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Surgery when suffering from AF and on blood thinners

Davidc1075 profile image
43 Replies

Can anyone help, I need to have my gall bladder removed. I'm I'm persistent AF going from 40 to 140 bpm in a minute or so. This is bought on on when I have pains in my stomach and have also suffered from.IBS most of my adult life.

Has anyone else had experience of having an operation whilst being in in AF and obviously on anti collaguents. Sorry if this is a stupid question.

Best wishes

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Davidc1075
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43 Replies

Had a partial knee replacement while on warfarin but not in AF. Had to stop warfarin 6 days before the knife in order to get my INR down to 0 ( normal) - anethestist was more concerned as to the possibility of AF kicking in when on the slab under the knife. I was able to provide anecdotal evidence that my AF was highly controlled by medication and diet. In the event nothing happened. I was on the slab for around 3 hours.John

BobD profile image
BobDVolunteer

No a stupid question but quite a common one.

As carneuny has said if taking warfarin there is normally a five day clearing period but the newer anticoagulants have a very short half life so normal would be one or perhaps two days. Best speak to your medical team and share you concerns.

Jalia profile image
Jalia

I had total hip replacement 7 weeks ago. I'm on warfarin and stopped that 5 days before. I had my 4th ablation 6 months previously and was still holding out in NSR. However the anaesthetist was cautious and I had to have an echocardiogram and further consultation with cardiologist before he would proceed. As it happens all went well . I was bridged with fragmin injections before resuming warfarin. The anaesthetist was given advice on procedure to follow if I went into AF during the op. ( I believe it was a bolus of Amiodarone and/or dccv)

in reply to Jalia

Thanks for reminding me ....yeah, I was bridged with Fragmin too, before going back on warfarin.

Auriculaire profile image
Auriculaire in reply to Jalia

How are you doing ? Are you walking normally now?

Jalia profile image
Jalia in reply to Auriculaire

Doing OK thanks Auriculaire . Need to work more on strengthening the operated side so still need to have the reassurance of one stick. Had to gave MRI yesterday as it appears I have some nerve damage on large area of thigh on opposite side due to Spinal anaesthesia

Auriculaire profile image
Auriculaire in reply to Jalia

I'm nearly seven month on from the second hip and still get twinges in my thigh going upstairs normally. It was fifteen months on from the first hip before I could put my right sock on without twisting my leg up behind! I still have some pain in the left hip but I suspect the metal band round my femur might have someting to do with it. I have been a bit negligent with the exercises though.

Jalia profile image
Jalia in reply to Auriculaire

Think I expected too much. Your post makes me feel a bit better. I've managed tights and socks at 6 weeks. However had my second fall this evening on both knees....not as bad as first one 3 weeks ago when I fell on my face as well. Really knocked me for 6 as I can't remember having a fall for over 30 years and that was on ice ! Being on warfarin as well gives me cause for concern. I'm going to be ultra careful !

Auriculaire profile image
Auriculaire in reply to Jalia

I fell on my knees in the garden but luckily no damage done! I try to be extra careful and move slowly . I cannot get up from a kneeling position using just my leg strength . I have to lean on something and use upper body . Overall I am a bit disappointed with the hip ops. But maybe I expected too much as well. I have read on some forums that improvement can go on for 2 years.

jeanjeannie50 profile image
jeanjeannie50

I'm also waiting to have my gallbladder removed and have to stop taking Warfarin 5 days before the op. After those 5 days my blood should be much the same as someone who doesn't take an anticoagulant for AF.

Jean

Nannysue1 profile image
Nannysue1 in reply to jeanjeannie50

Have they mentioned anything about your AF Jean? Reading this I was wondering what happens to those of us who are in AF all of the time, when faced with a surgery?. Sue

jeanjeannie50 profile image
jeanjeannie50 in reply to Nannysue1

They know about my AF, but I've not been told anything other than to stop my Warfarin. I guess a lot of people have AF these days.

Nannysue1 profile image
Nannysue1 in reply to jeanjeannie50

That's what I thought. Good luck with your surgery.

Thomas45 profile image
Thomas45 in reply to Nannysue1

I have permanent, though asymptomatic AF.One day I had a grumbling pain below my right ribs. Next day, a Saturday, it hadn't resolved itself so I rang 111 and saw saw an out of hours GP. He diagnosed it as a grumbling appendix and told me to drive home, get what I needed for a hospital stay, and get a taxi to hospital, going straight to a particular ward. I arrived at 2.30pm, was put on nil by mouth, and was given, through a cannula both vitamin k and an antibiotic. Just before midnight I was told they'd do the operation in the morning. It turned out to be 2.30 on a Sunday morning when I was wheeled into the operating theatre. During the operation my heart rate rose to over 200bpm. I wasn't woken up until 3 hours after the end of the operation because of it. It took 2 days for my heart rate to return to normal.

When I had two colonoscopies a year later I chose not to have sedation, and all went well with no increase in heart rate.

Nannysue1 profile image
Nannysue1 in reply to Thomas45

Thankyou for that info. Glad to hear it all turned out ok

Davidc1075 profile image
Davidc1075 in reply to jeanjeannie50

Jean how long did you have to wait from being told you needed surgery until the date of the op or are you still waiting for an appoiment. Many thanks David

jeanjeannie50 profile image
jeanjeannie50 in reply to Davidc1075

I've lost track of how long I've been waiting for my op. It was all booked for last July, but then was cancelled about a week before because of covid. In total I've had three pre-meds, the last one about 6 weeks ago.

Fortunately I've not had any problems with my gallbladder since February 2021, so I guess I'm bottom of the op pile. I did question should I still have it and talked via the phone to the consultant I'm with. He said because of the size of one of the stones I have, if I didn't have it now, I'd probably get an attack when a few years older and say I wish I'd had it done earlier.

My sister had hers removed urgently last year, she was in dreadful pain with her gallbladder and became jaundiced. I was in pain for about 6 months. Mine started after I'd eaten a huge fried breakfast and then was on and off . I'm cautious about eating fatty food now. The pain is dreadful, isn't it?

Jean

Davidc1075 profile image
Davidc1075 in reply to jeanjeannie50

I had a CT scan for an unrelated issue 3 years ago. I had a problem with my stomach so went for a cystoscopy. Speaking to the doctor and said have you looked at my ct scan from last year and she came back and said oh you've got gall stones. Following up from that as I wasn't having any pain decided to put off any surgery. Big mistake post Covid. Now waiting months for an in clinic consultation no idea when they will do the op after that. Good thing is that I'm very over weight so not eating much and what I do eat come back up I should be at my target weight

You can only laugh about it

It's not the staff fault they are great when you actually get to see them.

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to Davidc1075

HiMy stones ended up as"blood balls.'

I said my grandfather had his out.

Read my earlier reply.

cheri JOY

Obviously talk to the Doctors who are performing the surgery. If you click on the link below and select the management scenario for your anticoagulant, scroll down to find the NICE recommendations for dental and surgery work……

cks.nice.org.uk/anticoagula...

jeanjeannie50 profile image
jeanjeannie50 in reply to

I found that link very interesting FJ, thank you for sharing.

bantam12 profile image
bantam12

I had my gallbladder out 2 years ago, I stopped my Apixaban 48 hours before op, was given 1 heparin injection whilst in and stayed overnight so they could monitor for AF, didn’t have any problems. Restarted Apixaban 5 days later. However if you have IBS ( I have IBD) you might well have problems with eating afterwards, if foods cause you issues and the docs don’t offer help ask to try Colestyramine, I can now eat everything whereas before I was fading away as anything I ate caused massive issues !

jeanjeannie50 profile image
jeanjeannie50 in reply to bantam12

That's interesting bantam. Is Colestyramine a prescribed drug, or do you buy it?

Jean

bantam12 profile image
bantam12 in reply to jeanjeannie50

Prescription only Jean, it’s a bile acid sequestrant and was a game changer for me, I literally struggled to eat anything for several months after my op, lost a huge amount of weight and became seriously underweight, my Gastro Con told my GP to prescribe it and it worked almost instantly.

Kaz747 profile image
Kaz747

I had ankle surgery 18 months ago. I stopped the anticoagulant (Xarelto two days before) and on the advice of my EP I increased my beta blocker for a few days before the surgery.

I had long conversations with my surgeon, my EP and the anesthetist. The anesthetist was wonderful and said she’d keep a very close eye on things. If my heart played up I’d be sent to the coronary care unit and if it was okay I’d go to the orthopedic ward. Thankfully it was perfect through the surgery but the following day I was tachycardic for a few hours.

LordGabriel profile image
LordGabriel

I’ve had 2 operations since taking Apixiban. You stop before the op- they tell you at the pre op when. Then they gave me a shot via a line while I was recovering. A day after, back to my normal tablets. Easy!

Davidc1075 profile image
Davidc1075

Thank you all seems that the AF is more of an issue than the blood thinners

Suesouth profile image
Suesouth

I had a small op under general anaesthetic in January, take Bisoprolol and rivaroxoban, they stopped the rivaroxoban for two days before, no problem afterwards!

bassets profile image
bassets

Good luck with the op.

I have just had surgery. I stopped the anticoagulants two days before and everything so far has been fine. The AF behaved too.

President2012 profile image
President2012

I had a Head operation last year. Was taken off Warfarin three days prior. I went into AF while on the table. They controlled it by administering metroprolol intravenously 5 mg at a time until the rate was controlled. I converted a few hours later in recovery. They are trained to handle such situations. Best of luck.

john-boy-92 profile image
john-boy-92

Check that the clinicians know the anticoagulant and other medication that you are taking and, ask when you should stop taking them. After the operation they will tell you when you can restart.

Glemham profile image
Glemham

Had my gall bladder removed a week ago at a week’s notice. I have been diagnosed with AF following my repair to my mitral valve two and a half years ago, although luckily I haven’t had any episodes so far. I had a phone call from an anaesthetist as a pre op assessment and told to stop my Edoxaban 2 days before. Because of the heart issues, I had the op in hospital rather than in a treatment centre, so I could be monitored closely and stay in overnight if necessary. I found that very reassuring. The op itself and hospital experience went extremely well, thanks NHS and all the staff who cared for me, and luckily I was able to go home on the day. However a couple of observations. I hadn’t realised that, although the op is classed as minimally invasive, it is still very painful and takes quite a while to recover from. I am still far from right-my tummy sports an interesting array of wounds and bruises and I have a lot of flatulence and upset bowels. This is par for the course but , if it doesn’t clear up, I will enquire about Colestyramine. Also no driving for 2 weeks and no heavy lifting for 6. Basically it’s a take it easy fairly long recovery. I am however very glad it’s finally been done . Best wishes for your op.

Davidc1075 profile image
Davidc1075 in reply to Glemham

Thanks for that its great that your on the road to recovery hopefully not in pain. Mine is so bad that I'm now on morphine every 4 hours and cant even see the consultant until May even though he has recommended the operation when I have a telephone interview last week. I'm unlucky that the waiting times here in Bedfordshire are amongst the worst in the country. Hope your recovery continues and no need for a further op. Best wishes

Glemham profile image
Glemham in reply to Davidc1075

My sympathy to you. Dreadful for you to have so much pain. I had to wait 18 months for my op after I painfully passed a gallstone, but luckily I only had a bit of discomfort after that. Op for me was more preventative to stop the possibility of more stones, which can cause major problems. So wrong that it depends where you live on how soon you get help.

Ppiman profile image
Ppiman

I might have to have a small op in the near future and I've been told that I shall need to stop the rivaroxaban two days before it. I get AF only very occasionally, luckily.

Steve

fairgo45 profile image
fairgo45

I've had many surguries whilst on warfarin and it's never caused a problem.Like you I had a gallbladder operation it was 9 months of agony you'd have to have gallstones to appreciate how miserable it is to be in such pain.

When I was offered an operation the night before Christmas eve I jumped at the chance.

I was in chronic A/F when I went into surgery but when I came round it had gone into NSR and stayed like it for two months.

Home Christmas eve and district nurse came every day to check on me and monitor my INR.

Just don't worry you will be fine and best of all able to eat again.

Davidc1075 profile image
Davidc1075 in reply to fairgo45

I'm on morphine ever 4 hours now but even so it doesnt seem to touch the sides sometimes. Great to hear you experience which makes me feel more reassured that's why this is such a great site to be a member and get such personal experiences. Best wishes to you

fairgo45 profile image
fairgo45

It's a shame the waiting lists are so long because it's so hard to eat normal food.I found the pain eased if I used a heat pack in fact it became my best friend for pain relief

I ended up losing 16lbs.

If fact I existed on sushi and dark chocolate for months if I tried to eat normal food then I couldn't eat for days I have never eaten sushi since.

When you have your operation you will need to keep away from things like sausages high fat foods like cheese etc but it doesn't take long to return to normal.

Let us know how you get on

kocoach profile image
kocoach

Hi David, yes I have had surgery on my abdomen and during the operation the Dr's said I went into afib and it delayed the surgery but all they did is wait until I converted I guess and finished it. I don't know if they gave me anything during that time bit Thank GOD it turned out OK. The surgeons know how to deal with all types of circumstances so I wouldn't be too cxoncerned, just give it to JESUS He'll be with you ALL the way. GOD Bless and have a wonderful day. P.S I am 75 years old, partially dis-abled with a whole slew of physical problems so if I can get through a surgery I'm sure you'll fly through like a breeze.

JOY2THEWORLD49 profile image
JOY2THEWORLD49

HiJust had a TVT Surgical Mesh removal.

I had to stop anti coagulane 3 clear days prior and then the day of op and had to wait 3 more clear days. This is most important.

Gall bladder removal is done through tummy button.

Years of stomach upsets ended when they removed the disintegrated gall bladder and I had 4 ports to exttract bits of GB from surrounding organs!

They warned me this time being a persistent rapid AF that I needed to be below 100h/r otherwise NorthShore NZ DHB would not do the op.

Luckily in Dec I ent privately to a Spec Cardiac interested person.

I was started on CCB Calcium Channel Blocker. Diltiazem 180 (too much and have 120mg a.m.and 2,5 Bisoprolol at night.

My at rest during day is 93h/b and 48 h/b at night.

At last A F CONTROLLED.

Was up to 186 h/r on Metroprolol

Was up to 156 h/r on all Bisoprolol

Up to your Team

but I was uncontrolled when 4 months after Stroke 2019 with AF and 4 days found to have Thyroid Cancer I was not controlled. I had an extra imedical n the op room. 1 against 2 in my triage team wanted the op until at least 6 months from stroke date.

But I think your night rate is more helpful. Have you had a monitor?

That will show night, day, resting and effort difference.

Hope this helps.

chers JOY

Elfiejean profile image
Elfiejean

I have had a pacemaker insertion and a colonoscopy while taking 81mg of aspirin and Xarelto. They stopped both meds 3 days before. It would have been 5 days with warfrin. I did fine. I took all other meds even on the day with a small amt. of water.It made me a little apprehensive but sometimes you take a small chance and it's all right. Perhaps a consultation with your doctor. Hope all goes well for you.

Davidc1075 profile image
Davidc1075 in reply to Elfiejean

Thank you and I hope your well too.

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