Re: Lovenox. . . type of anesthesia to choose

[Guest guest]

It's a blood thinner which is given in lieu of the older blood thinners.

There are fewer risks so that one doesn't have to have periodic blood

tests while one is on thinners. With the older types there is less

control over the dosage so that it can cause internal bleeding

including bleeds into the brain.

On Jan 14, 2010, at 11:06 AM, sms wrote:

> I hadn't heard of Lovenox before. Is this a common injection for both

> spinal/epidural and general anesthesia?

> Wondering if there is a pill that would do the same thing?

>

> I understand that with the spinal the chance of waking up with a

> horrific

> headache can sometimes happen due to leakage of spinal fluid. Ack!

> Both

> headache/migraine as well as nausea are two aspects of anesthesia I

> would

> really like to avoid. Is there a way to avoid either or both of these?

>

> From: jujulabee@...

> Date: 01/13/10 07:03:39

> Joint Replacement

> Subject: Lovenox

>

> I think most of us with no medical background were nervous about

> giving ourselves a shot.

>

> The Lovenox shots are really not like a " shot " . They come in a

> completely self contained package and are more like a " plunger " than a

> hypodermic needle. You essentially place something on a piece of fat

> (easy in my case LOL) and then rapidly push the plunger down -- that's

> it - very easy and completely painless.

>

>

>

>

[Guest guest]

Thanks Juju,

I'm still interested in the second part of my question which addresses - how

to choose between spinal and general anesthesia and how to completely avoid

headache and nausea.

----------------------------------------------

From: jujulabee@...

Date: 1/14/2010 11:35:05 AM

Joint Replacement

Subject: Re: Lovenox. . . type of anesthesia to

choose

It's a blood thinner which is given in lieu of the older blood thinners.

There are fewer risks so that one doesn't have to have periodic blood

tests while one is on thinners. With the older types there is less

control over the dosage so that it can cause internal bleeding

including bleeds into the brain.

[Guest guest]

To me it's a no brainer since spinal is less invasive and carries far

fewer risks of complications.

When I was researching I talked to doctors I knew and they all would

go with spinal if possible because of the increased risk of

complications for general.

Of course no everyone who has a general has complications -- it is

just an increased statistical risk and since there was no benefit to

general, I opted for spinal or epidural.

I I had a spinal with no headaches - it's a very low complication. I

had no nausea either. I had a tiny bit of queasiness the second day

but really nothing that I would even call a complication as it passed

almost immediately.

There are effective anti-nausea drugs which are used in the hospital

if it is an issue and they work quite well.

On Jan 14, 2010, at 11:41 AM, sms wrote:

> Thanks Juju,

> I'm still interested in the second part of my question which

> addresses - how

> to choose between spinal and general anesthesia and how to

> completely avoid

> headache and nausea.

> ----------------------------------------------

> From: jujulabee@...

> Date: 1/14/2010 11:35:05 AM

> Joint Replacement

> Subject: Re: Lovenox. . . type of

> anesthesia to

> choose

>

> It's a blood thinner which is given in lieu of the older blood

> thinners.

>

> There are fewer risks so that one doesn't have to have periodic blood

> tests while one is on thinners. With the older types there is less

> control over the dosage so that it can cause internal bleeding

> including bleeds into the brain.

>

>

>

[Guest guest]

Sasha,

I don't think there is any way to completely avoid the possibility.. Those are

simply potential side effects. I've had general several times and have never had

any reaction to it at all, others that I know have had slight headaches which

went away fairly quickly.

Jeff

________________________________

From: sms <sms@...>

Joint Replacement

Sent: Thu, January 14, 2010 2:41:17 PM

Subject: Re: Lovenox. . . type of anesthesia to choose

Thanks Juju,

I'm still interested in the second part of my question which addresses - how

to choose between spinal and general anesthesia and how to completely avoid

headache and nausea.

----------------------------------------------

From: jujulabee@...

Date: 1/14/2010 11:35:05 AM

Joint Replacement

Subject: Re: Lovenox. . . type of anesthesia to

choose

It's a blood thinner which is given in lieu of the older blood thinners.

There are fewer risks so that one doesn't have to have periodic blood

tests while one is on thinners. With the older types there is less

control over the dosage so that it can cause internal bleeding

including bleeds into the brain.

[Guest guest]

Lovenox helps prevent blood clots.  Until I had DVTs, none of my surgeries

required Lovenox. 

 

The shot is subcutaneous, not injected in any veins...normally, the best spot is

around the belly button.  It's not terribly painful.  Anything connected with a

needle does have some element of pain, but it depends upon the individual's

feelings.

 

There's not a pill to be given as a substitute.  Most hospitals will give the

patient a kit about Lovenox, it comes with a tape to watch on giving the

injection.

 

More years ago than I care to admit, a friend told me prior to having a

C-section, to never sit up if I was given a spinal.  As it happens that's

exactly what I had, so I refused to let them sit me up for 12 hours after

surgery.  I didn't have a headache.  Some friends of mine have sat up after

surgery and a spinal and had not one bit of problem.  I think if I had to do it

over, I'd refuse to sit up.  I've heard the spinal headache is horrible.  Better

safe than sorry, right?

 

Hope this helps.

 

Lynn

 There is a crack in everything, that's how the light gets in. 

    Leonard Cohen

Here's my art blog:  http://www.adreamseyeview.blogspot.com/

From: sms <sms@...>

Subject: Lovenox. . . type of anesthesia to choose

Joint Replacement

Date: Thursday, January 14, 2010, 2:06 PM

I hadn't heard of Lovenox before. Is this a common injection for both

spinal/epidural and general anesthesia?

Wondering if there is a pill that would do the same thing?

I understand that with the spinal the chance of waking up with a horrific

headache can sometimes happen due to leakage of spinal fluid. Ack!  Both

headache/migraine as well as nausea are two aspects of anesthesia I would

really like to avoid. Is there a way to avoid either or both of these? 

From: jujulabee@...

Date: 01/13/10 07:03:39

Joint Replacement

Subject: Lovenox

I think most of us with no medical background were nervous about

giving ourselves a shot.

The Lovenox shots are really not like a " shot " . They come in a

completely self contained package and are more like a " plunger " than a

hypodermic needle. You essentially place something on a piece of fat

(easy in my case LOL) and then rapidly push the plunger down -- that's

it - very easy and completely painless.

------------------------------------

[Guest guest]

Alas, there are not guarantees as to how to completely avoid headache and

nausea. I had spinal with both my knee surgeries. With the first I felt

great afterwards and was immediately alert. However I did vomit a lot at

first and then was given shots for that. I talked with the anesthesiologist

about it for the second and it was fabulous ‹ alert and ready to get up; no

nausea. I was a very happy camper.

Here¹s what I read about frequency of headaches. I¹d talk with the

anesthesiologist about it as these numbers may have changed as procedures

improve. S/he may also have ideas about your particular situation and the

suitability for you.

Best,

Jackie

> Will I get a headache ?

>

> Postdural puncture headache occurs infrequently with these techniques. The

> risk seems to be higher with younger age and larger size of the needle. The

> risks is about 1% with Epidurals and 3% with Spinals. This is believed to be

> due to a leak of cerebroSpinal fluid from the needle hole in the dura. The

> occurrence of this is greatly reduced by using a smaller needle when possible.

> If this headache does occur it may be treated initially with hydration and

> pain medicines. If the headache does not resolve it would be treated with an

> Epidural blood patch. This if essentially using the patients own blood to

> block the leak via the Epidural technique.

>

>

>

>

> Thanks Juju,

> I'm still interested in the second part of my question which addresses - how

> to choose between spinal and general anesthesia and how to completely avoid

> headache and nausea.

> ----------------------------------------------

> <snip thread>

[Guest guest]

Thank you all for the information. I'll try to see if I can get a call back

from the anesthesiologist's group to talk with a doc. It seems to be common

policy to speak only be able to speak to the anesthesiologist the night

before surgery and not before. The Pre Op Dept. says that they don't even

know who it will be until that time. My hope was that I could choose the

anesthesiologist just like I did the OS. Made a whole lotta sense to me.

Sasha

[Guest guest]

I talked to an anesthesiologist during my pre-surgery physical. Then

talked to the person doing it immediately before. It worked ok for me

because I'd researched and knew what I wanted to do and I was just

confirming with them. I think it was helpful with second surgery

'cause I got to talk about the previous nausea and it was fresh in her

mind.

Jackie t

Jackie on

Borntodrum.org

Girights.net

AMIE Oakland, CA

510-332-5998

Sent from my iPhone with one finger typing; so apologies if I sound

abrupt ...not to mention typos!!

On Jan 14, 2010, at 3:11 PM, " sms " <sms@...> wrote:

> Thank you all for the information. I'll try to see if I can get a

> call back

> from the anesthesiologist's group to talk with a doc. It seems to be

> common

> policy to speak only be able to speak to the anesthesiologist the

> night

> before surgery and not before. The Pre Op Dept. says that they don't

> even

> know who it will be until that time. My hope was that I could choose

> the

> anesthesiologist just like I did the OS. Made a whole lotta sense

> to me.

> Sasha

>

>

>

>

[Guest guest]

Jackie,

Where did you research? I would like to do the same.

I have googled and read what I could about the spinal and general, but it

was not specific to the various anesthetics that they use. Don't know if

that would help me much, but I could try.

Sash

From: Jackie At AT & T

Date: 1/14/2010 3:40:23 PM

Joint Replacement

Subject: Re: Lovenox. . . type of anesthesia to

choose

I talked to an anesthesiologist during my pre-surgery physical. Then

talked to the person doing it immediately before. It worked ok for me

because I'd researched and knew what I wanted to do and I was just

confirming with them. I think it was helpful with second surgery

'cause I got to talk about the previous nausea and it was fresh in her

mind.

Jackie t

Jackie on

Borntodrum.org

Girights.net

AMIE Oakland, CA

510-332-5998

[Guest guest]

Hi Sash!

I didn't go to that level of info -- just pros & cons of general vs

spinal & epidural.

J

Jackie on

Borntodrum.org

Girights.net

AMIE Oakland, CA

510-332-5998

Sent from my iPhone with one finger typing; so apologies if I sound

abrupt ...not to mention typos!!

On Jan 14, 2010, at 3:46 PM, " sms " <sms@...> wrote:

> Jackie,

> Where did you research? I would like to do the same.

> I have googled and read what I could about the spinal and general,

> but it

> was not specific to the various anesthetics that they use. Don't

> know if

> that would help me much, but I could try.

> Sash

>

> From: Jackie At AT & T

> Date: 1/14/2010 3:40:23 PM

> Joint Replacement

> Subject: Re: Lovenox. . . type of

> anesthesia to

> choose

>

> I talked to an anesthesiologist during my pre-surgery physical. Then

> talked to the person doing it immediately before. It worked ok for me

> because I'd researched and knew what I wanted to do and I was just

> confirming with them. I think it was helpful with second surgery

> 'cause I got to talk about the previous nausea and it was fresh in her

> mind.

>

> Jackie t

>

> Jackie on

> Borntodrum.org

> Girights.net

> AMIE Oakland, CA

> 510-332-5998

>

>

[Guest guest]

Ah Hah. Okie Dokie, I'll take it from here and find out what I can.

Thanks to all who responded again.

Have a great night.

Sash

From: Jackie At AT & T

Date: 1/14/2010 4:14:52 PM

Joint Replacement

Subject: Re: Lovenox. . . type of anesthesia to

choose

Hi Sash!

I didn't go to that level of info -- just pros & cons of general vs

spinal & epidural.

J

Jackie on

Borntodrum.org

Girights.net

AMIE Oakland, CA

510-332-5998

[Guest guest]

I had never had a spinal before so I was a bit nervous but that's what my OS

(Dr. Coon) recommended. I told him that was fine with me...as long as I was

totally unaware of what was going on - I didn't want to hear anything. He said

he'd be sure I was sleeping comfortably. To be honest, I vaguely remember the

tiniest prick of the needle and that was it. Don't even remember laying back

down. I awoke following the surgery completely alert with no nausea or headache

at all. I'm so glad I had the spinal rather than general!

RTKR-9/16/09

Re: Lovenox. . . type of anesthesia to

choose

It's a blood thinner which is given in lieu of the older blood thinners.

There are fewer risks so that one doesn't have to have periodic blood

tests while one is on thinners. With the older types there is less

control over the dosage so that it can cause internal bleeding

including bleeds into the brain.

[Guest guest]

I had to give myself the shots after my first hip last spring, as well as after

a broken femur two years ago. It's really not anything to be worried

about--easily done, not painful. However, after my second THR this past Oct., I

discovered they are now giving the blood thinners as a pill. It's called

" Xarelto " or something like that. And it's also given for a month or so

afterwards, one a day.

As for anaesthetic vs. a spinal, I'd vote for the spinal! I don't do well with

anaesthetic. One kind gave me wierd realistic scary dreams, and I would wake up

for the first few mornings with my memory lost as to where I was, and even on

one memorable occasion many years ago, who I was--or with a distorted view of

reality.

Another kind of anaesthetic gave me horrible ongoing nausea (after my THR last

April). I'd start each day with an anti-nausea shot, which took a couple of

hours to take effect.

This time I got a spinal, and I woke up totally alert in the recovery room. I

was sitting up within a couple of hours of surgery, and no problems, no

headaches. Nobody mentioned that possibility. However, I did have a spinal tap

once, before a spinal fusion, and I was warned not to raise my head for twelve

hours after that.

Gail

>

> Lovenox helps prevent blood clots.  Until I had DVTs, none of my surgeries

required Lovenox. 

>  

> The shot is subcutaneous, not injected in any veins...normally, the best spot

is around the belly button.  It's not terribly painful.  Anything connected with

a needle does have some element of pain, but it depends upon the individual's

feelings.

>  

> There's not a pill to be given as a substitute.  Most hospitals will give the

patient a kit about Lovenox, it comes with a tape to watch on giving the

injection.

>  

> More years ago than I care to admit, a friend told me prior to having a

C-section, to never sit up if I was given a spinal.  As it happens that's

exactly what I had, so I refused to let them sit me up for 12 hours after

surgery.  I didn't have a headache.  Some friends of mine have sat up after

surgery and a spinal and had not one bit of problem.  I think if I had to do it

over, I'd refuse to sit up.  I've heard the spinal headache is horrible.  Better

safe than sorry, right?

>  

> Hope this helps.

>  

> Lynn

>

>

[Guest guest]

Jackie,

I also vomited a lot after my last surgery (spinal). One of the nurses thought

it might be the morphine pain pump they give you for the first couple of days.

So they took it away, and my nausea cleared up quickly after that. Like you, I

didn't have nausea from the spinal.

Gail

>

>

> Alas, there are not guarantees as to how to completely avoid headache and

> nausea. I had spinal with both my knee surgeries. With the first I felt

> great afterwards and was immediately alert. However I did vomit a lot at

> first and then was given shots for that. I talked with the anesthesiologist

> about it for the second and it was fabulous ‹ alert and ready to get up; no

> nausea. I was a very happy camper.

>

>> Best,

> Jackie

>

>

[Guest guest]

dear jackie

i had a THR in June with total anesthesia, including intubation....they thought

it

might be a long sugery, which is was and pretty invasive...i had NO bad side

effects

at all...and no nausea or headaches afterwards! i do have a sensitivity to

morphine,

so my doc decided to use something different after surgery for pain and it was

so much better....i didn't have a choice, but am glad about the type that he

used...most importantly

you have to speak with the anesthesiologist before hand about the surgery

itself,

and your options...i was hesitant to mention my past morphine experience, til

the

nurse in pre-surgery interview brought it up, very matter of factly she

said... " well, it sounds like you have a morphine allergy! " be your own best

advocate and after that

trust the experts to make a good choice on your behalf...

also, i was pretty well prepared emotionally/psychologically for the surgery

but in pre op felt a bit anxious, so asked for some nice versed to be sent down

my

IV line....that helped me over that little edge riding off to the operating

room..

if you need any more help, please ask!!

celaine

> >

> >

> > Alas, there are not guarantees as to how to completely avoid headache and

> > nausea. I had spinal with both my knee surgeries. With the first I felt

> > great afterwards and was immediately alert. However I did vomit a lot at

> > first and then was given shots for that. I talked with the anesthesiologist

> > about it for the second and it was fabulous ‹ alert and ready to get up; no

> > nausea. I was a very happy camper.

> >

> >> Best,

> > Jackie

> >

> >

>