Cautery for nosebleeds on anticoagulants

[Finvola]

Has anyone taking anticoagulants had cautery for nosebleeds and was it a success?

I’ve been referred to ENT for investigation of repeated bleeding from the same place in one nostril and am hoping for some sort of solution to the inconvenience.

[jeanjeannie50]

Hi Finvola

I've been having nosebleeds since a child and still get them now. My theory is, if a vein is going to give way somewhere I would rather it was in my nose than anywhere else. I declined the offer of cauterisation and I now view the vein in my nose as a safety net against other bleeds.

My bleeds do stop fairly quickly and are perhaps 15 minutes at the longest. If they were a lot longer than that I'm sure I would change my mind.

Jean

[Finvola in reply to jeanjeannie50]

Thank you Jean. I started to have nosebleeds only after Apixaban and have eliminated (hopefully) the serious bleeds which were caused by allergic reactions and needed A&E each time. Currently mine need a 15 to 30 minute grip and are a nuisance because I have them so often.

Were you offered cauterisation whilst on anticoagulants?

[jeanjeannie50 in reply to Finvola]

No, I wasn't on anticoagulants when I was offered the cauterisation.

[Finvola]

Thank you goldie - wasn’t sure if it would be considered in anticoagulated patients.

Yes, they are a big problem, especially so in cold weather.

[cassie46]

My dad was on Warfarin and was prone to nosebleeds which lasted hours. He did have cauterisation done and this helped for a few years. After that he would have to go to A & E to have a ballon inserted (its packing inside which they gradually expand) this would stay in for a few days then removed. They normall call ENT to come and do it. On one occassion he was in hospital for a blood transfusion, he had become very anemic. He had the transfusion in the afternoon, early evening he had a nose bleed and lost nearly all of the blood transfusion and had to have another the next day!

[Finvola in reply to cassie46]

Awful experiences for your dad, cassie - I escaped the rhinopack by the skin of my teeth last time in A&E when the bleeding stopped.

[jsheard]

I use to have really bad nose bleeds , ever since I was a child,so I had mine cauterised two years ago and I haven’t had one since,I never blow my nose just use a nasal spray when needed,I am on warfarin etc

[Finvola in reply to jsheard]

That sounds really positive - long may it be so.

[JulesAF]

My 88 year old mum started on eliquis and had terrible nose bleeds - very scary! I was convinced that the anticoagulant was to blame and that seeing an ENT was a waste of time.

The ENT performed a quick cauterisation on a particular spot and that was the finish of the nose bleeds. I would now highly recommend this option. Good luck! Jules

[Finvola in reply to JulesAF]

Thanks Jules - I too wondered if it would be worthwhile - or even if it would be offered to a 73 year old on Apixaban. It turns out that I’m only a youngster!

I hope your mum is free of them for good.

[val757]

I’m on Rivaroxaban and am just recovering from a major nosebleed which wouldn’t stop. It required packing as described by Cassie for 48 hours to stem the flow before cauterisation in hospital. The cauterisation was successful and was the least worrying thing of the whole episode. It was a one off so back on the rivaroxaban tomorrow. And for anyone worried about ACs not having an antidote, I was managed with IV fluids and with blood on hand should I need a transfusion.

[Finvola in reply to val757]

Thank you val - that’s reassuring to know.

Best wishes with your recovery.

[cassie46 in reply to val757]

Val - as per my reply above my Dad had loads of nose bleeds (Never had them before Warfaarin) and various bad bleeds from cut and falls - but A & E never once offered him the Warfarin Vit K antidote - I think it is rarely used.

Cassie

[kyoom]

Hi Finvola,

Yes I have been experiencing nose bleeds,especially first thing in the morning after waking up.

I am on a blood thinner (Brilinta) 90mg x2.and bisoprolol for my post MI and stents insertion since May 2016.

I have reduced the blood thinner dose to 90 mg OD with an 81 mg Aspirin at night time.

My nose bleeds frequency have decreased to occasionally.I can live with that as a side effect of the blood thinners.

What is the type and dosage of blood thinner are you taking?

Take care.

KA

[Finvola in reply to kyoom]

Hi kyoom - I take one of the NOAC’s - Apixaban 2 x 5mg daily and would not be fully anticoagulated on the lower dose of 2.5m.

Like you, I was content to manage the bleeds as a side effect when I had one or two a year, using saline rinsing etc but recently they have become so frequent that my GP felt we should get advice from a consultant.

Best wishes for continued moderation of them.

[kyoom in reply to Finvola]

Hi Finvola,

thank you for the quick reply.

The 5mg OD is not a very high dosage so that's good.

I think that if the nose bleeds are very frequent,(daily) then one should consider cauterization of the blood vessels before it gets worse.The anti coagulant therapy is a life saver for some of us.

Let me know if you have any more questions.

your friend in pain.

Kyoom

[BevCynfelyn in reply to Finvola]

Hi Finvola - like you I am on 2 x 5mg Apixaban per day. I have had two horrendous nosebleeds since Christmas, including one very inconveniently on Christmas Day morning. I can think of better ways of spending Christmas than with my head in the washbasin! But will put up with them as I wouldn't want to not be on the Apixaban.

[Finvola in reply to BevCynfelyn]

Misery for you Bev.

A thought based on my own experience - since starting Apixaban, developed an inflammatory allergic response to cleaning agents, but especially sprays and most especially glass cleaning sprays. This resulted in horrendous bleeds until my GP and I worked it out by elimination. Might be worth noting anything that could have triggered them over Christmas. ☹️

[BevCynfelyn in reply to Finvola]

Both began when I was getting up....maybe I should have stayed in bed!

[kyoom in reply to BevCynfelyn]

I agree with your comments.