Week Old Hematoma

[Kim B]

Last Sunday I slipped on a rug and slammed my butt into the sharp edge of the kitchen counter before falling to the floor. It didn't really hurt too much at the time, but by the next morning I had a large hematoma that became more painful throughout the day, so decided to play it safe and see my PCP. After he consulted w/my cardio, I was instructed to stop Coumadin for 4 days. I also spoke w/the pharmacist and researched on the internet because I've learned here how many doctors do not understand how to manage coumadin, but I am satisfied that the advice I got was good.

Now that I've been back on the Coumadin for two days, the hematoma is starting to hurt a bit more and it still looks the same, but at least it isn't growing. I'm just curious if anyone has dealt with this type of situation and how you managed your Coumadin during the healing process. I don't plan to do anything stupid, but it is tempting to go back off the Coumadin for a few more days. I have an On-X valve and it is very unlikely that I would experience any negative consequences (yes, I know the trials have not been completed).

I guess I'm just throwing this out for feedback and I do understand that no one here is going to tell me it is OK to stay off the Coumadin. Any comments or stories of dealing with a similar injury?

 

[Lynlw]

I've never heard of anyone going off coumadin for days for a bruise that wasn't a bad head injury or internal organs.

 

[Bina]

Doing a search on VR for "bruise" in the Coag Forums turned up the usual treatments:
Elevate the site, apply ice, check circulation, keep taking Coumadin and checking INR.

 

[Freddie]

I had a really ugly black eye, saw the doc and never went off my coumadin. I kept ice on it for about 4 days.

The pain you feel is probably the muscle, which of course is bruised and always being used.
Have you been taking any Tylenol to relieve some of the pain?

 

[olefin]

Few years back I slipped on icy steps and fell down 5 steps made of brick. Believe me I had bad bruises on my back, hip and thigh. I was pretty sore for a while.

I would disagree with my cardiologist if he wanted to stop warfarin for bruises, especially not before checking INR.

Now if I hit my head that would be a different situation.

 

[Cooker]

Stopping coumadin for a bruise ... NEVER .... I have bruises that take weeks to go away, sometimes even get little knots in the middle of them ... find a new cardio ... unless it is a major bleed causing life threatening issues that is just plain nuts ... IMHO

 

[ShezaGirlie]

I fell off the boat trailer hitch o don't ask) and got a doozy of a bruise on my shin. That was almost a month ago and it's still a little discolored along with the bump that still hurts. Bruising on warfarin isn't fun -- it hurts loads more and takes forever to go away.

I'd never stop warfarin for any type of bruise.

 

[Kim B]

Interesting replies. I checked my INR two days prior to the Dr. visit and it was 2.8. The NP thought I needed to take a couple of days off Coumadin but wanted to confirm with the PCP. My PCP agreed (said it would continue to get bigger if I stayed on Coumadin) but called the cardio first to make sure he agreed (and he did agree). Then I discussed it with the pharmacist and he said that although he wasn't a doctor, he would go off it for a few days in my situation. Later that night I read about large hematomas and anticoagulants, and learned many doctors give this advise. Since so many sources said the same thing, I thought the recommendation was a good one. I am truly surprised that no one else here has been told the same thing .

At least now I am no longer tempted to go back off of it for a few more days.

Freddie, yes I'm taking Tylenol and sometimes half of a Vicodin for the pain. It isn't excruciating, but just enough to be really annoying and have trouble sleeping. Probably after one more week I'll see some improvement.

 

[Herb M]

To stop coumadin for 4 days is risky. If a person is going to stop Coumadin, that person should be in a hospital where moitoring will take place.

How dumb can doctors be?

 

[Cris N]

I'm dealing with a good-sized hematoma right now. It's on the inside forearm and the bruise is about 5 inches long right now. Quite a knot on the thing too. I have absolutely no idea what I did but obviously hit it in a strategic spot

I've had a few hematoma episodes and they eventually disappear just takes a while.

I wouldn't dream of going off warfarin to treat it. A head injury, yes, but then I'd probably get myself to the hospital anyway.

 

[catwoman]

Kim:

Exactly where is the hematoma? I'm assuming on your butt. The soreness is due to muscule injury, and you're continually moving those muscles around. Much different from the huge bruise I've had above my left knee for more than a week now. It doesn't hurt, but there is a hematoma there.

Nearly every time I fly, I get a bruise and some are doozies. That's due to the the cattle drive of every passenger trying to get off immediately and swinging luggage down from overhead bins and hitting the person standing next to them.

Skipping 4 doses is pretty drastic. One dose, maybe, if you wanted to play it safe and since you have an AV replacement, but not 4.

 

[zipper2]

Kim never come off your warfarin for anyones instruction regarding
a hematoma

My experience last week i tried to get a grocery cart to cooperate
on a sidewalk well.......it won by my leg trying to lift it on curb
my leg slipped and not only a bruise but my chin is quite pretruded
(huge bump for week now) tons of bruising along with it now
I swear between my toes and legs im having very unlimited good luck
using them latelyActually i see my doc tomorrow bout this
I hope your taking coumadin and on a healing mend now with your
hematoma.....God Bless

Hematomas take forever to feel better and go away

 

[olefin]

I am truly surprised that no one else here has been told the same thing .

Maybe because we never asked. I didn't after I fell down 5 steps.
Also some of us don't do exactly as doctors recommend when it comes to warfarin. Most medical people worry about high INR and don't have as much concern about low INR. My INR has been 7.1 with no problems but I get worried if it gets below 2.5.

 

[catwoman]

Kim:

After rethinking this thread, holding any dose won't do any good. You were in range, and any change in dosage won't affect your INR immediately. Depending on your dosage, your INR could plummet to "normal" (nearly 1.0 for a non-anticoagulated person) PDQ if you take a high dose or it could take a couple of days to get down to normal if you take a lower dose.

And then you'll need to get back to range.

You don't want to play that yo-yo game.