Re: Coumadin / Surgery

January 21, 2004

Hi

I finally decided to take the plunge and see whether my rotator cuff

tear can be improved or fixed. Here too, getting information when to

stop Coumadin has been quite varied from 3 to 5 days before surgery,

continuing after, to waiting another 2 days after surgery before

taking Coumadin again. Recommendations from doctors, yes I consulted

quite a few.

Hope some of our members could help with some advise.

/

January 21, 2004

the test result between the pin prick or through the vein are identical in

results l was told and noticed myself.

tony

January 22, 2004

:

I had an colonoscopy a couple of months ago & they had me discontinue coumadin 5

days before the procedure. I just received instructions from the Cleveland

Clinic where I will be having a PVA by Dr. Natale on the 13th of Feb & they told

me to quit coumadin 3 days before the procedure. I told the nurse my PT levels

bounce all over the place & should I discontinue a few days sooner to make sure

my levels were down ? She replied that Dr. Natale would do ( & obviously has

done) the procedure even if my PT levels were 3, so go figure ! With the

colonoscopy, I resumed coumadin immediately, but it's probably different with a

surgery & the risk of bleeding afterwards.

Thor 24/7

Re: Coumadin / Surgery

Hi

I finally decided to take the plunge and see whether my rotator cuff

tear can be improved or fixed. Here too, getting information when to

stop Coumadin has been quite varied from 3 to 5 days before surgery,

continuing after, to waiting another 2 days after surgery before

taking Coumadin again. Recommendations from doctors, yes I consulted

quite a few.

Hope some of our members could help with some advise.

/

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January 22, 2004

At 11:56 AM 1/22/2004 -0600, you wrote:

>:

>

>I had an colonoscopy a couple of months ago & they had me discontinue

>coumadin 5 days before the procedure. I just received instructions from

>the Cleveland Clinic where I will be having a PVA by Dr. Natale on the

>13th of Feb & they told me to quit coumadin 3 days before the procedure. I

>told the nurse my PT levels bounce all over the place & should I

>discontinue a few days sooner to make sure my levels were down ? She

>replied that Dr. Natale would do ( & obviously has done) the procedure even

>if my PT levels were 3, so go figure ! With the colonoscopy, I resumed

>coumadin immediately, but it's probably different with a surgery & the

>risk of bleeding afterwards.

I have had cataract surgery on both eyes in the last two months. The eye

surgeon said that he was comfortable working with the INR between 2 and

3. They did not take me off of coumadin for either eye. For the first

one, I had a protime test about a week before and the INR was 1.8. They

made an adjustment on the coumadin (warfarin) and the next time the INR was

2.0. That was about three weeks ago and I had the other eye done today.

No problems so far.

in Portland OR

February 12, 2004

Hi,

I like to know what other surgeons suggest as to the number of days

required, for Coumadin to lose its effectiveness and to get the blood

to clot normally. Counting the days of abstinence before and after

surgery would in my case total 7 days. My cardio acknowledged that I

am not in a high risk catagory, however, after 5 days without

Coumadin, clotting possibilities go up rather quickly. My surgeon

suggested to stop 4 days before surgery, my cardio 3 days. Because

of possible bleeding after surgery I will have to wait another 2 days

before taking Coumadin. It was agreed to start me on Lavenox?

(spelling) 2 days after if I am healing well.

The last thing I want is go through all this prep and then find out

that the surgeon cannot proceed.

/

February 12, 2004

, I just had a full mouth tooth extraction in the hospital for 5

days. They took me off of Coumadin 4 days before surgery on Jan.

16th and put me back on the day after surgery.

Good luck,

Debbi, OU Alum in OKC

snip

>

> Hi,

>

> I like to know what other surgeons suggest as to the number of days

> required, for Coumadin to lose its effectiveness and to get the

blood

> to clot normally.

February 13, 2004

Hi Debbi,

I guess not too many of our members have encountered surgery while on

Coumadin.

I would think that your surgery must have been quite traumatic. Did

you receive any stitches? Was there any bleeding involved

afterwards? Besides poking holes into my shoulder I was told I will

have 2 incisions and there will be some bleeding afterwards, plus a

number of stitches - don't want to go into too much detail. I

remember you talked about swelling - I will be sent home with an

icepack on my shoulder and some pain killers that will knock me out -

hmm.... That is enough to think about - don't want to have any

additional problem with my afib or clotting on top of it.

Take care and thanks for the information.

/

> , I just had a full mouth tooth extraction in the hospital for

5 days. They took me off of Coumadin 4 days before surgery on Jan.

> 16th and put me back on the day after surgery.

>

> Good luck,

> Debbi, OU Alum in OKC

>

February 13, 2004

> > , I just had a full mouth tooth extraction in the hospital

for

> 5 days. They took me off of Coumadin 4 days before surgery on Jan.

> > 16th and put me back on the day after surgery.

> >

> > Good luck,

> > Debbi, OU Alum in OKC

> >

February 13, 2004

>

> Hi,

>

> I like to know what other surgeons suggest as to the number of days

> required, for Coumadin to lose its effectiveness and to get the blood

> to clot normally. Counting the days of abstinence before and after

> surgery would in my case total 7 days. My cardio acknowledged that I

> am not in a high risk catagory, however, after 5 days without

> Coumadin, clotting possibilities go up rather quickly. My surgeon

> suggested to stop 4 days before surgery, my cardio 3 days. Because

> of possible bleeding after surgery I will have to wait another 2 days

> before taking Coumadin. It was agreed to start me on Lavenox?

> (spelling) 2 days after if I am healing well.

> The last thing I want is go through all this prep and then find out

> that the surgeon cannot proceed.

>

> / , I had lung surgery, in the hospital 3 mos, was on coumadin,

they took me off for just 3 days before surgery, and gave me heparin shots on

those days, then after surgery back on the coumadin in a few days.

February 14, 2004

I have had skin surgery where all layers of skin were removed. The Dr

cartorized(sp?) any bleeders as he worked. Sorry about the spelling, I couldn't

even

get close enough for the spell check to find it.

This is, of course, much simpler surgery than most.

Guy

February 14, 2004

I'm going in for a Colonoscopy March 1st - and my EP gave me the go ahead to

come off of Coumadin for five (5) days before.

Ellen

******************

----- Original Message -----

Someone wrote:

> > I like to know what other surgeons suggest as to the number of days

> > required, for Coumadin to lose its effectiveness and to get the blood

> > to clot normally. (snip)

*******************

February 14, 2004

I did forget to mention that I did stop the coumadin, I think it was 5 days

before a colonoscopy. The Dr clipped some polyps out and asked me to not

restart the coumadin for another day.

Guy

February 14, 2004

In a message dated 2/14/2004 8:12:51 PM Pacific Standard Time,

guygooch@... writes:

<< I did forget to mention that I did stop the coumadin, I think it was 5

days

before a colonoscopy. >>

Guy,

I also stopped Coumadin for three days before a colonoscopy over two years

ago. I was in a lengthy afib episode at the time and was quite nervous about

stopping the Coumadin. However, I had no polyps or other abnormalities, so I

was able to start the Coumadin the day after. This recent stoppage of Coumadin

a few days ago has been the only one during which I was in sinus, but I

suffered no strokes or other ill effects from stopping Coumadin on two previous

occasions while in afib.

in sinus in Seattle

February 14, 2004

At 03:43 AM 2/15/2004 +0000, you wrote:

>Just to mention I too had skin surgery last year, and as reported here,

>went through the same process, no changes in my Coumadin intake and ending

>up with a blood oozing site

>that took about 3 days to heal.

I also had skin surgery a couple of years ago and the surgeon requested

that I come off Coumadin three days before and start again after two

days. I recently had Cataract surgery and lens implants. The eye surgeon

was comfortable with me on Coumadin, as long as he knew about it. No problems.

in Portland OR

February 15, 2004

In a message dated 2/15/2004 4:05:00 PM Central Standard Time,

madisonn99@... writes:

I wonder whether 1.2 is low

enough for my surgery.

xxxxxxxxxxxxxxxxxxxxxxx

At the lab where my pro times are done up to 1.4 is considered normal.

Brenta

February 15, 2004

Probably everyone is different, but I discontinued coumadin on the 9th of Feb

for a PVA (PT 2.3 then) & on thursday the 12 th it was 1.2

Thor

Re: Re: Coumadin / Surgery

I'm going in for a Colonoscopy March 1st - and my EP gave me the go ahead to

come off of Coumadin for five (5) days before.

Ellen

******************

----- Original Message -----

Someone wrote:

> > I like to know what other surgeons suggest as to the number of days

> > required, for Coumadin to lose its effectiveness and to get the blood

> > to clot normally. (snip)

*******************

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

February 15, 2004

Hi Thor,

getting your pt checked the week of the surgery is probably a good

idea. I will discuss it with my doc. You discontinued coumadin for 3

days, if I understand you correctly. I wonder whether 1.2 is low

enough for my surgery. I can see where 3 days might be cutting it a

little too close for me.

Hope your PVA went well.

/

> Probably everyone is different, but I discontinued coumadin on the

9th of Feb for a PVA (PT 2.3 then) & on thursday the 12 th it was 1.2

> Thor

February 15, 2004

>

> Hi Thor,

what time of the day did you take your coumadin. I normally wait

until late at night between 9 and 10 pm. Even that matters as to how

long it works. Hope you don't mind my curiosity.

>

> /

>

> > Probably everyone is different, but I discontinued coumadin on

the

> 9th of Feb for a PVA (PT 2.3 then) & on thursday the 12 th it was

1.2

> > Thor

February 15, 2004

:

1.2 is normal - as if you weren't taking coumadin (to the best of my knowledge)

As I posted last week, had the PVA on Friday @ the Cleveland Clinic by Dr.

Natale after tests on Thursday. (EKG, echocardiogram, TEE) As has been reported

by others, it does take a while ! I was Schd. @ 3:00 PM on Friday, actually

started @ 6:30 & finished about 11:30 PM. I did experience some very minor

bleeding @ one of the groin entry sites, so they kept compression on all three

sites for about an hour after we were finished. (that may be normal as far as I

know) Someone mentioned recently that the worst thing about a PVA (AND IT'S NOT

THAT BAD !) is the need to be immobile for all that time & in my case, another 4

hours after I got a hospital bed, and I would agree. It makes your back sore,

but as soon I was able to get out of bed (about 4:00 AM) that soon went away.

I'm having minor side effects since it's it less than 48 hours since the PVA

(which I was advised to expect & not be concerned about) such as very mild

shortness of breath, slight fatigue, & chest discomfort. (I think the chest

discomfort is from the TEE, as I only notice it if I cough or take a deep

breath) Today is much better than yesterday regarding these post PVA symptoms,

and oh yes, IT WORKED ! (The PVA nurses got a kick out me taking my pulse all

the time)

As for the procedure itself, it was basically painless. Because of your sedated

state, it didn't seem like 4-1/2 hours to me, more like an hour. Dr. Natale did

three PVA's on Friday, mine being the last (obviously !) He apologized for the

delay - he said the case before was difficult - I told him I had waited 5 months

and another 3 hours didn't seem like much of a delay to me. Anyway, I'm less

than 48 hours into this, but so far, so good. Dr. Natale advised me that

occasional skipped beats & short episodes of AF during the first 2 to 6 weeks

post ablation is normal & is referred to as " heart beat irritability " because of

the PVA. He also advised me that after 2 months if I wasn't NSR then the

procedure would be considered a failure & a " touch up " PVA would be done in 3

months. Dr Natale's associate (also an EP) told me they have a first time

success rate of 85%, and 95% of a " touch up " is required. I am taking Betapace

for 2 weeks (for rhythm control - new for me) & the Verapamil (for rate control)

as been discontinued. I know there are many " long of tooth " in this group & all

this is old news, but I thought some newer members or those considering a PVA

would be interested. I certainly won't hesitate to have the " touch up " if

necessary.

Thor, FORMALLY 24/7 AF (so far !)

Re: Coumadin / Surgery

Hi Thor,

getting your pt checked the week of the surgery is probably a good

idea. I will discuss it with my doc. You discontinued coumadin for 3

days, if I understand you correctly. I wonder whether 1.2 is low

enough for my surgery. I can see where 3 days might be cutting it a

little too close for me.

Hope your PVA went well.

/

> Probably everyone is different, but I discontinued coumadin on the

9th of Feb for a PVA (PT 2.3 then) & on thursday the 12 th it was 1.2

> Thor

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February 15, 2004

, I take mine in the morning. I'll ask my Dr. friend if it makes difference.

(I wasn't aware that it might)

Thor

Re: Coumadin / Surgery

>

> Hi Thor,

what time of the day did you take your coumadin. I normally wait

until late at night between 9 and 10 pm. Even that matters as to how

long it works. Hope you don't mind my curiosity.

>

> /

>

> > Probably everyone is different, but I discontinued coumadin on

the

> 9th of Feb for a PVA (PT 2.3 then) & on thursday the 12 th it was

1.2

> > Thor

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

February 15, 2004

Thanks, Brenta, that is good to know.

/

> At the lab where my pro times are done up to 1.4 is considered

normal.

> Brenta

February 15, 2004

Hi Thor,

it proves I no longer read all the messages. But I am glad you read

mine. You stated 24/7 Afib - reflecting permanent afib before the

procedure? To my knowledge the outcome of a PVA tends to be less

successful for permanent afibbers?? I will be following

your 'success' with interest as another member in permanent afib.

The best of luck and keeping my finger crossed, it will work for you.

/

> :

> 1.2 is normal - as if you weren't taking coumadin (to the best of

my knowledge)

>

> As I posted last week, had the PVA on Friday @ the Cleveland Clinic

by Dr. Natale after tests on Thursday. (

February 15, 2004

Hi Thor, again,

I always like to hear from professionals, even though experience

taught me they don't agree all too often.

Timing Coumadin, in my case, applies twofold.

Just as our heart meds, so does Coumadin reach its peak at a certain

time, to my knowledge that peak is reached by Coumadin in 3 to 4

hours after intake, and will start leveling off. Affecting your INR

reading depending on when the test is performed. If I took the C in

the morning my surgeon would actually have allowed for 3 days

without, as in your case. I could go into more details, but how

technical do I want to get?

Would like to hear what your dr. friend has to say.

Again best of healing and good luck.

/

> , I take mine in the morning. I'll ask my Dr. friend if it

makes difference. (I wasn't aware that it might)

> Thor

February 15, 2004

Thor - I greatly appreciate your details, and I wish you the very best of afib

free luck. Thanks for sharing.

Stef

tk_wascow wrote: