Blood thinners

[Martin32]

Any advice please my mum is going for a small operation as a day patient and has been asked to come off her blood thinners for 2 days is this normal ,she has a small skin problem and does not require a overnight stay in hospital

[BobD Volunteer]

Interesting question Martin and funnily enough I was going to post today about this subject.

I have a small skin cancer (rodent ulcer) which needs to be removed (waiting list three months) and asked the consultant when I saw him on Monday about my warfarin. His comment was that I should have an INR test two days before and provided it was below 3.5 (ideally below 3) they would operated. With my margin as 2 to 3 this all looks fine and attainable. I can only guess that different doctors have diferent views and knowing my doctor as I do suspect he is pretty well up to date with curent thinking.

[10gingercats in reply to BobD]

Gosh.These doctors do so differ!I was on Warfarin when I had a smallish heart surgery job done ....NO need to come off Warfarin though.Blood loss was normal for that op.

[Martin32 in reply to BobD]

Thanks bob

[Hidden in reply to BobD]

Blimey, are you mellowing or have you just given up!! 😂

[BobD Volunteer in reply to Hidden]

Given up mate. Not feeling strong enough to fight it today.

[wilsond in reply to BobD]

😂😂😂😂😂

[Hilly22 in reply to BobD]

x

[MarkS in reply to BobD]

I've had several BCC's removed and was just asked to get my warfarin down to ideally around 2. It was 2.2 and it was fine.

[CDreamer]

Which anticoagulants? 48 hours applies to the NOACs and INR readings for Wafarin.

It is perfectly normal to come off NOACs 48 hours before any surgical procedure and to restart immediately after the procedure.

[Martin32 in reply to CDreamer]

Thanks NOACs is what she’s on

[Hidden]

I had to stop warfarin 6 days prior to knee replacement surgery. When I was returned to the ward after surgery I was given Fragmin ( a bridging anticoagulant) and returned my Warfarin dose later that night. No sweat. From when I stopped warfarin to when I got back in range was 29 days.

[Woundbird]

Dont am not sure but dont

My father was stopped from warfarrin for 10 days due to operation and was hit with a stroke so dont

It has to be confirmed from cardilogist and if she stops warfarrin they should replace it with injections thats what i was told at the time unless 2 days is considered safe

Thanks god i hit my father on his face to wake him up and when he woke up he didint know us and didnt know anything about us for a whole night before starting to relaise again who we were

[foxglove1]

Hello

I like Bob had a skin cancer (rodent ulcer) that was removed last week. The procedure took half an hour, I was not advised to stop my apixoban and there was no adverse bleeding at all either during or since with the wound heading well.

[foxglove1]

healing well!

[opal11uk]

On Warfarin 20 years and for minor ops had to get INR down to 1.9

[Drummerswidow]

I’m on NOACs. Having an op next Friday and have to stop them 48 hours prior to surgery.

[Hidden]

On NOAC and EP wants me to continue it as normal prior to my ablation next week.

[MarkS in reply to Hidden]

For ablations it's essential you remain on whatever anticoag you're taking. An acquaintance had a stroke recently following an ablation where I don't think he was properly anticoagulated.

[Hidden in reply to MarkS]

I know, I was simply providing the poster with information to show how advice differs depending upon which op/procedure you are having.

[CDreamer in reply to Hidden]

I rather think it is the procedure which differs as I just had a pacemaker implanted for which I had to stop anticoagulants 48 hours prior - but I dint stop for ablations?? I wonder if it really is the risk of bleeding? The scar for the implant required 8 staples versus a couple of dissolving stitches for ablation.

[Hidden in reply to CDreamer]

As I said, delending on the op or procedure.

[Hidden]

I am waiting to have a minor day op but it has been postponed because they are worried my AF isn’t under control enough to stop the Pradaxa for a couple of days.

Di

[Rostom]

I am a newbie now taking Apixiban so I don't have a vast knowledge base but had a flexible sigmoidoscopy yesterday and was advised not to take my morning dose of Apixiban. In reality the procedure was done before my dose was due, so I did not miss a dose. I think the doctor was very careful but I can report there was no bleeding.

Could someone please explain why it is so dangerous to come off anti-coagulants (for example, for 2-5 days before a larger surgical procedure)?

As I understand it (but not much understanding!), one is in more danger taking and stopping an anti-coagulant than not taking it in the first place.

Is this correct and why? Wouldn't the body just dissipate the clotting feature, putting one back to prior commencing it?

Is there extra risk of stroke when starting and temporarily stopping an anti-coagulant?

[CDreamer in reply to Rostom]

Good questions - there was a talk on anticoagulants at the Patients Day and all I can remember is that the efficacy of NOACs protection will vary during day anyway.

I am not sure there is a definitive answer as I think it is all about which is perceived to be the greater risk.

[radagast58]

Minor skin surgery as a day case carries a relatively low risk of serious haemorrhage and in the end it is down to the operating surgeon to accept and manage that risk. If you are concerned you could ring whoever prescribed the DOACS for further advice. I assume there would be a specialist nurse who could help?

Hope things go well for your mum

.

[kymd]

I’m on Pradaxa and it doesn’t have a test to monitor. My dr who does spinal injections prefers 7 days off. Which seems quite long. Any both else on pradaxa who has had or. Different procedures?

[shazzafloyd]

i have been on warfain 4 yrs now i recently went into st thomas for an ablation apparently they do not stop you taking wafarin now or give any fragmin injections they just like you to have weekly inr tests

[Sportfix]

I had a biopsy recently & am taking Rivaroxaban. The specialist told me to stop taking 48hrs before. I asked my EP cardiologist & he said any surgeon would ask you to stop taking anticoagulant before any procedure, so ok. All was great & biopsy too. Hope it all goes ok for your Mum.

[Martin32]

Just an update on my mum she did have 48 hours rivaroxaban free due to the operation close to a blood vessel and I’m pleased to say all went well but we had a long couple of days thanks for all the advice

[lemondrive42]

Hi martin32 only now seeing this post so a bit late replying sorry , i i had a liver biopsy august and had to leave it off for 5 days which unfortunately ended up in me being off anticoagulants for a month as i had a liver bleed after biopsy ,scary times ,but thankfully

i was absolutely fine hope all went well .