... years due to a blood clot in her lungs. THis past November, she had to go to the hospital due to two broken vertebrae. Doctors took her off Coumadin for five days and the day before surgery, she had a massive stroke. My question -- should the doctors have done the surgery sooner or while she was off Coumadin, should they have given her aspirin or maybe heparin to ward off a stroke? thank you for your assistance. It just baffles me that a strong, healthy, although 88 years old, has to suffer from this stroke
Hi moserr, I'm very sorry to hear about your mother. Very sad, indeed. However, this community is more for sharing experiences, opinions, stories, etc. No one really has the medical expertise to guide you through this. I will recommend this, All doctors belong to a Physicians Group. Find out what group her main doctor is a member of. Write a letter to the Director of his group (they are usually physicians too) and let him/her know about these concerns you have. I would also send a copy of the letter to the hospital. They(the Group) will initiate an investigation and question the doctor about this. The hospital will more than likely tell you they do not employ the doctors, only give them privileges to work out of their facility, thereby releasing them from any liability. But if they are on notice about this doctor, they will ask him about this too. But it's the Group he belongs to that will do the investigating. I would also copy the letter of concern to the AMA. Request a response in writing. I would then consult with another doctor about the findings. make sure he/she isn't in the same Group as doctors tend to cover for one another. At least you may get some answers. I really don't know what else you can do to find out what else should have been done. try to find an independent opinion. Usually the AMA can help you through this. Sorry I couldn't help you more. I hope and pray your mother is doing ok and making progress.
I will keep you and your family in my prayers,
Like Marjorie said, usually patients on Coumadin do a Lovenox "bridge" before surgery. Christine gave you great advice! So sorry to hear your mother had to suffer a stroke! Aspirin and Heparin would have caused excessive bleeding during surgery. Lovenox is what is usually used. You have to go off Coumadin before surgery and usually 5-7 days is the average time to be off to prevent hemorrhage. Lovenox is a low molecular weight heparin that doesn't cause as much bleeding during surgery but still prevents clots from forming so they will use this in the interim. Is she allergic to pork by chance? Or had thrombocytopenia, history of aneurysm, active uncontrolled hypertension or had any spinal or epidural punctures? These are containdicated with Lovenox. If she is allergic to pork she would not be able to take Lovenox. Epidural or spinal anesthesia or a recent history of a spinal tap or epidural puncture would have put her at risk for other complications (epidural or spinal hematoma could cause long term or permanent paralysis) so they would not have been able to use Lovenox. So there may have been reasons they couldn't use Lovenox. You might want to find out why they didn't use it.
- Coumadin Information for Consumers
- Coumadin Information for Healthcare Professionals (includes dosage details)
- Side Effects of Coumadin (detailed)
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