2nd Mitral Valve Replacement Next Week

dick0236;n875132 said:

lso thinking tonight that I might do well to inform my barbers that I am on Coumadin after the surgery?


Why will you need Lovenox shots for a dental cleaning? I get my teeth cleaned twice per year and have never had a need for anything like Lovenox. In fact, after 50 years on warfarin, I have never found it necessary to inject myself with Lovenox......for any reason. The only med I use prior to invasive dental work is 2000mg Amoxicillin, an anti-biotic.

Why tell your barber?......unless he/she gives you a shave with a straight razor.....and he/she is very old and shaky... If you tell him/her I guarantee they will scared to death and will surely cut you....LOL

Me thinks you are giving warfarin way too much credit for causing uncontrolled bleeding. BTW, I used to use a little toilet paper to help clot the shaving cuts. Now that I'm retired I use an electric shaver......completely solved the "nic" problem.

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Perhaps I am mistaken about the Lovenox prior to dental cleanings. In fact, while typing this I just remembered that my surgeon said that I would have to taper off of warfarin & supplement w. Lovenox before "surgeries" or dental "procedures" - which I assume likely means serious dental work (I do need some crowns & fillings).

But, doesn't antibiotics mess w. your INR range? I have read by others on the blood thinner that even antibiotics that supposedly do not interact w. warfarin can cause INR trouble?

In sum, my surgeon said that small scrapes (like my puppy's razor sharp teeth) & cuts are not really the concern on warfarin, but rather the major issues like breaking a bone, etc. Is this true?

Also, would there be any diff. in all that you guys are stating w. a mech. mitral valve?

Stop stressing over nothing and relax

Homeskillet;n875167 said:

...Oh, another quick question, in your experiences on warfarin, does flying or being at high altitudes cause INR to fluctuate?

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This question has been covered and no ... and flying you aren't usually at "high altitude" because they pressurise the cabins ...

Metaphor tip: when driving on snow and the wheels start spinning, the surest way to get stuck is to just keep gassing it and keep those wheels spinning. You won't get anywhere except stuck deeper. Right now you're spinning the wheels big time (and like Ripley in Aliens) just grinding the broken shaft. So really, just stop creating the imagined issues in advance and just deal with whats before you right now (which is plenty I'm sure).

Take your recovery carefully, eat the food before you (in recovery) because you need the strength. See if you can get some KimChi to eat in the ward after ICU as that'll get the pooShute going again more easily than any of the other methods that the hospital will offer ... and really you won't enjoy being constipated post surgery


Lay back and relax ... keep reading this it'll help ...

Homeskillet;n875164 said:

Perhaps I am mistaken about the Lovenox prior to dental cleanings. In fact, while typing this I just remembered that my surgeon said that I would have to taper off of warfarin & supplement w. Lovenox before "surgeries" or dental "procedures" - which I assume likely means serious dental work (I do need some crowns & fillings).

But, doesn't antibiotics mess w. your INR range? I have read by others on the blood thinner that even antibiotics that supposedly do not interact w. warfarin can cause INR trouble?

In sum, my surgeon said that small scrapes (like my puppy's razor sharp teeth) & cuts are not really the concern on warfarin, but rather the major issues like breaking a bone, etc. Is this true?

Also, would there be any diff. in all that you guys are stating w. a mech. mitral valve?

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As I mentioned earlier I had fillings several weeks ago, and 2 x incisions in my chest to remove wires and did not need to do anything with my INR, maybe there are different protocols where you are?

I can't imagine it would be an issue unless it was having your wisdom teeth out which I remember from 20 years ago produced plenty of bleeding,
I think breaking a bone especially if it was displaced would be pretty major (I know from experience it does cause extreme pain when it's you hand) but then that's not really something anyone can plan for warfarin or not

The range for a mechanical mitral is generally 2.5-3.5 , my aortic valve is 2-3
so if youve read how INR (international normalised ration) works out-
INR 1.0 normal clotting time 10-12 seconds
INR 2.0-3.0 clotting time 20-30 seconds
INR 2.5-3.5 clotting time 25-35 seconds

Antibiotics generally take several days of regular use to have an effect , for any dental work I take a one off 2000mg dose of antibiotics one hour before (and from what I've read this is the recommened standard ), so I haven't seen any affect with this yet, even if there was a slight change with weekly testing I could miss it if any,like a pot hole in a 10km stretch of road , so it's not like you have to take a course of them for a week or anything like that.
As you say some things can have an effect on INR which are not meant to interact, thats where regular weekly testing comes into it's own I reckon,
warfarins not a prison there to stop you living life or going somewhere

As Pel said "Stop stressing over nothing and relax "
even though I know this advice is probably the hardest to take right now

The streets of Phoenix are littered with the decomposing corpses of Warfarin users.

Homeskillet;n875163 said:

Got some Schick razors today, along w. a special lubricating cream designed to avoid nicks.

Also just purchased $200 worth of bandages & wound sealant designed specifically for anti-coagulant users here:

Surgery in less than 48 hrs. Meeting w. surgeon tomorrow to grill him w. some hard questions before surgery. Thank you again!

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Don't buy any more stuff until you have had the surgery!!! Dealing with warfarin is not rocket science.......just take the warfarin as prescribed, test routinely, and live, love and enjoy....or you'll drive yourself NUTS!!!!!!!!!!!!!!!!

Agian;n875179 said:

The streets of Phoenix are littered with the decomposing corpses of Warfarin users.

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I know ... but its kept a secret outside of there ... this is a picture I took when I was there last ...
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this is of course just after taking 4mg ... imagine what happens to me every day when I take 7mg?

Pellicle, that's really gross I doubt I could stop that with a little toilet paper patch. You must have to buy gauze by the truckload.

dick0236;n875188 said:

Pellicle, that's really gross I doubt I could stop that with a little toilet paper patch. You must have to buy gauze by the truckload.

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a couple of rolls ought to do it ...


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Long time, no post. Greetings all regulars. Glad to see the same solid group still giving good, comforting advice and information!

Reading this thread with interest at first, then started skimming.

First off, welcome aboard, Homeskillet!

Life on warfarin. I'm 44 years old and in my 27th year or 26 1/2 or something on warfarin. No bleeding events, no strokes, some unexplained bruising (well, initially - then my wife tells me I was snoring again). I test weekly. Work with your cardiologist and your insurance to obtain a home testing kit. While they have some interesting advice about warfarin, I find one thing they are pretty good at is knowing what is and isn't allowed with various insurance providers. If VA is similar in some ways to Medicare, it should be covered.

I survived 20 years without home testing, and was not a good patient. It didn't exist, then my insurance didn't get on board after it first came out. So it was off to the lab monthly, which was a pain for a teenager, and twenty something to be obedient about.

I shave frequently. Nothing fancy. Just barbasol and a mach 3, or whatever cheap promo they mailed me last.

As far as lovinox, I've bridged (that's what they call it) three times. Once for a second open heart, once for a vasectomy (certain areas have a great capacity for blood - TMI?), and once for gallbladder / appendix removal. All three were a hassle and would have been easier without warfarin, but none proved to be difficult to manage or any kind of nightmare.

Never had an issue with dental work.

Sternum wires don't "feel" like anything after a while. Sure, the texture is there. But there isn't any associated discomfort if done well. I don't notice them unless I touch them. Sitting idle, they don't feel like anything.

Ticking is what it is. Ideally one gets used to it. It's even a nice conversation piece at times. I always have something interest to share during icebreakers when they ask you to share something unique about yourself. "Everyone, be very quiet and listen." Recently moved into a new place, nice house with a big tiled shower. But it's an echo chamber. Kind of amusing really.

Best part is - the valve has a lifetime guarantee!

Best wishes as you process all of this. Sounds like you're hearing some interesting things. I wish you well as you process all the info and decide what does and does not make sense.

Superman;n875196 said:

Best wishes as you process all of this. Sounds like you're hearing some interesting things. I wish you well as you process all the info and decide what does and does not make sense.

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I believe he is currently admitted and awaiting surgery. So I guess we'll hear when he comes out.

I hope he has a smooth recovery (as I do for all of us)

Superman;n875196 said:

Long time, no post. Greetings all regulars. Glad to see the same solid group still giving good, comforting advice and information!

Reading this thread with interest at first, then started skimming.

First off, welcome aboard, Homeskillet!

Life on warfarin. I'm 44 years old and in my 27th year or 26 1/2 or something on warfarin. No bleeding events, no strokes, some unexplained bruising (well, initially - then my wife tells me I was snoring again). I test weekly. Work with your cardiologist and your insurance to obtain a home testing kit. While they have some interesting advice about warfarin, I find one thing they are pretty good at is knowing what is and isn't allowed with various insurance providers. If VA is similar in some ways to Medicare, it should be covered.

I survived 20 years without home testing, and was not a good patient. It didn't exist, then my insurance didn't get on board after it first came out. So it was off to the lab monthly, which was a pain for a teenager, and twenty something to be obedient about.

I shave frequently. Nothing fancy. Just barbasol and a mach 3, or whatever cheap promo they mailed me last.

As far as lovinox, I've bridged (that's what they call it) three times. Once for a second open heart, once for a vasectomy (certain areas have a great capacity for blood - TMI?), and once for gallbladder / appendix removal. All three were a hassle and would have been easier without warfarin, but none proved to be difficult to manage or any kind of nightmare.

Never had an issue with dental work.

Sternum wires don't "feel" like anything after a while. Sure, the texture is there. But there isn't any associated discomfort if done well. I don't notice them unless I touch them. Sitting idle, they don't feel like anything.

Ticking is what it is. Ideally one gets used to it. It's even a nice conversation piece at times. I always have something interest to share during icebreakers when they ask you to share something unique about yourself. "Everyone, be very quiet and listen." Recently moved into a new place, nice house with a big tiled shower. But it's an echo chamber. Kind of amusing really.

Best part is - the valve has a lifetime guarantee!

Best wishes as you process all of this. Sounds like you're hearing some interesting things. I wish you well as you process all the info and decide what does and does not make sense.

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Very helpful & practical post, as every other post has been.

Surgeon said he had to prescribe a home testing kit (can't just buy one by myself), but that he would have no problem doing so. Will self-pay if I have to, but just seems most practical.

Requested On-X valve today. Surgeon seems adamant about a mech. valve, but did said he could not guarantee that it would last for a lifetime since he has "no other case to compare your case to."

Surgery in about 10 hrs. Going to try to sleep for a few.

Just want to thank every single post on this thread. Has been a tremendous blessing to my wife & I.

Will check back in when I am able post-op.

pellicle;n875203 said:

I believe he is currently admitted and awaiting surgery. So I guess we'll hear when he comes out.

I hope he has a smooth recovery (as I do for all of us)

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Going in in the morning.

"See" you some time afterwards.

Homeskillet;n875204 said:

Requested On-X valve today. Surgeon seems adamant about a mech. valve, but did said he could not guarantee that it would last for a lifetime since he has "no other case to compare your case to."

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I would agree with that. My view is that there is no certainty in life except death and taxes, although some manage to minimize taxes

I feel it's best expressed as: if you are young enough that a mechanical valve gives you a chance of lasting a lifetime, while any other option is a certainty for replacement (unless you die beforehand).

Superman;n875196 said:

Long time, no post. Greetings all regulars. Glad to see the same solid group still giving good, comforting advice and information!

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Consider me your go to guy on toilet paper
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All th very best for the surgery today. haven't read your entire post. Just the first few lines and then realised it was the 6th today.. Hope to see you post on here very soon. Good Luck x

pellicle;n875207 said:

Consider me your go to guy on toilet paper
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Is that cause your big on cushiony softness? Maybe soft strong and long? Or just a gentle touch....

Warrick;n875213 said:

Is that cause your big on cushiony softness? Maybe soft strong and long? Or just a gentle touch....

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I'm a sorbent guy, cos I'm a single sheet wiper, not a scruncher or a folder
Following (my tradition of too much information without getting into the brown) on from Dicks point about stemming shaving nicks with a bit of date roll...

I'm sorry, the lifetime guarantee thing is just my morbid sense of humor. Should the valve fail, the guarantee is up! People that find out I had this done don't quite know how to take that one in real life either. Probably not a good joke for a newer recipient. My apologies. Good luck today in surgery! I'm sure you'll be in good hands. See you all on the other side!