In AFib & procedure due in 6 days - help!

[irene75359]

On Sunday, after a long but relaxing drive to the silver city to see my Mum for her 95th birthday tomorrow, I awoke yesterday morning to rapid heart thumping, and am still in AFib this morning (30 hours now). I only have bisoprolol as a PIP and although it lowered my heart rate I am still in AFib. As well as disappointment (to put it mildly) as I haven't had an episode since my diagnosis last December, I have an additional problem in that I am due to have a colonoscopy next Monday, and have to stop warfarin tomorrow in preparation.

When I saw the specialist re blood in stools (bright red), after the examination he said all the signs were that I was fine, and the colonoscopy was just to make sure. So at the moment I am more worried about stopping the warfarin than the procedure. And just to further complicate things, my daughter is booked for a C-section Tuesday and I need to be up to speed to help.

I really don't know what to do - I am so scared of stopping warfarin. Really appreciate any advice.

[Rellim296]

Oh, it never rains but it pours... Great that you have a new grandchild to look forward to but the return of AF is such a disappointment.

You have a choice of ways forward and need advice to select the best - possibly your colonoscopy can be safely postponed, although the peace of mind when you get a negative result would be helpful. The first thing is to get the AF dealt with by something with more power than bisoprolol. You may be able to sort it and carry on, gain protection from something like heparin and go ahead with the procedure. The warfarin will continue to give you some cover for a few days.

[BobD Volunteer]

I think first job is to talk to the colonoscopy people and explain your predicament. It may be that they do not wish to proceed if you are in AF.

Next thing is to see you GP about getting something done about your AF. GPs are not usually the best people to see so you need specialist care.

[pottypete1]

When I had to come off Warfarin for a Colonoscopy I had to inject myself with an alternative drug each day for the 5 days leading up to the procedure. They were not prepared to leave me without anticoagulation.

Check with your doctor

Pete

[Buffafly]

Don't know if you have had a colonoscopy before but if not you may not know that the prep wipes you out and I certainly wouldn't want to combine it with AF! I think the colonoscopy people will want to postpone.

[irene75359]

Thank you all so much for your advice - I am going to ring the hospital and cancel the procedure for the time being. To my dismay, I am still in AFib although not with very high pulse rate so don't feel too bad. The next step is to visit my mother's GP for an emergency supply of warfarin (only brought enough to last me until five days before the procedure - yes I know!). My husband is really concerned about me and thinks I can ask the GP for flecainide too but I have told him it has to be prescribed by a consultant. And we have my Mum's 95th birthday party today - all good fun! Tomorrow we head back south and will be home Friday. Hopefully will get all sorted then.

[PeterWh in reply to irene75359]

Irene. If you have been prescribed Flecainide before, especially in the last 6 months, your mother's surgery can contact your one and then they can prescribe.

Are you having blood tests for the warfarin? You shouldn't rely on past doses pre AF.

[irene75359 in reply to PeterWh]

Peter, all I take is warfarin and I have Bisoprolol as a PIP. I have never been prescribed anything else, there was no need (until now). I am under the warfarin clinic with my GP and have a testing kit too, although not with me. Procedure now postponed, and my GP faxed through a prescription to the pharmacist so all under control (except my heart).

[PeterWh]

Where is the silver city?

[irene75359 in reply to PeterWh]

Aberdeen! Also known as the granite city.

[PeterWh in reply to irene75359]

I know it as the Granite City. Went there a few times in the early 1990s.

[Dodie117]

I had colonoscopy but did not have to come off warfarin.

[irene75359 in reply to Dodie117]

I was told to come off in case in case they want to remove polyps during the procedure. When I cancelled and explained I was in afib they are sending me to the bridging nurse - thank you so much #pottypete1 - I didn't know about that possibility.

[PeterWh in reply to irene75359]

That's good but just be aware that some places do not monitor properly and do it by average so someone is not protected. For instance they stop warfarin and then start injections 3 to 5 days later and by 5 days you can be well below 2.0 especially if you are close to 2.0 at the start. Ideally you need daily blood tests with quick results but you did say in another response that you had your own tester.

[barbara2 in reply to Dodie117]

I have read that also… Not necessary to go off warfarin for a colonoscopy as it is not considered to be risky procedure.

[irene75359]

Yes - I will keep on top of that, thank you.

[Kodaska]

The first thing to do is note that you aren't dead yet. Once you see that clearly, everything else will become more manageable.

OK, now that you're still kicking, what's the real problem? It isn't AF because that isn't harming you right now. It could be your innards, but that also probably isn't urgent. It isn't your daughter's C-section because it's her body, not yours. It isn't your mother's 95th birthday party (congratulations!) because it's her, not you.

So what's the problem?

I've come to realize that when I experience this sort of thing - a cascade of pseudo-crises - the problem is self-importance. That's right, I'm the center of the universe so everything I'm concerned about is of earth-shattering significance. I have to be in control of everything all the time, and if I'm not the entire universe will go off the rails and God will be unhappy.

OK, this is ridiculous, but when I unpacked my fears, this is what it all came down to. I've written it with tongue in cheek, but the essence remains true: we put a lot of energy into our fears because we think they're important. They're not, except as they get in the way of seeing things clearly.

Still not dead yet? Hooray! Now take a few deep breaths, prioritize your issues, and get on with them, one at a time.

Compassionately,

Koda

[Ren912]

I'm on Pradaxa and had to stop it for 2 days before and one day after my recent colonoscopy. Had polyps removed and no bleeding!

[irene75359 in reply to Ren912]

There doesn't seem to be a common standard!

[PeterWh in reply to irene75359]

No there is no common standard.

Many CCGs / hospitals have different rules so that's the first challenge and then the second challenge is that different consultants within them have their own rules. In both instances sometimes there is no logic nor keeping up with current knowledge and practice, particularly in the area of anticoagulation which is essentially the preserve of cardiac / stroke specialists but which can / needs to be addressed or affects every clinical area!!!

For instance unless its a NICE or NHS England document if one CCG produces a policy document and guidance notes and then another one sees that and thinks that it is good it could take the second CCG two years or more to get the document written, approved, doing staff training and up and running!!!! All depends on their systems.

[Ren912 in reply to Ren912]

I'm in Canada.

[irene75359 in reply to Ren912]

Ah! My friend emigrated to Canada many years ago, and from what she tells me your health care system is brilliant - it has been for her and she has many different problems.

[Ren912 in reply to irene75359]

I think our health system is great, walk out of doc offices and emergency rooms with nothing owed. There is a $45 fee for the ambulance. I will see an electrophysiologist soon but again no payment required for consultation or surgery. We might have longer to wait than in some countries for procedures but never for emergencies.

[blackcat123]

I also had to stop Apoxaban for 2 days before my colonoscopy. I went into AF during the evening of the day I was having the prep. It didn't really make me feel any worse, I was a bit worn out anyway from running to the loo every few minutes! I also had polyps removed with no bleeding.

Judie.

[irene75359 in reply to blackcat123]

I have been warned so know what to expect! I am rescheduled for October 4th.