Tonsilectomy

[Blake777]

Hey guys, been gone for awhile, but I always come back to my friend experts when I need you. I have been having major problems with fibromyalgia so they put me on 600 gabapentin 3 times a day, I just started this dose when my ENT found something on the back of my throat, gave me antibiotics to see if it would clear up, but it didn't. Now he wants me to have a tonsillectomy, he said he would just take a small sample. But now I need to go down slowly on the gabapentin and probably get off warfarin, not sure about what they want me to do with that yet, probably going to bridge me with lovenox.

But there is some bleeding with this and risks as with all surgeries I guess. But I only have like two weeks to get off the meds and then hopefully I won't have a bad bad fibro flare, because I will have to take something for that horrible pain in my arms and legs and tylenol does not work. Would you have this surgery? Feeling kind of scared, maybe because it is the throat area and can bleed easily, even after surgery if scab comes off. And I know I can not stay off warfarin too long. What do you all think? Thanks in advance.

Ronda

 

[Protimenow]

I would probably trust the doctors -- but be aware that there's a method for performing a tonsillectomy without actually cutting tissue. My wife had it about 13 or so years ago, done by a very good ENT. Instead of using a scalpel, the surgery was performed using radio frequency impulses to, essentially, 'cook' the tonsils into oblivion. She had trouble with pain (for some reason, she metabolized the anesthetic extremely quickly), but I think that this was relatively bloodless.

A procedure of this type may still be possible (I don't know if they still do it anymore, or if you can find a doctor in your area who does this procedure), but it may be worth considering - especially because you're on warfarin.

I hope that it all works out for you.

 

[Blake777]

Thanks for replying Protimenow. I will sure be asking about the procedure when I go in next week for physical. I do have a really good ENT, or supposed to be one of the best here in Oklahoma, part of the OU Physicians. I will be asking a lot of questions. I keep reading about people having a lot of pain after this procedure, I hope it's not entirely true because I have had enough pain for a lifetime, so sick of pain. But we do what we have to do. I guess I should be worrying about what the biopsy might turn up but for some reason I'm concerned about bleeding to death. But I'm sure it will all turn out fine. Thanks again!

 

[Protimenow]

Probably the biggest issue with this procedure is, I think, that there really isn't much tissue to biopsy -- if I understand correctly, the radio frequency emissions pretty much BURN the tonsils away. It doesn't sound like fun, but in theory the worst part is the injection of novocaine (or whatever they use).

I doubt that a tonsillectomy - even the usual kind - will cause you to bleed to death as long as your doctors realize that you're on an anticoagulant and know what they're doing. I would be surprised if they haven't done the same surgery on others who were taking warfarin.

 

[Blake777]

Yes, I'm sure they have. But I was under the impression I was going to be put to sleep since it is going to be done in hospital and I have to see a anesthesiologist before the day of surgery. Maybe I can by pass the Novocaine part. Thanks again Protimenow.

 

[Protimenow]

If it's a surgical procedure, involving hospitalization, an anesthesiologist and actual cutting, you probably WILL completely bypass the novocaine part. (Of course, they may put some kind of residual anesthetic in the area where the tonsils used to be, so that when you come out of anesthesia you won't be in pain.

 

[Blake777]

Yay! No needles, except for IV of course. I'm used to pain, in it on a daily basis, lots of it. But I know throat pain is a whole other area of pain. But maybe I can handle it. Don't need to eat, need to lose a pound or two, so that will help out fine.
Thanks again!

 

[kfay]

Why are they telling you to go off of the gabapentin for this surgery? I've taken that drug for years as a preventive for migraine headaches and have had many surgeries while taking it, including my last heart surgery and back surgery just 3 weeks ago. Never has been brought up that I need to go off of it for any procedure. They always tell me to take my morning dose the day of surgery and then as soon as I'm able to swallow something, they give me my next dose. No problem.

Good luck with the having the surgery. I had mine out as an adult and to be honest, it was quite painful for me. I had mine out in the hospital under general and ended up staying for a week because I refused to swallow anything due to the pain, so they kept me on an IV. It was only after I realized that it was just as painful to swallow my spit as it was to swallow anything else that I finally started eating and drinking. I'm sure yours won't be that bad, but just be prepared for some pain.

 

[Blake777]

Well I guess I started this post out wrong. The procedure I am having is probably not a tonsilectomy. I am having a small piece of tissue clipped off my tonsil (biopsy). So sorry if anyone misunderstood me. Thanks for all the comments. I don't know which medicines I will have to go off yet until I see them again on Friday, and the anesthesiologist.

They did start me on Lovenox today because for some reason the 4mg I was taking made my INR take a nose dive and I am now at 1.9. So they wanted me to go ahead and start Lovenox since it was so low and also because I will be having surgery soon anyway. Omg! these dang shots hurt! Is there a way to make the sting go away. Should I go faster with the injection? Anybody take these?

 

[Gail in Ca]

I have used Lovenox a few times, and I still give myself bruises with pretty much each shot. The last time, I faithfully used an ice pack after the shot and still it bruised me. Once, it even bled all night into my t shirt, thru the Band-Aid. I wish a nurse could come and give them!
Hope I never have to bridge again. As for bleeding, I would think the doctor could tell you if it will cause a lot. I know my doc knew I would bleed after my surgery to remove melanoma, but I don't think she thought I would bleed as much or as long as I have.

 

[Blake777]

Well I was admitted Thursday for major chest pain, just got home. They said I was in the grey area for maybe a blockage. One of my blood test came back abnormal but too low for heart attack and in the grey area, so they are saying that I might have inflammation of heart, which can sometimes mean there may be some kind of blockage. Had to go to hospital ER close to my house because pain was so bad I could not make it the 10 miles to my hospital my surgeon and doctor work out of. So I have to schedule angiogram probably along with the biopsy so I won't have to start lovenox again. I have the biggest hematoma from a shot the nurse gave me, not looking too good to me but she said she hit a vessel. But I am watching it. Hate these dang shots! My INR is at 2.9 and don't have but one more shot. The cost of these darn things or my prescription was $500 and I didn't know I could get a drug program through medicare so I am basically screwed on this and didn't qualify for the program warfarin clinic signed me up for. So called warfarin clinic today to see if maybe he could give me more samples but he never called back, figures. So one more shot for Saturday, but not sure if I should take it or not. Anyway, good to be home, going to lay down.

 

[Bina]

Well I was admitted Thursday for major chest pain, just got home. They said I was in the grey area for maybe a blockage. One of my blood test came back abnormal but too low for heart attack and in the grey area, so they are saying that I might have inflammation of heart, which can sometimes mean there may be some kind of blockage. Had to go to hospital ER close to my house because pain was so bad I could not make it the 10 miles to my hospital my surgeon and doctor work out of. So I have to schedule angiogram probably along with the biopsy so I won't have to start lovenox again. I have the biggest hematoma from a shot the nurse gave me, not looking too good to me but she said she hit a vessel. But I am watching it. Hate these dang shots! My INR is at 2.9 and don't have but one more shot. The cost of these darn things or my prescription was $500 and I didn't know I could get a drug program through medicare so I am basically screwed on this and didn't qualify for the program warfarin clinic signed me up for. So called warfarin clinic today to see if maybe he could give me more samples but he never called back, figures. So one more shot for Saturday, but not sure if I should take it or not. Anyway, good to be home, going to lay down.

sorry to hear of your troubles.....I've only ever had a single shot of Lovenox and my nurse daughter stuck it quickly in my tummy, no problem.
If your INR is already at 2.9 you really shouldn't need that last shot, but I am not your doctor.
Best wishes.

 

[Blake777]

Well that is how the nurse shot me too, really quick, but it gave the biggest bruise of all, but she said she must have it a vessel. Anyway, the plan was to get off warfarin Sunday to be ready for surgery Friday, but now everything has been pushed back since I went to hospital and missed my appt. with anesthesiologist and my physical. Didn't take a shot last night, because I didn't have one, and didn't need one. My INR is 3.3 now and I only took 2mg last night only because if I skip I will drop every time. My regular dose right now is 2mg.

But now I have a new problem! I had to go back to ER yesterday. Can't walk on my leg after some numbness when I got out of the hospital the first time. Went back to make sure I didn't have a stroke because I had a really bad migraine when they released me. Well they found no clots and did a CT scan of head for bleeding, and nothing. Still can't walk because my thigh muscle where the numbness was hurts and at the same time muscle feels dead or not working. Morphine didn't do anything for this pain. So I am now fighting something else, but hopefully I will see my primary this week. Thanks everyone for you help.

 

[Eva]

Good luck and keep us updated after you see your physician.

 

[epstns]

Blake - Have you been having any back trouble? Some of the leg symptoms sound similar to those of a pinched nerve in the back.

 

[Blake777]

Yes I do have lumbar problems, but I have been having muscular problems with my legs a lot lately and rhuematologists said it might be my back and not my FM. But the more I walk on it the more it numbs up and muscles seem twisted or something. But as long as I use the cane not too many problems. I thought maybe I had a TIA, since I had a really bad migraine when I left the hospital and they gave me meds for it and then when I got home leg started going numb. They did a CT Scan, but I read that they may not show up on CT Scans. Pain is much better but it feels so weird like twisted muscles and and pain when I don't use the cane. I have no back pain now or did I have it when it happened. They told me today to just ice it. Now on to the mystery of why I get spasms in my stomach. Have to get an ultra sound for that. Thanks a lot everyone for your advice.

 

[Protimenow]

FWIW - when I had my TIA, it didn't follow a migraine or any noticeable head pain. In fact, I took a short nap, in my chair at my desk, and when I got up, it felt like one of my legs got 'light.' I immediately took 2 grams of aspirin, suspecting that this may have been a TIA, and then tested my INR. It wasn't until the next evening that I finally went to the ER, and in the morning they did an MRI and confirmed the diagnosis.

I still get ocular migraines -- but don't think a lot about them. I keep my INR in safe range, with weekly testing.

My initial guess, given your symptoms, was that something got pinched when you were in the ER waiting for a doctor to see you.

 

[Blake777]

They took me right in, didnt have to wait to be seen. But I did have a test of my valve and I kept getting darn spasms under my ribs while they were doing the test. So I was kind of squiggling around to get them out because they hurt, all the while trying not to mess up the ekocardiogram test. That might be how I did something to my lower back. But now my leg is going completely numb while I sitting here, the whole leg. That is why it is kind of scaring me, but I already been to doctor so just a sit and wait to see what happens I guess.

 

[Bina]

when in doubt---check it out