ALCapshaw2
Well-known member
Does anyone know if Cipro (antibiotic) Ear Drops affect INR?
'AL Capshaw'
'AL Capshaw'
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INR vs. Cipro Ear Drops?
- Thread starter ALCapshaw2
- Start date
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G
geebee
Al,
I know Cipro oral can affect INR so I would think the ear drops could as well since some of it could probably make its way into the body through the ear. Just a guess tho.
I know Cipro oral can affect INR so I would think the ear drops could as well since some of it could probably make its way into the body through the ear. Just a guess tho.
G
Guest
Like the recent question about metronidazole, it is unlikely to have much effect if there is no broken skin.
ALCapshaw2
Well-known member
allodwick said:Like the recent question about metronidazole, it is unlikely to have much effect if there is no broken skin.
I 'thought' the Urgent Care Doc said there was a 'cut' along the canal leading to the eardrum. Eardrum and behind seemed to be OK.
Wouldn't there have to be 'broken skin' somewhere for bleeding to occur?
BTW, my ProTime Anticoagulation System reported INR = 3.7 Does anybody know if the ProTime is consistently on one side of 'actual' (or Lab) INR? Or can it be on Either Side of 'actual' INR (Lab Draw or better machine)
'AL Capshaw'
D
DrAllan
Al,
I am a retired otolaryngologist and must respond to your two questions regarding bleeding from the ear canal and the use of Cipro drops.
First, how did you get a small laceration in your ear canal? It is highly unlikely that the surgery on your neck could in any way involve your ear canal. If I had to guess, you scratched the canal yourself, which is more lileky thasn perhaps having an ear probe thermometer used to take your temperature. The skin in the ear canal is very sensitive and to get a leceration, you would have had immediate pain.
The concentration of Cipro in the drops is much higher than an oral or IV dose. This is because oneneeds high topical concentraion to be effective on the skin. Even if the entire depth and circumference of the canal was denuded of skin, there would not be any significant blood levels obtained because of the small amount (even though more concentrated) present. Even with a large hole in the eardrum there is no significant blood level.
Best to you,
Allan
I am a retired otolaryngologist and must respond to your two questions regarding bleeding from the ear canal and the use of Cipro drops.
First, how did you get a small laceration in your ear canal? It is highly unlikely that the surgery on your neck could in any way involve your ear canal. If I had to guess, you scratched the canal yourself, which is more lileky thasn perhaps having an ear probe thermometer used to take your temperature. The skin in the ear canal is very sensitive and to get a leceration, you would have had immediate pain.
The concentration of Cipro in the drops is much higher than an oral or IV dose. This is because oneneeds high topical concentraion to be effective on the skin. Even if the entire depth and circumference of the canal was denuded of skin, there would not be any significant blood levels obtained because of the small amount (even though more concentrated) present. Even with a large hole in the eardrum there is no significant blood level.
Best to you,
Allan
ALCapshaw2
Well-known member
Dr. Allan,
Thank you for your input.
The only thing that I can think of is that when my ear 'itched', I put my little finger in it and may have scratched the surface somewhere with my fingernail.
Life on Coumadin can sure get 'complicated' in a hurry!
The Urgent Care Doc was concerned about blood loss each time the dressing is changed. He commented on the "Big Hole" under my skin (just below the armpit, about 2 inches). My understanding of the original plan was that he was just going to LANCE the cyst but apparently he took out an unknown amount of tissue after getting in there. The incision is about 1-1/2 inches across.
Before he began, I told the surgeon that I had my INR tested and it was 5.5 I am suspicious of this reading. The Nurse did NOT impress me with his knowledge or technique, putting a VERY LARGE blood drop on the test strip. The meter took an inordinately LONG TIME to come up with that reading. A blood draw was sent to the Lab 2 hours later and came back with an INR of 3.2. My ProTime Home Tester reported an INR of 3.8
Like the Urgent Care Doc, I'm getting a little concerned about total blood loss if I keep bleeding at the incision each time the dressing is changed. It was a good thing we did NOT make this second change at home! We would not have had the needed materials (large pads, enough 4X4 pads, foam tape for the compression bandage) or enough hands and experience to deal with the blood loss.
SO, what to do NOW (Monday morning)?
I plan to notify EVERYBODY involved in my care, starting with the CRNP at the Coumadin Clinic, my PCP (internist), the Surgeon's Nurse (Surgeon usually in OR on Monday), and maybe even my Cardiologist. I'm beginning to wonder about the extent of the cutting the surgeon did while anti-coagulated and if he really understood what to expect.
Any further input and ideas are welcome!
'AL Capshaw'
Thank you for your input.
The only thing that I can think of is that when my ear 'itched', I put my little finger in it and may have scratched the surface somewhere with my fingernail.
Life on Coumadin can sure get 'complicated' in a hurry!
The Urgent Care Doc was concerned about blood loss each time the dressing is changed. He commented on the "Big Hole" under my skin (just below the armpit, about 2 inches). My understanding of the original plan was that he was just going to LANCE the cyst but apparently he took out an unknown amount of tissue after getting in there. The incision is about 1-1/2 inches across.
Before he began, I told the surgeon that I had my INR tested and it was 5.5 I am suspicious of this reading. The Nurse did NOT impress me with his knowledge or technique, putting a VERY LARGE blood drop on the test strip. The meter took an inordinately LONG TIME to come up with that reading. A blood draw was sent to the Lab 2 hours later and came back with an INR of 3.2. My ProTime Home Tester reported an INR of 3.8
Like the Urgent Care Doc, I'm getting a little concerned about total blood loss if I keep bleeding at the incision each time the dressing is changed. It was a good thing we did NOT make this second change at home! We would not have had the needed materials (large pads, enough 4X4 pads, foam tape for the compression bandage) or enough hands and experience to deal with the blood loss.
SO, what to do NOW (Monday morning)?
I plan to notify EVERYBODY involved in my care, starting with the CRNP at the Coumadin Clinic, my PCP (internist), the Surgeon's Nurse (Surgeon usually in OR on Monday), and maybe even my Cardiologist. I'm beginning to wonder about the extent of the cutting the surgeon did while anti-coagulated and if he really understood what to expect.
Any further input and ideas are welcome!
'AL Capshaw'
D
DrAllan
Al,
Sorry to here about the sequence of events you describe. Without actually examining you I cannot be sure what is going on. However, let me try to make some sense out of this whole surgical bleeding issue.
Think about an infected cyst as a balloon filled with water the walls of the cyst were more or less attached to the surrounding skin and underlying muscle. With infection these attachments swell up and lead to the scarring that makes a secondary removal technically more difficult. When one incises the cyst and evacuates the liquid pus contents, then a hole is left behind. Your surgeon did not likely remove any tissue since the cyst itself is only the wall of the balloon. The cyst is normally filled with a mixture of cheesy dead skin and skin oils. However, this hole is not like a hole make by digging out some material, it is a hole that was made by expansion of the cyst pushing the surrounding tissues away. When all is healed this will come together without a noticeable defect.
In regards to the bleeding, infected tissue is friable and has in growth of blood vessels to bring the white blood cells to the infection. These are tiny vessels and usually stop by pressure dressing or packing the cavity with some sort of gauze drain. During the early stages, removal of the dressing or the drain allows these vessels to bleed since any clot at the bleeding end is easily disrupted. Alas, the Coumadin does no help and will prolong the time course of bleeding and healing.
As far as the volume of blood loss, there are some interesting behavior patterns of patients regarding the site of the bleeding in the perception of the severity of the problem. Several tablespoons from the nose or anywhere on the face makes most patients feel that they are going to die. On the other hand, vomiting up large quantities of blood or passing the same by rectum seems to be underestimated as to the severity. If I may reveal some of my male chauvinist tendencies, women who have the experience of menstruating frequently under or over estimate the volume of blood loss from any of these same areas.
Bottom line, if your dressing is not leaking through between dressing changes, then you are having not significant blood loss.
I will be out of reach for the next several days because of entering the hospital for a second try at ablation for AF.
P.S. Most nosebleeds and ear canal lacerations are from self inflicted reasons. Sometimes trying to convince a paretn to cut their childs nails is a challenge since they didn't come to a doctor, pay high fees, and be told that they need to more carefully groom their child. now adults, that is another story completely
Sorry to here about the sequence of events you describe. Without actually examining you I cannot be sure what is going on. However, let me try to make some sense out of this whole surgical bleeding issue.
Think about an infected cyst as a balloon filled with water the walls of the cyst were more or less attached to the surrounding skin and underlying muscle. With infection these attachments swell up and lead to the scarring that makes a secondary removal technically more difficult. When one incises the cyst and evacuates the liquid pus contents, then a hole is left behind. Your surgeon did not likely remove any tissue since the cyst itself is only the wall of the balloon. The cyst is normally filled with a mixture of cheesy dead skin and skin oils. However, this hole is not like a hole make by digging out some material, it is a hole that was made by expansion of the cyst pushing the surrounding tissues away. When all is healed this will come together without a noticeable defect.
In regards to the bleeding, infected tissue is friable and has in growth of blood vessels to bring the white blood cells to the infection. These are tiny vessels and usually stop by pressure dressing or packing the cavity with some sort of gauze drain. During the early stages, removal of the dressing or the drain allows these vessels to bleed since any clot at the bleeding end is easily disrupted. Alas, the Coumadin does no help and will prolong the time course of bleeding and healing.
As far as the volume of blood loss, there are some interesting behavior patterns of patients regarding the site of the bleeding in the perception of the severity of the problem. Several tablespoons from the nose or anywhere on the face makes most patients feel that they are going to die. On the other hand, vomiting up large quantities of blood or passing the same by rectum seems to be underestimated as to the severity. If I may reveal some of my male chauvinist tendencies, women who have the experience of menstruating frequently under or over estimate the volume of blood loss from any of these same areas.
Bottom line, if your dressing is not leaking through between dressing changes, then you are having not significant blood loss.
I will be out of reach for the next several days because of entering the hospital for a second try at ablation for AF.
P.S. Most nosebleeds and ear canal lacerations are from self inflicted reasons. Sometimes trying to convince a paretn to cut their childs nails is a challenge since they didn't come to a doctor, pay high fees, and be told that they need to more carefully groom their child. now adults, that is another story completely
M
Mary
Not to highjack your thread, Al, but good luck with the ablation, Dr. Allan.
