Surgery & thinners

[PaulaL1971]

What is the longest time anyone has had to stop X for any kind of surgery, big or small? And when did you go back on? Thanks for any replies 😊

[Hidden]

hi,

don't know what X means but I am on warfarin. Have stopped twice. Once for CT scan, stopped a week before hand back on it as soon as scan was over.

Second was for partial knee replacement. Again stopped a week before , immediately after surgery was given two injections of Fragmin ( a bridging anticoagulant), then a few hours later back on warfarin.

no sweat ! job done.

[Hidden]

I have stopped Pradaxa on two occasions two days before dental surgery and recommenced the same evening.

[PaulaL1971 in reply to Hidden]

Did you have extractions? Or was the bleeding bad?

[Hidden in reply to PaulaL1971]

I had an extraction the first time, root canal the second. No more bleeding than usual

[Hidden]

Had gallbladder surgery last year (the mini-lap). Stopped coumadin 2 days prior to get INR down to 2.0 which is where the surgeon wanted it. Started back with my usual schedule the day after surgery. My surgery was day-stay so was up walking around same day. Did fine. I self tested at home and never got below 2.0 Everybody was happy; no unusual bleeding, no problems. irina1975

[10gingercats]

I was stopped taking Apixaban for 2 days before a hip replace. following a sudden accident...no problems. I

[azriverrat]

Just depends on the surgery, thinner and what the surgeon and heart doctor want. So no one size fits all answer.

[ILowe in reply to azriverrat]

Exactly. I can provide information if I have more details. A lot depends for instance on why you are taking anticoagulants. The Medical Literature on surgery actually divides patients into groups. Metallic heart valve patients for instance are a bigger problem than those with "only" AF.

Traditionally, and still today, for those on warfarin. for many operations, patients were told to stop warfarin for 1-2 days, then to become an inpatient. A constant drip of heparin was set up for a day or more until the desired low INR was attained. Then the drip would be stopped and soon afterwards ... because the effects of heparin are short lasting.. surgery would restart. Then heparin would be restarted in order to give some protection, and warfarin restarted usually but not always the same day. This is known as the "heparin bridge". Patients would be released once the INR was high enough.

The heparin bridge has been much criticised. In some cases it is judged to be more dangerous than the problem it attempts to solve. It is used less and less. But not all doctors seem aware of modern trends. If ever it is proposed to me again I intend if I can, to show the latest research that I agree with!!! and argue against the bridge.

[PaulaL1971 in reply to ILowe]

I am on Xarelto for unprovoked pe's 3 years ago.

I need to have 8 top teeth extracted in about 3 weeks and was wondering about how bad the bleeding with be.

[ILowe]

Probably no bleeding. Modern dentists know how to control the bleeding and they use special dressings. Even if there is some bleeding there is nothing to worry about. Blood has a cleansing action. My peridontologist told me after an extraction to use a soft toothbrush every time after eating, and to attack to the point of minor bleeding. Hydrogen Peroxide.. mouthwash strength is the best mouthwash since it attacks the bits of food stuck where the brushes cannot reach.

[PaulaL1971 in reply to ILowe]

Really? So it is safe then?

I have the worst phobia of dentists ever, and I am making myself ill with worry about these extractions.

[ILowe]

Completely safe. The beauty of dental work is that 1/any bleeding is trivial 2/it is highly visible therefore can be managed. I speak from experience of hospital level extractions.

See for instance this review. dentalacademyofce.com/cours...

...minimal risk...if bleeding complications occur, they can usually be easily controlled with local measures for haemostasis. .. up to INR 4.0

[PaulaL1971]

Thankyou so much, I feel slightly more at ease.

Would they probably use stitches for multiple extractions?

[PaulaL1971]

Thankyou for replying.

Do you think as it's 8 extractions they might use stitches?