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warrenr

Well-known member
Joined
Apr 3, 2004
Messages
169
Some of you are familiar with my father's stroke after a screening colonoscopy. For those of you that are not, here is what happened in a nutshell. Father stopped coumadin 4 full day's before procedure. Several hours after procedure a clot broke away from his St Jude Mech Mitral Valve. He had a massive right side embolic stroke. Is know in nursing home for rest of his life.

I am in the process of putting a book together for valver's, afiber's, and dvter's that will specifically address anticoagulation protocol for various medical and dental procedures that you valver's have to deal with.

I need help putting a list together of some of the most common real life medical and dental procedures you valver's have to deal with. There are several thousand members at this site so we should be able to come up with a very good list.

Let's start the list​
 
warrenr said:
Some of you are familiar with my father's stroke after a screening colonoscopy. For those of you that are not, here is what happened in a nutshell. Father stopped coumadin 4 full day's before procedure. Several hours after procedure a clot broke away from his St Jude Mech Mitral Valve. He had a massive right side embolic stroke. Is know in nursing home for rest of his life.

I am in the process of putting a book together for valver's, afiber's, and dvter's that will specifically address anticoagulation protocol for various medical and dental procedures that you valver's have to deal with.

I need help putting a list together of some of the most common real life medical and dental procedures you valver's have to deal with. There are several thousand members at this site so we should be able to come up with a very good list.

Let's start the list​
Click to expand...

Very sorry about your dad, that really stinks. I dunno why they discontinued the Coumadin. I've got a St. Jude's mitral, and had a screening colonoscopy about a year ago. Doc didn't have me change my dosage at all for the procedure.
 
I depise

I depise

coumadin/warfarin. I have severe cad, almost every 3 months I have to have an angio; 4 days in hospital minimum, thicken my blood with vitamin k; then after ,heparin drip!! When my husband has his 6 month angio, he's in and out in hours.... I dont even want to see a dentist..lol.. he wants to work on some molars.. I will go eventually...lol :p , but I must say this, its better than the alternative that I had :eek: Love Yaps
 
Gall Bladder

Gall Bladder

Very common surgery in middle age. Good luck with Book!




warrenr said:
Some of you are familiar with my father's stroke after a screening colonoscopy. For those of you that are not, here is what happened in a nutshell. Father stopped coumadin 4 full day's before procedure. Several hours after procedure a clot broke away from his St Jude Mech Mitral Valve. He had a massive right side embolic stroke. Is know in nursing home for rest of his life.

I am in the process of putting a book together for valver's, afiber's, and dvter's that will specifically address anticoagulation protocol for various medical and dental procedures that you valver's have to deal with.

I need help putting a list together of some of the most common real life medical and dental procedures you valver's have to deal with. There are several thousand members at this site so we should be able to come up with a very good list.

Let's start the list​
Click to expand...
 
So sorry to hear about your father.

Removing the patient from Coumadin is more of a perk for the doctor. They do not have to deal with excessive surgical bleeding, etc. This could leave the patient with a life changing situation. I wish they would think....or offer brige therapy when taking people off.

I refuse to stop taking my Coumadin....unless I use Lovenox or Heparin!
 
Routine scaling and warfarin withdrawal

Routine scaling and warfarin withdrawal

Very sorry about your father's experience.

Here's one for your list, I hope it keeps growing.

Periodontist (Dr. G. Clark, Guelph, Ontario) told me I would have to stop warfarin 5 days prior to scaling my teeth because he was afraid of bleeding.

I won't repeat my response to that beyond saying I would not choose a tooth over my brain. Thank heaven I knew better.
 
Warren,

If you are just looking for a list of things to address regarding coumadin here is mine:

root canals
teeth scaling
colonoscopy
in-grown toenail removal
hysterectomy
infected surgical scar (surgery to remove old stiches)
broken foot
ovarian laporoscopy

That's all I can think of for now. If you want more specifics regarding how these were handled, let me know.
 
Also sorry about your father. What a nice thing to do, to try and prevent other people from having the same problem your dad did!

Other possible surgeries etc.

D & C for women
nasal septum surgery
gall bladder surgery
kidney stone issues...either via the machine that pulverizes them, or by actual surgery.
Biopsies of any kind
A really bad fall with tremendous bruising (while on coumadin)
pacemaker insertion (I was bridged with heparin)
Angiogram (also bridged with heparin)
more heart surgery
carotid artery surgery...stent or bypass
carpal tunnel surgery

Actually, probably every surgery that one could possibly have could be listed!

And another dangerous issue with coumadin aside from pending surgery is when your INR gets too high, an ER doc or other (hopefully you will get to your own doc who is knowledgeable) may try to hold your coumadin and/ or give you vitamin K innapropriately. An informed patient will know better, but many folks are not informed!

Good luck with this project!
 
So sorry about your dad.

I feel like the knowledge and information I have gained on this board literally saved me from problems both during dental implant surgery and my recent colonoscopies and polypectomies.

My dental surgeon talked to my cardiologist and let me stay on my Coumadin with no adverse effects or bleeding.

Unfortunately I had to go to war with my Gastroentenologist and disobey his directions to go off any combination of Coumadin/Lovenox for ten days.

Mark
 
Mark,

I suggest that if you ever have a colonoscopy again with or without biopsy that you show the Guidlines set forth by the ASGE Standard's of Practice Comittee for anticoagulation to your gostro. ;)
 
I will be off coumadin tonight for an Ablation of the AV Node.
Adding to the list I remember going off for Radiofrequency Nerve Ablations for pain. While taking coumadin for 20 years I cannot think of one procedure, surgery or exam where my INR levels were not addressed. Oh yes an eye exam was no problem.
 
Thanks to all you who posted all the possible times that drugs could play an integral part in our day to day lives. ie dental procedures. Gives me some more things to think about as I am facing surgery, and trying to make an educated decision as to what valve I would choose if I have to choose one.
 
I am sooooo sorry to hear about your dad..... I can't beleive the surgen had him go off coumadin for 4 days...that is crazy....my doctor had me go off coumadin for 2 days for my heart cath. One more thing that I just recently found out about by accident was massage with herbs.... it dropped my inr down to 1.9.......I love massages just will never have that kind again and I am going to mention it to the massage theripies....she is awsome but I am certian she had no idea that some of the herbs could interfer with coumadin.
 
There were two times when Joe has had to be off anticoagulation without bridging. There were no other choices at the time.

One was when he had a complete bleedout after gallbladder surgery, and this was done to save his life. He was off anticoagulation for over a week, probably closer to 10 days. It was the scariest time. The choices were either get the bleeding under control or he would die, or risk a stroke or worse from clotting.

And the last time was his recent slip and fall accident. He bled profusely inside his leg and it had to be brought under control, since his bloodcount was dropping. They tried keeping the anticoagulation at a minimal level, but it wasn't enough to prevent further bleeding. He was off for several days, but not as long as during the gallbladder mishap.
 
I have only been off warfarin once since my surgery. I was off for, I think, 3 days, and my INR was at 1.6 when it was tested before I had my sternal wires removed as an outpatient procedure. Now that I look back on this, due to my liver processing warfarin and the fact that I must take 72.5mg per week, I know that this was a hefty risk. I didn't need to go off warfarin that many days to have a drastic drop in INR. My surgeon didn't seem to think that it was too low at 1.6. But he also recommended I keep my INR at 2.0, and my cardiologist says 2.5-3.5, and I take the cardio's advice there. I have had dental crowns placed with no problems and have not been off warfarin since my wire removal.
I will not do a colonoscopy, and am waiting for the non-invasive one.
Gail
 
First of all, I'm so sorry to hear about your Dad. This is something that scares me to death. I wish the Doctors would all get on the same page about when coumadin is really needed to be stopped or not.

When I first started on coumadin, my levels were all over the place and every once in a while it would get pretty high. The first time that happened, my cardio told me to hold for two days....it dropped like a bomb. He suggested that to me another time, and I knew better then and told him I would only need to hold for a day because of my previous experience.

The several months ago, I was going to have a TEE done and he wanted me to stop for 4 days for a TEE!!!!! I thought that was insane, so I did some checking around on VR and talked to other cardio's and finally he agreed to stop just for the day before. Thank you all you VR's who helped me on that one!!

Now, yesterday I went in to my Internal Med. Dr, who by the way all of the sudden is in charge of my coumadin & INR....my cardio handed it over to him without letting either one of us know.....but anyway, I was 7.1 the night before I saw him and he wanted to hold it for 2 days. When I told him I wouldn't do that, that I would only hold for one night because of my previous experience, he said are you sure? I just wanted to say no....I'm just taking my chances and guessing at this!!! Yes, I'm sure....I've been through this several times already. Boy, we really have to stand up for ourselves and challenge these Dr.'s once in a while.

This morning I had my gallbladder scanned, I'm still waiting to hear the report, but if they say I need it taken out, what do I do???? What are some other people's experiences with gallbladder surgery and how long did you have to hold the coumadin etc??? I want to find out as much as possible ahead of time!! And then I'll get to argue with the Doctors some more :rolleyes:
 
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