warfarin users---what is the longest you have had to be off anticoagulation?

[bvdr]

On August 7th I will see my neurosurgeon and get a date for my cervical spine surgery. I know I will have to be off warfarin for longer than I have ever been before. I am really interested in hearing from those with mechanical mitral valves who have had to have warfarin suspended for a period of time to find out how they did. I'm not talking about holding doses because the INR got too high but rather interruptions for other reasons such as surgery. Thanks so much everyone.

 

[Nancy]

Betty-

There were several times when Joe was off Coumadin for a couple of weeks or more. Once when he had a total bleedout after gallbladder surgery, once when he fell on the ice and really made a mess inside with a LOT of internal bleeding inside his leg and trunk, and once when he had a brain bleed. They even gave him fresh frozen plasma and Vitamin K. There was no choice in any of these situations, it was all life threatening. He never had a problem from being off it. It worried many of his doctors to have to do it.

It scared me to death. Pretty nerve-wracking, I won't deny it.

 

[geebee]

Betty,

I can't help with the coumadin info since I have never been off coumadin without bridging.

However, I do want to wish you well and will be thinking of you as you face this surgery.

 

[Karlynn]

I've never been off Coumadin for anything yet. I also just wanted to chime in with my prayers and best wishes for our sweet Betty.

 

[Ross]

Well I'll tell you like my Cardio told me, it's a very minimal risk for short duration. Still unsettling for me, but that's the scoop.

 

[fyrfytr]

Hey Betty,
I haven't had to be off of it in the 4 yrs I have been taking it now, I had to get my INR down to 2 when I had my skin cancer surgery on my ear.
Just want you to know that you are in my thoughts and prayers.

 

[Karlynn]

Betty, how long are they telling you you need to be off it? And how long without any bridging?

 

[bvdr]

Thanks everyone. I appreciate your responses. Karlynn, I may have to be off and without bridging up to two weeks. The surgeon said he expects it to go well but said he had to add that he had a patient in similar circumstances that "had a big stroke". I don't know any particulars as yet except he is planning on an anterior approach. I'll feel better once this is behind me........waiting is the hard part. It seems to me I've heard that somewhere or other.

 

[Karlynn]

Betty, we'll all feel better once this is behind you. I'll pray that the worst part of this ends up being the not-knowing what will happen.

 

[Sherry]

Betty, I was off for a few days before some gastro testing years ago but nothing to speak of. Will keep you in my thoughts as you go through this surgery, my friend.

 

[azpam]

TWO WEEKS OFF???? WHOA! That sounds not too wise to me!!

 

[Birky]

surgery

surgery

I was off 5 days prior to hand surgery along with a hernia repair. This was the protocol of the cardiac surgeon. My cardiologist does not do this, he wants the bridging done. I had no problems being off for that period of time,

 

[bvdr]

Well, I got my surgery date today of Sept. 5th. He is going to remove a cervical disc, put in a bone graft, plate, & screws. The plan is for my PCP to manage my anticoagulation. Neurosurgeon wants me off warfarin for 7 days prior to surgery and about the same afterwards. I can bridge for part of the period before surgery. I have to see my PCP for medical clearance and providing he deems me fit enough for surgery then we can work on the Heparin vs. Lovenox bridging. That appointment is for the 28th. I'm feeling OK about it now and am actually relieved to finally have a date.

 

[Karlynn]

I'm sure you're very happy to know that you have a definite date to get this all behind you. You will be in my prayers.

 

[Lisa in Katy]

Betty, it sounds like your Neurosurgeon is being overly cautious. I've had three surgeries since my MVR - D & C, LAVH and Wire Removal. The D & C was an emergency so they gave me a big shot of Vitamin K in the evening and I skipped that evening's dose of Coumadin to get me to 1.8. I started Coumadin again the night after the surgery, as soon as they were sure that I wasn't bleeding. The other two weren't emergencies, so we had more time to figure out the protocol. Seems like I was off Coumadin for 2 days before surgery, but bridged with Lovenox. Started taking Coumadin again the day after surgery. When I skip a dose of Coumadin, my INR plummets, so 7 days without seems crazy to me.

I'd like to hear Al's take on all this.

 

[MarkU]

I've done Lovenox bridges three times for colonoscopies but haven't been off Coumadin for anything else in the past seven years.
Had some battles with my former gastroenterologist and a dentist who both wanted me to go off Coumadin cold-turkey for five days for a relatively minor procedures. When they wouldn't listen to my objections or wouldn't even talk to my cardiologist about it, I switched doctors.
I can still see the bewildered look on the dentist's face when I asked him when the last time someone had actually bled to death in his dental chair.

Mark

 

[alicia]

Hey Betty, The longest I have been off Coumdin was for 4 days and given a shot of Vitamin K due to a 7.5 INR/PT...After those 4 days when I was tested, my level had bottomed out to 1 so I was put in the hospital on a Heprin drip for 5 days until my INR was 2.5...Seems 2 weeks is an awfuly long time to be without Coumadin. Im sure youre in good hands though. Best of luck to you.

Alicia