Pulmonary Embolism Support Group
By far the most common form of pulmonary embolism is a thromboembolism, which occurs when a blood clot, generally a venous thrombus, becomes dislodged from its site of formation and embolizes to the arterial blood supply of one of the lungs. Symptoms may include difficulty breathing, pain during breathing, and more rarely circulatory instability and death.
I have not been here for a while, which means things are good in the PE/Warfin department per say. But now I have a concern and need to opinions about the following situation:
Gastro doctor says stop Warfin 4 days prior to procedure and wants me to see PCP who monitors me prior to procedure to check with him and get RX for Lovenox to start after the procedure for 7 days with my Warfin. During a previous appointment unrelated to this PCP said he does not like Lovenox and says patients are fine w/o when minor procedures need to be done. He does not like the drug per say and says it is too costly. I on the other hand do not want to take any chance given my situation with PE being the result result of Leiden Factor V. I am even nervous about the 4 days w/o Warfin and would actually think since Lovenox is a short term drug the maybe I should also be using this up until the morning before the procedure. The cost of the Lovenox is covered under my insurance for a $65 copay through the special pharmacy division of our mail order drug/RX company vs an almost $300 copay at a retail pharmancy . So the cost is not a concern here. As much as I hate the thought of the colonoscopy (the prep really as I have had one years ago) and I am leary of the Lovenox injections as it has been a while (although my fdil is a nurse and she could show me how to do them again) I am more afraid of what could happen w/o the Warfrin and Lovenox. I did schedule with PCP and rescheduled colonoscopy to make sure my blood levels are good and so I could get the Lovenox which I probally will have to presude PCP into. I would like to hear other people's experiences simlar to mine or those who have had to stop Warfin temporarily.
Thanks,
Jen
Gastro doctor says stop Warfin 4 days prior to procedure and wants me to see PCP who monitors me prior to procedure to check with him and get RX for Lovenox to start after the procedure for 7 days with my Warfin. During a previous appointment unrelated to this PCP said he does not like Lovenox and says patients are fine w/o when minor procedures need to be done. He does not like the drug per say and says it is too costly. I on the other hand do not want to take any chance given my situation with PE being the result result of Leiden Factor V. I am even nervous about the 4 days w/o Warfin and would actually think since Lovenox is a short term drug the maybe I should also be using this up until the morning before the procedure. The cost of the Lovenox is covered under my insurance for a $65 copay through the special pharmacy division of our mail order drug/RX company vs an almost $300 copay at a retail pharmancy . So the cost is not a concern here. As much as I hate the thought of the colonoscopy (the prep really as I have had one years ago) and I am leary of the Lovenox injections as it has been a while (although my fdil is a nurse and she could show me how to do them again) I am more afraid of what could happen w/o the Warfrin and Lovenox. I did schedule with PCP and rescheduled colonoscopy to make sure my blood levels are good and so I could get the Lovenox which I probally will have to presude PCP into. I would like to hear other people's experiences simlar to mine or those who have had to stop Warfin temporarily.
Thanks,
Jen
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Look at what my best friend did with my picture!
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We all have 24 hours in a day. How we spend these hours is important. Watching a little bit of a video about how sitting affects us made me aware of how much sitting and laying down I do. Gonna have to work on that.Your turn. Tell me another truth.
He told me to schedule the surgery and then three days before the surgery, to lower my warfarin so that I would get down to about 1.2-1.3.
The morning of the surgery, I'd need to go to my lab and get an INR. If was around that low range, then come in for the surgery.
Ok, think about that. I have to go to a lab in the morning where they don't know what my INR is until later that day and try to get the results so that I can make it to a surgery at an office completely on the other side of the city, IF my INR is low enough. If not, then I wouldn't be able to do the surgery and we'd have to start the process all over again. I said forget it. The teeth aren't bothering me and just the thought of the running around the morning of a surgery trying to make this all work stressed out. It's like, just give me the freakin' lovenox and it's all good. I don't get what exactly they "don't like."
As far as the gastro doctor he wants me to off Warfin for 4 days prior to the procedure (no Lovenox) and then start Lovenox and Warfin the evening after the procedure. So no bridging with Lovenox and no Warfin for 4 days - this worries me.
Anyway, yeah, I'd worried too.
The thing is you stop the lovenox 12 hours before the colonoscopy so it's not in your system at all when you have the procedure. That's why I don't get the real issue here.
I've have colonscopies regularly because I have ulcerative colitis. I've never had an issue with bridging with lovenox and then starting warfarin the next day after the procedure, along with lovenox until you're INR is on the upswing.