... 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
Thromboembolic Stroke Prophylaxis - Hi. My 88 year old mother has been on Coumadin for several?
- Asked
- 27 Jan 2011 by moserr
- Updated
- 29 Jan 2011
- Topics
- coumadin, ischemic stroke, thromboembolic stroke prophylaxis, surgery, blood disorders
Details:
Responses (2)
christineATU
27 Jan 2011
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,
chris
DzooBaby
28 Jan 2011
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.
moserr
28 Jan 2011
Thanks DzooBaby. Mom was going to have back surgery -- they were to "infuse" the two vertebrae that were broken. Not sure if they were going to give her an epidural or not -- I've requested her medical records and will dig deeper -- but thank you so much for your comment -- it's been most helpful and puts my mind at some ease that the doctor did not make a mistake if they were indeed going to give her an epidural. I remember the doctor saying they were not going to totally put her under anesthesia -- so epidural may have been the route they were going to take. Thank you again and have a good weekend.
christineATU
29 Jan 2011
You may want to get some help reviewing the medical records. They can be very difficult to decipher. I'm not saying you should sue for malpractice, but it may be to your benefit to have a malpractice attorney review the records to help you understand better the reasons for not taking special precautions with your mom. DaZooBaby really knows her stuff! Excellent info!
Further Information
- Coumadin Information for Consumers
- Coumadin Information for Healthcare Professionals (includes dosage details)
- Side Effects of Coumadin (detailed)
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Ms. Chris -- you were more than helpful! I just didn't know where to turn, but I will carry out with your suggestions. It just makes me mad that I've kept mom healthy all these years and relying on doctors who has our utmost trust can make a mistake -- a painstaking error for mom at that. She is paralyzed on her entire right side and lost all memory and speech. We're doing rehab, but at her age ... I know we all make mistakes ...
Thanks for your insight!
chris is right. However I am on Coumadin for life due to a blood clotting disorder and they always put me on a drug called Lovenox when they have to take me off the Coumadin for tests or surgeries so you may want to check on that. I too will be praying for your mother and family. please let us know what happens take care and my prayers and thoughts are with you, marjorie zych
Marjorie-- thank you so much. Sorry to hear about your blood clots, but it seems you have everything under control! thanks for the advice-- I certainly thought the doctors could have placed mom on some either type of medicine also while she was off Coumadin. She was on Coumadin for a reason. thanks for your prayers and well wishes -- we're struggling. She'll never walk again, but if I can get her speech back so she can communicate, I'll take that!
Good luck and I will definately be thinking of you and your mom, marjorie zych
That's good to know, Marjorie! It sounds like this doctor may have made a big mistake. I truly hope she regains speech and is able to communicate. That is really sad that someone would not take special precautions when taking someone off a life saving drug, if even for a few days. You've been through so much yourself!! I'm so happy you're doing better. :-)
I'm happy to help however I can. I had to write a similar letter to a Physicians group and they did investigate. Although they sided with the doctor, at least it's on record and he will think twice about how he practices medicine in the future. I will keep you in my prayers. Please let us know how your mom progresses.
Best wishes,
chris
I almost forgot! Please get copies of all her medical and hospital records before any changes can be made. It's been done in the past. I know it sounds cynical, but doctors will do very unsavory things to cover up mistakes. Get those records asap.
Yes get those records because I had a situation similar to this and records were changed at the last minute. Thanks chris I am doing better talk to you soon, marjorie zych