More On Uterine Ablation!

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Creed3

VR.org Supporter
Supporting Member
Joined
Sep 12, 2002
Messages
856
Location
Virginia
Well everyone, here is the latest on my quest for a uterine ablation. My gyn had told me that I could have it done and stay on coumadin since I was having the freezing technique done. I had the procedure scheduled and then heard from my pcp that my gyn wanted me to come off of coumadin and take injections of lovenox. I spoke with my pcp who is an internest and he suggested that I cancel the ablation and we could discuss this the next time I was to see him. I have since spoken with him about this and he told me that my gyn doesn't want to do the ablation while anticoagulated because of the numbing injections given and the possibility of bleeding from the injections. My pcp told me that I have a 6% chance of a stroke if I am not anticoagulated for the procedure. A chance I am not willing to take. He told me eventhough I may be on lovenox or heparin that during the procedure my blood would be the same as the average person not on anticoagulation.
My pcp had just taken blood from me recently to check my cholesterol etc....and the results came back that I was anemic. When he drew the blood I had been bleeding and passing clots for over a week. I was taking iron at the time but he has me taking even more iron because of the anemia. I went back and was retested for anemia and it was fine, but I hadn't started my period yet. I just started my period the day after he drew the blood and I have now been bleeding for 11 days and passing clots for about 9 days so far and still going. My pcp told me that if the heavy bleeding continues to make the anemia worse then I will have to change my mind about having the ablation. I have been searching around for a gyn that would consider doing the ablation while on coumadin but I haven't heard anything back from any of them yet. I contacted a gyn at UVA and I am getting ready to contact some others. I really hope I can find someone to do the procedure without coming off coumadin. That 6% chance of stroke is something I am not willing to take. I would think that if I was in the hospital having the ablation and I started to bleed that I would at least be in an environment where they could control whatever bleeding occurred. That seems more reasonable to me than a 6% chance of a stroke.
I will also be talking with my gyn again to find out why he told me I could stay on coumadin and then changed his mind. I also want to find out if he has ever performed an ablation on someone who takes coumadin. I am guessing he hasn't. He did tell me that he has done ablations before where women not on coumadin have had some bleeding. I'm not sure to what extreme but maybe that is why he is concerned. I don't know. I just know that I am going to eventually need to have the ablation done and I definitely want to stay on coumadin. I just need to find someone who is willing to do it. If anyone is aware of any physicians in Virginia that have done ablations or would be willing to consider doing one please let me know. So far it just seems like no doctor wants to touch me while on coumadin.

On the bright side, after being on coumadin for 3 1/2 years, I have finally gotten my pcp to say yes to a home monitor. I have contacted QAS and they are working on it for me. I hope everything goes smoothly. I am a little afraid that my insurance may give me some problems and won't cover the unit. At least I have the ball rolling. I'll let you all know what happens.

I know this thread has gone on and on. Sorry for the rambling on.
I know it seems as though I haven't been around lately but eventhough I haven't posted much I check in everyday to see how things are going with everyone. You guys are the best.

Take Care!
Gail
 
Hi Gail,

I fully feel your frustrations. It is for reasons you list that I opted to deal with the debilitating monthly BS. They wanted to hospitilize me for 10 days for a simple ablation proceedure. The lenght would be the same as that of heart surgery or a hysterectomy. Just takes that long for my levels to come back up.

Once they agree I can have the hysterectomy....I will have it done. They would rather see me do the ablation and not go though the other changes a hysterectomy will bring. My feeling is that the risks are almost as high either way. Being off the Coumadin, lenght of stay in the hospital, infections, on and on. I would rather rid myself completely than go through that torture for a quick fix that may not stick.

Hope all goes well with you.
Take care.
 
Heparin bridging

Heparin bridging

Hello Creed3

When I had abdominal surgery last fall I took Enoxaparin/heparin injections twice daily--8 a.m. and 8 p.m. Each dose lasted for 12 hours.

So, I had the last shot at 8:00 p.m. the evening prior to the surgery--gone by 8:00 a.m. the following morning and then had the surgery. At that point my INR was probably the same as someone not anticoagulated.

Surgeon originally wanted me off warfarin for 5 day before surgery and 2 days after--he got educated real fast when I heard that. To his credit he listened and I got the bridging I needed.

I was given warfarin orally and heparin shots the day following surgery without incident.

Thee are many threads on this board about bridging therapy.

Hope this helps--just my experience anyway.

One really needs to know their way around warfarin/Coumadin.
 
I had my uterus removed (via vaginal surgery) in 1988 due to endometriosis and almost hemmorage bleeding each month. I was anemic and had almost constant pain.
I stopped coumadin 3 days before the surgery, went into the hospital the day before (my PT was around 18 - back in the olden days before INRs) and was started on heparin. I started my coumadin again the actual morning of surgery. I was discharged the next morning because it was Christmas Eve and I wanted to be with family. My PT on discharge was 17 and came up very quickly from there. So, all in all, it was pretty easy and I was protected on all sides (coumadin and bleeding threat). I had more bleeding than a normal person would have but the doctor said nothing was difficult.
I bring this up as an alternative to lovenox although it did require a 48 hour hospital stay. I would think they could do the same for an ablation.
 
ablation

ablation

creed3,

You should ask Dr. Marty if he know's a good gyn in Virginia.
 
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