for anything. Reading this thread it came back to me - Amicar. It is given in injection or tablet form for very severe cases but has been used topically to oral wounds with good success. I know this is too late for your case but figured I'd put it here as a FYI before it fades back into the corners of my mind again (memory is still not quite what it was before surgery).

 

[Guest]

Janet - you are lucky. You got good advice from both doctors.

If I remember correctly, Amicar is extremely expensive and if given by mouth or injection, it promotes clotting throughout the body, not just where you want it.

 

[epstns]

This is just my own anecdotal experience, so take it with a grain of salt. I am not taking coumadin, and am still awaiting valve replacement, but I've had (unfortunately) numerous extractions in the last few years. In most cases, if I experience unpleasant bleeding while still at the dentist's office, I ask him to place one or two sutures to help stop the bleeding. When he does this, I don't feel anything because of the remaining effect of novocaine from the extraction. When I go back a week later to remove the suture, it really isn't painful at all. Works for me every time. (Of course, with aortic stenosis I pre-medicate always. . . )

 

[jeffp]

If I remember correctly, Amicar is extremely expensive and if given by mouth or injection, it promotes clotting throughout the body, not just where you want it.

Yes, it was quite expensive. When my daughter needed it, is was covered by our pharmacy insurance. The oarl surgeon uses it topically on the site vs sytemically (yep, would not be a good idea for us valve job folks that way). He has is stored in his fridge if needed for future use for her.

 

[danielgilboa]

Thanx all. The bleeding finaly ended a week after the extraction. After running to the surgeon for the third time, I just let it bleed go on and off, and it finaly stopped. If this ever happens again, I guess I should be transfered to heparin prior to the procedure.

I heard there are pads of Gelfoam that can assist local clotting. Any experience?

 

[hensylee]

Thanks for letting us know. I know you are glad that this is over - and you'll know what to do if it should ever happen again. You will be prepared with info for your dentist. And VR members are wiser for all you have been through. Blessins........

 

[Eowyn Rose]

I had my tooth pulled 2 weeks ago. My dentist was suprised how little I bleed when he pulled the tooth. I had no bleeding afterwards either. I was on antibioticas and on warfarin.
I was also using a well known homeopatic remedy. Over many years I aquired knowledge and trust in homeopatic remedies. Most of the time I consult a proffessional homeopatic practioner and I always consult a trusted pharmacist. I have strong evidence that myself, family members and my dog respond very well to the help of homeopathy. I only take advise from my well trained homeopatic practioner and from trusted pharmasists.
What I am saying is that if you ever thought of using homeopatic remedies that I like to let you know that I benefiting greatly from using the remedies.

Eowyn Rose

 

[tobagotwo]

Homeopathic practitioners vary greatly in their experience, knowledge and competence. Some are excellent: some are horribly ignorant, potentially disasterously so.

I have seen several posts that included information and herbs directed by homeopathic practitioners for ACT patients that specifically were not appropriate for warfarin (Coumadin) users.

I make no reference to Eowyn's person. However, I suggest checking out some of any new homeopath's recommendations against Al Lodwick's website or looking them up for anticoagulation effects before trusting that new person's recommendations.

While some of them can be very knowledgeable, HPs are not trained as medical doctors in order to become practitioners. Trust them only based on what you can check on and by their results. Do not trust their health advice simply because they seem to be trustworthy or because they make you feel secure and comfortable.

'Nuff said,

 

[Eowyn Rose]

Thanks Bob for adding your comments. I absolutly agree with, and I am glad you added your responds.
Eowyn Rose