Holding comadin bleeding

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Matt C

Well-known member
Joined
May 16, 2012
Messages
46
Location
Christ Hospital Oak Lawn IL Dr. Papps Dr. Brestic
Had my Aortic replaced in October 2011 bridged to lovenox had a hernia rectal surgrey done friday. Went home saturday ended in Er sunday non stop bleeding from rectum. Was rushed into surgrey Monday they wanna hold comadin/ lovenox for. A week I bridged tye correct way but they think I cut in rectum was irritated so they went in and stiched it.

How long is safe to hold off any antigolcant having a mechanical valve? Still in Hospital.
 
Matt,

You might get accurate information from other users of this forum but your best bet is to follow your doctor's directions. Make sure the hospitalist is consulting with your cardiologist. Together, they will decide how to balance the risks.
 
As a general rule, when your INR drops below 2.0 you are supposed to use lovenox to bridge. Of course, lovenox causes more uncontrolled bleeding than coumadin.

With a mechanical valve, as little as 3 days without anticoagulation can cause a stroke. I know you've had a bleed, but blood cells can be replaced. Brain cells cannot. Not no, but HAIL no, don't let them hold your anticoagulation for a stinking WEEK. DO They want you to stroke out??? Idiots. They are used to dealing with a-fib patients. They don't care, it's not THEIR brain.

CALL YOUR CARDIOLOGIST OR OTHER TRUSTED ANTICOAGULATION MANAGER!!! Don't let the hospital folks decide for you. I've found many doctors and nurses don't know Diddly, including some cardiac surgeons and my last post surgical discharge nurse!
 
That's two of us who have said you need to consult your cardiologist. Do it today.
 
Nurse is calling surgeon who did surgrey for hernia he is the wanting to hold it for a week more but waiting on confirmation since cardiologist here said no auggested to atart up again tonight. They think its less then 1 percent per day chance risk of stroke. Waitng to see what surgeon tells her.
 
He's an ANAL surgeon, not a cardiologist. Certainly not a valve specialist, and he's NOT CERTIFIED IN ANTICOAGULATION THERAPY. He's certified in butt holes.

And you don't want to be that 1%. Nor does YOUR cardiologist have to be on staff at this hospital for you to insist that they consult with him.

No one will advocate for you but you. You have to INSIST and fight for yourself. Even if that means you have to get more blood products over the next few days because you are leaking. Don't be passive.
 
Matt C said:
Nurse is calling surgeon who did surgrey for hernia he is the wanting to hold it for a week more but waiting on confirmation since cardiologist here said no auggested to atart up again tonight. They think its less then 1 percent per day chance risk of stroke. Waitng to see what surgeon tells her.
Click to expand...

Those statistics are great on paper -- unless you're the 1-percenter. (And if you're off anticoagulation for 1 week, does that "1 percent per day chance risk of stroke" mean you have a 7% chance of a stroke? I don't think that's a 1 percent per day risk.)
I've been a 1- to 5-percenter 3 different times -- and lived. Statistics have to happen to someone, and that someone could be you. I do not attend to be a stroke statistic.
Your cardiologist may not be on staff at the hospital you're at, but he/she could certainly talk to your general surgeon.
Good luck!
 
Holding for a week is way too risky.
You are the patient and you have say in your care.
You by all means need to discuss this with a qualified coumadin manager. Don't let them 'insist'
on something that can be so dangerous for you. Don't be afraid to speak up. It is your health/brain cells.

Do you have a primary care doctor at that hospital? If not, your cardio certainly can become involved
in consulting about this.

Best wishes. Let us know what you all settle on.
 
I was at 1.4 about 3 days ago so its still gonna take a few days to get me therapitic just told nurse even if surgeonns team says no I am demanding it. Exactly not gonna sit around for a statisitc thanks guys I have been so busy working and for the past week one bad thing after another.
 
Hi

to the OP, I'll leapfrog off AgilityDog here and add

AgilityDog said:
As a general rule, when your INR drops below 2.0 you are supposed to use lovenox to bridge. Of course, lovenox causes more uncontrolled bleeding than coumadin.
Click to expand...

also Heparin is used in Hospital too. I can only agree with:
I've found many doctors and nurses don't know Diddly, including some cardiac surgeons
Click to expand...
 
My Coumadin was held for at least 5 or 6 days with no Lovenox bridging when I had my subarachnoid hemorrhage, due to high INR, caused by bacterial infection. My cardio was on duty at the hospital when I was admitted for BE after being given Vit K shots in the ER the night before.
They felt the risk was very low for a stroke for a valve in the aortic position. I was bleeding in my brain, so they had to make a judgement call. I think I was started up on the 6th day or maybe 7th day, and can't remember if I was bridged with Lovenox or heparin when they started it up, 4 yrs ago. Sometimes you have to trust your doctor and God, I guess. I came through fine. I know I was a bit worried about being off Coumadin, but my docs were more worried about the brain bleed. I never knew how low my INR was. I was really too sick with the BE to care much.
 
Thanks Gail we all know how much Drs know about these types of things. My cardio does not work out of this hospital wish he was so I am dealing with cardio assigned to me surgeon was pushing not to restart but they will tommrow had a complication to orginal surgrey and rushed back into the OR to have another. Just fed up with this hospital in general suppose to he a good hospital.
 
Matt - Have you been able to contact your own cardio? His office could certainly contact the docs at the hospital and get the point across better than you may have.

Since you're local, which hospital are you in now? I had a small hernia repair at Advocate Lutheran General (Park Ridge) in March, and it went super well there.
 
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