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Yet Another Colonoscopy Question
- Thread starter Homeskillet
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I had thus far no need for the process, but Pellicle is very good at making important articles, the attached file is just something i got from one of the doctors in the family, just in case, could be of interest. just a thought.
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pellicle
Professional Dingbat, Guru and Merkintologist
Hi
and to add something a bit descriptive to that tables' risks assessment this is from
Guidelines on the management of valvular heart disease and mentions risks
so basically almost all of us here will be in Low prosthesis and the patient risk factors need to be determined on a per person basis but bPatient-related risk factors makes it pretty clear (as would previous stroke history).
HTH
and to add something a bit descriptive to that tables' risks assessment this is from
Guidelines on the management of valvular heart disease and mentions risks
so basically almost all of us here will be in Low prosthesis and the patient risk factors need to be determined on a per person basis but bPatient-related risk factors makes it pretty clear (as would previous stroke history).
HTH
pellicle
Professional Dingbat, Guru and Merkintologist
slipkid
Well-known member
I remember one of the hassles with that was that the syringes are prefilled with a certain dosage, yet for my weight I was only supposed to inject a lesser amount. So I had to expel some of the dose b4 injecting, also eyeballing that, trying to do the injection part etc etc, was all overwhelming for me, and was given multiple different instructions for doing the injection by different DRs/nurses etc, in the end I managed with great difficulty but ended up with a belly totally covered black/blue/blood red from the injection bruises (caused by warfarin slower clotting I guess at the same time). It was a horrible experience I'm not looking to go through again....
carolinemc
Well-known member
yeah, hate the bruising. Now I am also diabetic and do my insulin in the stomach and hate that too. And thing is, also on another injectable for my A1C, do that shot in the thighs. Hate that also. I bruise so easy due to the Warfarin and bumping into things sometimes. And pinches.
Hi everyone. I finally did my colonoscopy and endoscopy on April 16. My cardiologist had me off Jantoven on April 13 and testing every day and emailing him for instructions. I was also brdiging with Lovenosx for several days. I went from 3.5 to 1.4 and then back up again. Last day on Jantoven was April 12. April 13 my INR was 3.5 and I took nothing. April 14 I tested 3.3 and took nothing.
April 15 Was a Monday I tested 2.1 and was instructed to take a shot at 9 AM and another at 9PM.
April16 Tuesday was colonoscopy day and endoscopy I tested 1.4. I had no polyps and only brushings for upped endo, I was told to take a shot at 11;30 am and another at 9pm that night.
April 17 I tested 1.4 and I had 2 shots and 6 mg of jantoven
April 18 I tested 1.7 and had 2 shots and 8 mg that evening of Jantoven.
April 19 I tested 2.1 had an AM and a PM shot and another 8 mg of Jantoven that evening.
April 20 I tested 2.7 , no more shots and 6 mg of Jantoven.
April 21 I tested 3.3 and took 4 mg of Jantoven
April 22 tested tested 3.5 and 6 mg of Jantoven.
I was told to go back to my normal medication amounts and test every Monday.
It was harrowing ....glad its over. But everyone is different and I emailed with my doctor every single day ! I have a great doctor.
Really glad.
pellicle
Professional Dingbat, Guru and Merkintologist
Well done, a perfectly conducted process ...
(myself I wouldn't have wasted time with the shots of heparin, but that's me)
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Thanks for sharing Sheenas. That's great info!
It's time for me to get my first colonoscopy with a St. Jude in the aortic position. I was told that due my valve model, its positioning, its action per echocardiogram, and my history (I've stopped warfarin several times before w/o problem) that there was no need to bridge for the procedure. I should stop 5 days before and start it up based on the colorectal surgeon's directive.
Just had a colonoscopy. My cardiologist insists on bridging. I have a St Jude grafted aortic valve. I hate the Lovenox injections. I get huge bruises. My inr drops like a rock and takes forever to come back up to range. Better than taking a chance of having a stroke.
There is nothing like a colonoscopy without removing polyps. They go in, they see stuff and if there is stuff, it's gotta be removed.
I think the question is, and I don't have the answer, if you stop Warfarin and drop your INR slowly to say 1.4 have your procedure and restart Warfarin after procedure. How long does it take for clots to start forming before they are dissolved again?
Warfarin stops your body from making clotting factors and without the raw materials, vitamin K. You will be in deficit.
I don't think a week of declining INR is a problem, I think staying for an extended period is the problem.
So what is an extended period?
If your INR drops fast and long before the procedure, by all means bridge but it will take a while on broth to drop it IMO.
Also be careful of Lovenox if they remove polyps, you may end up with bloody poo in the bowl.
Rather restart Warfarin and let your INR rise back slowly.
I think the question is, and I don't have the answer, if you stop Warfarin and drop your INR slowly to say 1.4 have your procedure and restart Warfarin after procedure. How long does it take for clots to start forming before they are dissolved again?
Warfarin stops your body from making clotting factors and without the raw materials, vitamin K. You will be in deficit.
I don't think a week of declining INR is a problem, I think staying for an extended period is the problem.
So what is an extended period?
If your INR drops fast and long before the procedure, by all means bridge but it will take a while on broth to drop it IMO.
Also be careful of Lovenox if they remove polyps, you may end up with bloody poo in the bowl.
Rather restart Warfarin and let your INR rise back slowly.
Last edited:
ChuckM
Active member
I didn't post anything prior to this because there were so many other threads, but I'll follow up with this. As always, everyone's experience may be different, but I can 100% confirm this.
My colonoscopy was scheduled for a Friday morning. I stopped warfarin after my prior saturday dose. I do not self test but my prior clinic test was probably 2 -3 weeks earlier and was 2.8, my normal range. After stopping Saturday night, I went back to the clinic on Tuesday to confirm I'd dropped below 2 and began to bridge with Lovenox 2 times daily. I did not take the Friday morning injection, tested prior to the procedure and was a 1.1. They removed one polyp with a cold snare procedure without incident. I was instructed to restart warfarin, eat normally and take the Lovenox injections beginning that evening. I had bloody poos through the weekend, returned to the coumadin clinic on Tuesday to test my inr which was 1.5 (continue Lovenox) and returned to the Gastro. Told them I was still bleeding, they checked things out, said let them know if it continued. By Wednesday night the bloody stools stopped but tested Thursday in the clinic and the inr was only to 1.8, continued Lovenox through the weekend. Returned to the clinic on the following Tuesday, finally hit 2.0 and was able to stop Lovenox.
Takes a while for me to rise and fall with my dosing, but it was the same after my heart surgery. They held me 4 days post ICU, with one of the reasons being they were trying to get my inr to the correct level. So the colonoscopy timing wasn't a surprise. I was a bit concerned with the bleeding as much as with it looking like the gastro doc was a bit surprised himself I was still bleeding. Certainly he's had people bridge with Lovenox?
My experience was definitely like @Mister_James, but it sorted itself out. No problems with the polyp, no return for another 10 years.
@Mister_James and @ChuckM both of you reported bloody stool after having a colonoscopy with polyp removal. Did the GI cauterize where he/she removed the polyp?
Because I've had serious hematomas while bridging after surgeries, I don't bridge for colonoscopies (per cardiologist's and GI doc's orders). I have been told to get my INR down to 2.0-2.5. I home-test. It's easy to get my INR down to 2.0, using INR results before previous colonoscopies.
One polyp was removed during my last colonoscopy (2023). The doctor told me she cauterized the area to prevent bleeding. It worked -- no bleeding.
Because I've had serious hematomas while bridging after surgeries, I don't bridge for colonoscopies (per cardiologist's and GI doc's orders). I have been told to get my INR down to 2.0-2.5. I home-test. It's easy to get my INR down to 2.0, using INR results before previous colonoscopies.
One polyp was removed during my last colonoscopy (2023). The doctor told me she cauterized the area to prevent bleeding. It worked -- no bleeding.
ChuckM
Active member
The GI specifically did NOT cauterize, they did a cold snare which was explained to me that it was a less risk of bleeding post op. I recall reading somewhere that after the initial procedure with cauterization, the scab can "slough" off and begin to bleed more than the snare procedure.
He was slightly concerned that my bleeding continued longer than normal but it was never so much that I'd call it a flow. Enough so that we contacted my cardiologist to inquire if we could half the lovenox dose, which was flatly denied. It was really only evident in my bm's. On followup, they attributed it to the lovenox shots, as it was most pronounced closer to any time I'd taken an injection. It would lessen if I had to go later in the day before the night's second injection.
