... I am currently on coumadin due to bilateral PE's and DVT's behind both knees related to a surgery in 2/12. My question relates to info from my orthopaedic surgeon that I go off coumadin 1 week before surgery and may be put on a different molecular weight Lovenox (from the one that got me ready for coumadin) right after stopping coumadin. I understand the Lovenox is taken until 9 hours pre-surgery and started several hours after surgery. My understanding is that the Lovenox lowers the INR-Proth. number but still keeps new clots from forming e.g. DVT's. I have an IVC filter to supposedly prevent more PE's. Has anyone gone thru this pre and post surgery anticoagulant procedure? Was it sucessful? How much later did they put you back on coumadin? Did you have to use the Lovenox used in the past before starting coumadin before for the next transition to coumadin after surgery?
I have been on coumadin for about 10 years after they found I had a DVT in my leg. Which then led my dr. to find out that I had a heriditary blood disorder called Factor 5 Lieden which basically thickens my blood Alot. I have had several surgeries & procedures done. When you are on Coumadin you are Always instructed that depending on the surgery & how much detailed it is kind of depends on the length of time you have to be off of it before a surgery & most times they will let you stop the Lovenox either right after the surgery or wait a couple of days.
But you will find this will be something you will have to do every time you have any type of surgery or procedure that will involve bleeding.
Good luck the Lovenox shots are painful & make sure to have the Dr or the dr. that watches over your coumadin or even the pharmacist on how to inject them properly. Kathy
Hi fastcarbon. Yes, you will have to go off Warfarin at least 3 days before any surgical procedure. If you are in the US, UK or Canada, FDA has recently permitted Doctors to prescribe RIVAROXABAN to patients who have undergone hip or limb (leg) surgery in lieu of Warfarin. This drug does not require PT-INR monitoring at all. I gather that it is expensive. Check out with a hemetologist. Take Care.
Went through this prior to a surgery. Got very explicit instructions on when to start/ stop the lovenox injections on "bridging" for both pre and post surgery. Also precise instructions on when to resume waferin. Did my own injections which made life a whole lot easier. Injections go into belly and are uncomfortable causing lumps and bruising but not really bad. Instructions need to be very detailed and in writing. Make sure ALL your questions are answered to YOUR satisfaction as it can be a scary time.
Another time, ended up in emergency room with acute appendicitis and C Diff. Needed emergency surgery as concern about rupture. Held me overnight giving 4 units of Plasma to try and deal with bleeding issues. Had surgery following morning and was in hospital for a week. All went well, so even in emergency situations there are ways of dealing with clotting issues. Do not remember exact times of Lovenox use but will be prior and after surgery. Doc will tell you when to resume Waferin and at what suggested dose and when to do INR. Good luck with your surgery, hope this helps.
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