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Stopping Rivaroxaban for surgery - a personal experience

In the 5 years that I have taken an anticoagulant, I’ve always been one of those people who resented it rather than feeling protected. In particular I hated Warfarin and the INR testing, so was slightly happier when I changed to Rivaroxaban.

Last week I had a procedure under general anaesthetic on my tear duct. I was told to stop Rivaroxaban 3 days before the operation and resume it 3 days afterwards. Although it is a small operation carried out by nasal endoscopy, there is some post operative bleeding which can continue for a couple of weeks. So, I’m back on the anticoagulant, using eye and nose drops and carrying out nasal washes. I am not bleeding to death.

Just before the operation, which I had refused in the past, the surgeon told me that stopping the Rivaroxaban was the most serious thing I had to do because the operation itself was straightforward.

No one knows what surgery I might need in the future. Further heart surgery perhaps; cataracts are common in our family and the elderly often need joint surgery.

This process has left me still resentful of anticoagulants. Being without Rivaroxaban for a few days was slightly scary but I am resentful of that feeling as well. Strangely I don’t mind taking the medications that control the AF itself. I hope this makes some kind of sense!

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I'm with you here, Mrspat. Anticoagulation takes one away from being a normal person and I found that unsettling. It made me feel that some bits of surgical adjustment would be out of reach except in extreme circumstances. I felt doors had closed.

Your operation seems to have gone well which must be pleasing.

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Relim, I have seen cardiologist for AF check up. And since I have planned to do colonoscopy, have asked him about stoping Abixaban He sAd that it is not problem to stop and start in 3 days after procedure .

In general , I am not sure If those newer anticougalant have quite settle.

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It is OK to stop anticoagulation for surgery but I feel doing so adds to the risks that are already there.

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I am on apixaban and had a colonoscopy. I was told I did not have to stop apixaban. All was fine.

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Me too.ditto. didn't stop it and there were no problems

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Hi Mrs Pat

I was on rivaroxaban when i developed a rash on legs

I stopped it for a week and the rash went off Doc put me on

Apixaban.

Like you i am uneasy about taking medication that interferes with the blood

after all the bible says "the life of the flesh is in the blood"

But what can we do/ as long as AF continues to plague us we are advised to

take this stuff.

Best of luck to you

Mike

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Regarding future surgeries......I recently had cataractsurgery and did not have to stop the anti coagulant......

I feel like you do about taking anti coagulants for the rest of my life.......but when I really think hard about having a stroke, I feel mostly grateful for the pills

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Mrspat,

I have been on Warfarin since Jan 2010, 8 years coming up. I have never had a problem but I am sympathetic to those that cannot handle it. I will be on ac's for life and I really don't care, the prospect of a stroke is far more terrifying.

I have twice had to come off Warfarin, once for a CT Scan and the second time something far more formidable - a partial knee replacement involving some 2 to 3 hours of surgery. In both cases ( and I statistically analysed the process - one of the values of self testing for INR ) I was 29 days from the last day I was in INR range and the moment I stopped Warfarin to the day I got back in target range. At no time did I feel threatened or vulnerable being off it. For the CT scan I was not given any bridging AC. With the knee replacement as soon as I was back in my room I was given by injection the appropriate doses of Fragmin, a bridging anticoagulant, that evening at my normal dose time I was told to return to Warfarin.

Job done, no worries. My next challenge is left eye cataract surgery, am not anticipating any issues here either.

So, apart from my wife, Warfarin is my best mate ......... ever !

John

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One of my small crumbs of comfort is that my anticoagulant isn’t Warfarin. Having to make compromises about food intake was a challenge for me. At least I am not having to go backwards and forwards to get INR tested. However, I quite understand that being able to measure something gives some people comfort.

Who knows what treatments will be available in the future. Just read something in the paper this morning that suggests that heart transplants will be replaced by gene therapy.

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Well, I hope gene therapy will be effective.

Two years ago we had someone posting this:

'I havent posted here much as I havent had AF for long but now I dont have it at all!

On 30th June I received the very special gift of a heart transplant! I am recovering well &feel amazing.'

Going back to INR testing, it's fine when the level is good but not good if it's bad and possibly even worse if it's only just good.

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I'm on warfarin and wouldn't be without it. In the last year I have had one planned operation to remove a large benign polyp from my rectal colon, and one unplanned operation to remove my appendix. With the former I stopped warfarin 3 days before and restarted 4 days after, and on the latter I was fed Vitamin K intravenously and had the operation 26 hours after my last dose of warfarin, and restarted warfarin 60 hours later. I eat what I want, and adjust the dose accordingly. I had a very painful adverse reaction to Rivaroxaban which I was on for only 12 days.

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I have been on Warfarin since 1992 and had 3 Ablations 1 Angiogram 9 Cardio versions and a 32 day stay in ICU with lung failure, which I had to have 6 pint infusion because of blood loss. I had to stop every time but have no problem on taking it when directed as a stroke frightens me more than anything else. My INR level is 2.5 to 3.5 3 ideal which I understand is slightly higher than most?

Be Well

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I think all of this needs a little perspective. In my opinion: the taking of an anti-coagulant is a sensible precaution as a response to the statistical increase in risk of stroke that we who have AF are exposed to.

What happens if you do not take them? Well, generally not much. You might have a stroke, but you might not. If you do, it is more likely to be a bad one, or fatal, than it would in other people.

You might drive into a tree tomorrow, or suffer some other disastrous event that was unforeseen, but you might not. Risk is something that is rather difficult to evaluate, and needs some thought and even training to understand properly. I found the little drawings that accompanied Sanjay Gupta's video about stroke risk to be very easy to assimilate, a good primer on risk.

Remember, before we had the modern scientific approach to medical matters, no-one knew about AF, or stroke, or that they were connected in any way. Life didn't stop for many, who survived for a long time with AF. But yes, some died. It's worth trying to avoid being one of them.

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What we need is a cure for AF I am very grateful for all the treatments we have for this condition but I would rather not have the dam thing.It is treated as a mere nuisance and something we should just get on with. That is easier said than done when it affects your quality of life. The fear of a being five times more risk of stroke also heart failure and early dementia does little to ease the day to day task of living with AF I for one don't want to be on Apixaban for the rest of my life and hope that one day there will be something to stop AF and not just stall it.

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My cardiologist told me that since my paroxysmal afib episodes are brief, when having complicated foot surgery I can discontinue my 15mg Xarelto (Rivaroxaban) for "2 or 3 days with no problem". I haven't had the surgery yet, but his casual attitude made me wonder just how important it is for me to pop that pill day after day. It's tempting to try to save money by taking the expensive Xarelto every other day . . . but that seems risky. Then again, if taking it every other day is too risky, the thought of stopping it for 2 or 3 days raises more doubt.

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In the UK, we don’t have the added quandary of cost or, at worst, we only have to pay a set amount for a prescription. Someone like me, with a congenital heart condition, could never afford private medical insurance.

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I had breast reconstruction while on Rivaroxaban, I seem to remember that I stopped it the day before surgery and restarted two days post. I also think I was given clexane injections while Iwas off Rivaroxaban. Clexane is an anticoagulant that is ? Was, given routinely to all patients over 40. Well it was when I was nursing. So you should be covered during an operation.

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My dad was on warfarin fir 15 years after bypass and valve replacement...then 3 operatiobs for bowel cancer...survived itall..died after hip broke..pneumonia..20 yesrs afterwards aged 83....!!!!!

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I'm on apixaban had cataract surgery a few weeks ago and didn't have to stop taking apixaban and had no bleeding at all

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