ALCapshaw2
Well-known member
Today was the day (Friday). My General Surgeon Lanced my infected Sebaceous Cyst while (more than) fully anti-caogulated and I didn't bleed to death. 
One bloody towel but far from being soaked. Not too bad. He did end up cauterizing around the incision(s).
Backtrack to Tuesday. Surgeon examined the sebaceous cyst, pronounced it infected and prescribed an anti-biotic, Bactrim, to see if it would help reduce the swelling by Friday. My Coumadin Clinic and Pharmacist gave conflicting information on the affect of Bactrim on INR. Another pharmacist (at the same pharmacy) discovered two different references with confilicting information on the SAME drug!
Later, our friend and tutor, AL Lodwick declared that Bactrim does indeed tend to Raise INR and noted that the more powerful (and expensive) antibiotic Levaquin had little effect on INR.
I stayed with the Low Cost approach (which was the only Rx he gave me). Coumadin Clinic scheduled a recheck for the following Monday. Surgeon said he would Lance the cyst on Friday and I would NOT need to go Off Coumadin (Hooray!). Friday comes and I decide to drop by the Coumadin Clinic for a quick INR check. Fancy Finger Stick Machine (with bar code reader and computer interface) says INR=5.5 after a L O N G delay as it processed what looked to me like a HUGE blood sample.
Off to the surgeon. I never knew that Lidocaine(?) could BURN so. The surgeon said that was the worst part. He was right. Surgeon said I could discontinue the antibiotic now that the pus was all squeezed out. I wasn't totally comfortable with that recommendation...
Think I was at least take this evening's dose, just to be safe.
I then went back to the Coumadin Clinic to see what to do about dosing adjustments and juggling the antibiotic. The Nurse Manager told me that whenever they read over 5.0 on a Finger Stick machine they require a retest by veinous draw. Later that afternoon she called to report INR = 3.2 by veinous draw. She explains that sometimes patients on antibiotics register (artificially) high INR on the Finger Stick test but Normal Range INR by veinous draw. (AL Lodwick: Feel free to express your observations in this matter - which reading do YOU believe?).
Surgeon advised laying on my side for an hour on a firm pillow to put pressure on the incision. I gave it an extra half hour. Took ONE pain pill 'just in case' but was never in great discomfort, if you don't count pulling off the tape!
Didn't mean for this to turn into a Novel. Sorry about that.
'AL Capshaw'
One bloody towel but far from being soaked. Not too bad. He did end up cauterizing around the incision(s).Backtrack to Tuesday. Surgeon examined the sebaceous cyst, pronounced it infected and prescribed an anti-biotic, Bactrim, to see if it would help reduce the swelling by Friday. My Coumadin Clinic and Pharmacist gave conflicting information on the affect of Bactrim on INR.
Another pharmacist (at the same pharmacy) discovered two different references with confilicting information on the SAME drug! Later, our friend and tutor, AL Lodwick declared that Bactrim does indeed tend to Raise INR and noted that the more powerful (and expensive) antibiotic Levaquin had little effect on INR.
I stayed with the Low Cost approach (which was the only Rx he gave me). Coumadin Clinic scheduled a recheck for the following Monday. Surgeon said he would Lance the cyst on Friday and I would NOT need to go Off Coumadin (Hooray!). Friday comes and I decide to drop by the Coumadin Clinic for a quick INR check. Fancy Finger Stick Machine (with bar code reader and computer interface) says INR=5.5 after a L O N G delay as it processed what looked to me like a HUGE blood sample.
Off to the surgeon. I never knew that Lidocaine(?) could BURN so.
The surgeon said that was the worst part. He was right. Surgeon said I could discontinue the antibiotic now that the pus was all squeezed out. I wasn't totally comfortable with that recommendation...Think I was at least take this evening's dose, just to be safe.
I then went back to the Coumadin Clinic to see what to do about dosing adjustments and juggling the antibiotic. The Nurse Manager told me that whenever they read over 5.0 on a Finger Stick machine they require a retest by veinous draw. Later that afternoon she called to report INR = 3.2 by veinous draw. She explains that sometimes patients on antibiotics register (artificially) high INR on the Finger Stick test but Normal Range INR by veinous draw. (AL Lodwick: Feel free to express your observations in this matter - which reading do YOU believe?).
Surgeon advised laying on my side for an hour on a firm pillow to put pressure on the incision. I gave it an extra half hour. Took ONE pain pill 'just in case' but was never in great discomfort, if you don't count pulling off the tape!
Didn't mean for this to turn into a Novel. Sorry about that.
'AL Capshaw'
