Anticoagulation withholding for spinal surgery

[bvdr]

Hi, I know that Sherrin and Randy have both had back surgery since they started coumadin but are there others? I need to find out specifically how the anticoagulation issue was handled. I had a cervical epidural last March and am in the process of getting a cervical nerve root epidural scheduled. This was ordered at the end of October and as of yet there is not a concensus of how to handle it. I had an appointment with my PCP today and we discussed it in some detail. This type of epidural is supposed to be both therapeutic for pain as well as diagnostic for pinpointing the exact nerve root for possible follow-up surgery. He doesn't want me to go through the risk of stroke from being off coumadin and/or paralysis from any bleeding into the spinal canal. He says this type of epidural has higher risk than the regular one used. The statement that really chilled me was that if I had cervical surgery there could be as high as a 2 week period in which I would be either totally off anticoagulation or be below therapeutic range. He gave me an injection of heavy dose steroids and another of toradol as well as percocet for at night to help contol the pain. I'll know more tomorrow. I think the problem I have (foraminal stenosis) can sometimes be done with the micro-invasive surgery so I love to hear from anyone who has had that specifically. Unfortunately it isn't the kind of problem that PT helps. I'm in a tight spot and could really use some help. Thanks so much.

 

[Lynlw]

Betty I am sorry you are still going thru so much pain i was hoping you were feeling better. they readjusted some of my meds and between the epi and med change i feel better than i have in while, I now have to remember to take my meds instead of like before counting down the last 2 hours until i could take my next dose. i makes such a difference in my life. I hope you have lots of success, Lyn ps i can't help w/ the coum but I remeber there were quite a few good post this summer w/ Randy having spinals

 

[RandyL]

Betty,
I bridged with Lovenox shots for all 3 spinal epidurals and I also had the micro mini invasive back surgery which I also bridged with Lovenox shots. In all the cases I stopped the Coumadin 5 days prior to the procedures and started the Lovenox. I stopped the Lovenox 24 hours prior to the procedures and I started the Coumadin and Lovenox 24 hours after the procedure. Of course I discontinued the Lovenox once I was therapeutic which generally took 5-7 days for me.Hope this helps you.

 

[bvdr]

Betty I am sorry you are still going thru so much pan i was hoping you were feeling better. they readjusted some of my meds and between the epi and med change i fell better than i have in while, I now have to rember to take my meds instead of like before counting down the last 2 hours until i could take my next dose. i makes such a difference in my life. I hope you have lots of success, Lyn ps i can't help w/ the coum but I remeber there were quite a few good post this summer w/ Randy having spinals

Thanks, Lyn. I am so glad you have had improvement with the epidural. It took about 1 1/2 to 2 weeks before you had substantial relief didn't it? When my PCP gave me the RX for Percocet I was thinking about you my friend and all you've gone through.

 

[bvdr]

Betty,
I bridged with Lovenox shots for all 3 spinal epidurals and I also had the micro mini invasive back surgery which I also bridged with Lovenox shots. In all the cases I stopped the Coumadin 5 days prior to the procedures and started the Lovenox. I stopped the Lovenox 24 hours prior to the procedures and I started the Coumadin and Lovenox 24 hours after the procedure. Of course I discontinued the Lovenox once I was therapeutic which generally took 5-7 days for me.Hope this helps you.

Thanks, Randy. It is exactly what I need to know. Do you know what kind of epidurals you had?

 

[RandyL]

You got me there. I think they shot me with steroids in different areas of my lower spine.