Protocol Changes

[tommy]

Changes changes changes.............

I saw my cardio for the first time in 3 years and he changed my INR target range from 2.5-3.5 to 2.0-3.0. (St Jude mech aortic valve)

For a recent colonoscopy, he was fine with holding 4 days prior and resuming the night of the procedure. Previously, he insisted on a Lovenox bridge.

Antibiotics are no longer required for the c-scope. Dental work - yes.

He put me on niacin since fish oil and heavy exercise couldn't get my HDL out of the basement.

No issues. Life is good!

 

[catwoman]

Tom:

Funny how protocols can change. Since your valve is in the aortic position, you can probably get by w/out any anticoagulation for several days. I refused to do that for my c-scope in December; I agreed to drop my INR down to 2.5, and the GI doc was OK on that.

How much niacin are you taking? My HDL is OK, but I'd like it to be a little higher. I had a non-fasting CBC 3 weeks ago and my HDL & LDL were OK (thanks to oatmeal and Cheerios!!!!!!).

 

[Lisa in Katy]

I've always heard that 2-3 was the range for aortic and 2.5-3.5 for mitral. Holding for 4 days without a bridge doesn't sounds like something I would agree to, but I'm no doctor. I thought for a colonoscopy you can be fully coagulated unless they need to remove polyps.

 

[tommy]

Since I have a history of polyps and an ulcer, staying therapeutic or using a "virtual" only duplicates the clean out process, because the odds are they will have to go in twice. So we cut to the chase using the standard process (and snipped 1 polyp and a piece of the ulcer). Also, since the Lovenox bridge has caused me nothing but problems, I didn't push back too hard when my conservative cardio suggested that I didn't need it. He suggested 4 days (the GE suggested 5 based on 2.5 as the lower end of the standard range). We had a frank discussion of risk and made a joint decision.

500mg Niaspan (time-release) once a day at bedtime. I've only been awake for 2 "flushing" incidences. I felt like there was a sun lamp on the back of my head and shoulders. I pretended that I was at the beach and went right back to sleep.

 

[ALCapshaw2]

Tommy -

What kinds of problems have you had with Lovenox?

'AL Capshaw'

 

[Marty]

Hold or bridge?

Hold or bridge?

My cardiologist has been using 4 day hold for many years now. Says he has had no problems with it.

 

[Eva]

.............

How much niacin are you taking? My HDL is OK, but I'd like it to be a little higher. I had a non-fasting CBC 3 weeks ago and my HDL & LDL were OK (thanks to oatmeal and Cheerios!!!!!!).

............
500mg Niaspan (time-release) once a day at bedtime. I've only been awake for 2 "flushing" incidences. I felt like there was a sun lamp on the back of my head and shoulders. I pretended that I was at the beach and went right back to sleep.

Marsha,

I also take 500 mg of non-flush Niacin . Last time I checked, my HDL rose from 40 to 50!

 

[tommy]

What kinds of problems have you had with Lovenox?

Bleeding. I'd slow bleed for 1-2 weeks. It happened a couple of times - from inguinal hernia repair and colonoscopies. I was in "catch 22", not wanting to return to Coumadin while I was already dripping, but not able to get off the stuff. Once, the GE went "back in" to cauterize the spot again, and it helped......about a week later. BTW......Lovenox is expensive and becoming a pin cushion on with an anticoagulant injection is not pleasant. Sure, I learned the "dry needle" trick, but still had lots of sore spots.

Anywhoooooooooooo ............. it's done and I'm content with the process ............ and grateful for the results.

I also take 500 mg of non-flush Niacin . Last time I checked, my HDL rose from 40 to 50!

Non-flush? What's that? Do you have a brand name? My HDL has been hovering in the upper 30's with lots of exercise and Quaker Oatmeal Squares, and low-mid 30's without exercise. Raising to upper 40's would be good - find out in 6 months.

 

[ALCapshaw2]

Marsha,

I also take 500 mg of non-flush Niacin . Last time I checked, my HDL rose from 40 to 50!

Is this (non-flush Niacin) something new?
Does it have a separate name?

Last time I tried a Niacin medication (Niaspan?),
I developed a really uncomfortable sensation
that felt like my skin was being impaled by thousands of tiny needles and this lasted for hours (2, 3, more?... I don't remember... but I DO remember how uncomfortable I was with this 'irritation')

 

[AgilityDog]

I think the non-flushing is a slow release. My DH takes it for his HDL, too. He gets it on the vitamin aisle at Wal-mart so you know it's not hard to find. Just look at the labels carefully.

 

[Herb M]

Slow release niacin is not the same as non-flush niacin. Yoy can find non-flush in a drug store, supermarket or vitamin store. I hav been taking it for several yers and never had aflush.

 

[tommy]

My DH takes it for his HDL, too.

Hey "neighbor". Is it working?

 

[Eva]

Is this (non-flush Niacin) something new?
Does it have a separate name?

Last time I tried a Niacin medication (Niaspan?),
I developed a really uncomfortable sensation
that felt like my skin was being impaled by thousands of tiny needles and this lasted for hours (2, 3, more?... I don't remember... but I DO remember how uncomfortable I was with this 'irritation')

Al,

Regular Niacin caused me allergy too...I had to take Benadryl to stop the allergy. The herbalist recommended Niacimide to avoid allergy then, but I did not dare to take it. Last summer, someone recommended this 'non-flush' or 'flush-free' Niacin and it really does not cause any 'flushing'...I am OK on it and it did elevate my HDL. Mine is product of "Nature Bounty".

 

[Eva]

Tom,

I am quoting my reply to Al:


QUOTE:

Regular Niacin caused me allergy too...I had to take Benadryl to stop the allergy. The herbalist recommended Niacimide to avoid allergy then, but I did not dare to take it. Last summer, someone recommended this 'non-flush' or 'flush-free' Niacin and it really does not cause any 'flushing'...I am OK on it and it did elevate my HDL.

Mine is product of "Nature Bounty".UNQUOTE

I just found out that Walgreens sell it. Here is the link:
http://www.walgreens.com/store/product.jsp?CATID=100148&id=prod393091