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appendicitis&PAF&Rivaroxiban

Kittyca profile image
11 Replies

Hello everyone, I decided to share my experience of acute appendicitis.

The pain was out of the blue while swimming but I managed to finish my swimming session and drove back home feeling bad. At home had strong low abdominal pain and fever up 39. Wait about 7 hours and decided to call surgery. They advised to call 111 and I got back a call very quickly and referred to out of hours GP at hospital. Hospital GP was a very nice man and suggested either 60%gallstones or 40% appendicitis and I was admitted to SSU at hospital.

Of course I was scared of a diagnosis of appendicitis because I didn’t expect it at the age of 62!

At SSU I had to wait up to 5 hours while seeing by the doctor. I was told all patients from A&E would go in front of me because I had been referred by GP. At last, when I saw a doctor he suggested that it was likely a gallbladder problem and booked an ultrasound in the morning the following day. He reassured me that there was not a problem to continue Rivaraxiban and I took a tablet. By the time I saw him I had missed my evening dose just in case of possible urgent operation and it had already been 30 hours since my last dose.

Morning ultrasound showed no problem with gallbladder and was sent to CT scan. Did it at about 18.00 and was diagnosed with acute appendicitis.

At once a senior doctor came and told an urgent operation was needed. I told about taking Rivaraxiban following their doctor’s advice.and after discussing doctors decided to postpone it because of risk of bleeding. Was given antibiotics. Next day they told I was still in risk and postponed my operation for one more day. DOCTORS AT HOSPITAL TOLD RIVARAXIBAN WAS THE ONLY ANTICOAGULANT WHICH DID NOT HAVE ANTIDOTE!!!!!!!

Eventually I was operated and an acute appendicitis was confirmed. Was allowed to continue Rivaraxiban after 6 hours post operation. Operation was laparoscopic.

But nobody could answer the question about Rivaraxiban and why the doctor at SSU advised me to take a tablet of it?

I was told:

- Rivaraxiban needs about 48 hours since the last dose for operation

- Rivaraxiban doesn’t have antidote.

Has anybody heard anything about it?

I would be very grateful for advice and hope my post will help someone in a similar situation

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Kittyca
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11 Replies
Jalia profile image
Jalia

What a nightmare for you. Glad you're all sorted now. I'm sure this will be of interest to those taking Rivaroxaban.

javo123j profile image
javo123j

As far as I know all NOACS are in the same boat as Rivaraxiban. I think there is one called Andexxa but it's expensive and not always available. Also not sure how effective it is.

Kittyca profile image
Kittyca in reply to javo123j

I have also heard about Andexxa but doctor was very confident and said that only Rivaraxiban didn’t have antidote. Very strange….. and a bit scary. Especially when I have already been in the situation when urgent op was necessary

baba profile image
baba

bnf.nice.org.uk/drugs/andex...

Suebo2 profile image
Suebo2

I’m glad that you are ok. There is an antidote for all except edoxaban (not included in the trial so not included in licence)

Really only need 24hr so from last dose (unless poor renal function)

If concerned can take blood levels of rivaroxaban

Usually stop anticoagulants whilst waiting for diagnosis , but this also depends on your thrombotic risk.

Operating with some rivaroxaban on board also depends on bleeding risk of op

I’m glad that you are ok. Take care.

Suesouth profile image
Suesouth

I had to stop Rivaroxoban for 48 hours when I had an op inJanuary!

JOY2THEWORLD49 profile image
JOY2THEWORLD49

HiI chose PRADAXA 110mg x twice a day because it has a cheap reversal med.

It covers 12 hours seriously but preop I had to stop 3 clear days prior to an op in March. Also H/R had to be under 100 and I had 2 anaethestists present.

I have persistent AF but CONTROLLED H/R day and 47 H/R at night which has not changed.

You were lucky that your appendix did not burst as you would have septasaemia. Blood poisoning.

How did you keep a level head.

Here in NZ we note that a 40s man attended A&E 3 times. He died. He had an ear infection which was not diagnosed and developed an abscess on his brain through it.

Oh dear .. the Coroner said that staff did not check complications.

cheri JOY. 73. (NZ)

Thomas45 profile image
Thomas45

I only took Rivaroxaban for 12 days before deciding that the level of pain it brought was unacceptable.As for anticoagulants and antidotes it had been accepted that the DOACs don't stay in the body long so there was no need for antidotes.

The recognised antidote for Warfarin, which I take, is vitamin K, but my experience of being given it prior to having my appendix out, at the age of 71, is that it's not a quick way of re- coagulating the blood.

My experience of appendicitis was on a Friday afternoon, 6 years ago, a grumbling pain appeared below my left ribs. At the time, as a retired librarian, I volunteered to work in my village library. I was due to work again on the Saturday. The other volunteer on that Friday said if I didn't feel better on the Saturday she would do my "shift". Next morning. I felt worse, rang her but went to do my shift until she arrived. Then sitting in my car I rang the out of hours doctor. I needed to drive 6 miles to see him. He thought it was appendicitis and arranged for me to be admitted to a hospital ward that afternoon. I was told to take a letter which he produced to a specific ward.

I did, was admitted at 2.30pm, and so started the re-coagulation of my blood, once a cannula had been inserted into my left wrist. Bags of vitamin K and antibiotics were fed through the cannula. After 9 hours I was told the laparoscopic operation would be in the morning.

Exactly 12 hours after I'd been admitted, at 2.30 on a Sunday morning, the operation scheduled to take an hour, began.

Unfortunately my heart rate rose to over 190beats per minute and I was kept under the anaesthetic for 4 hours. It was at 190 when they woke me up. I was kept in hospital until my heart rate had fallen to 80bpm which took 2.5 days.

Kittyca profile image
Kittyca in reply to Thomas45

Thank you Thomas45, in my case also lots of antibiotics were fed through a cannula. Plus they added codein for pain. But as soon as I knew about codein I refused it. I thought in the situation of acute appendicitis it is better to feel pain.Till now feel a bit confused: why the doctor who knew about possible appendicitis advised to continue anticoagulant plus why I took it following this silly advice.

I am in to minds: either ask this question at hospital or forget it . My Dad didn’t trust doctors. He liked speaking with them but always had his own opinion.

Vanna-C profile image
Vanna-C

In my experience, always ask questions, and check what you are told. I was in hospital with AF, heart rate in the 220 region, and heart failure.

They decided that they were going to do an angiogram the following morning.

They brought round the medicines, and handed me my Rivaroxaban. I questioned this, as my OH had recently had an angiogram (not on anticoagulant) and had bled impressively.

They assured me that the medication would not cause problems, and to basically do as I was told.

I decided to do some research. I found several articles advising to stop DOAC before angiogram, and then found a fact sheet from a nearby hospital which said the same thing.

When the doctors came round later that evening, I spoke to them again, and the senior doctor was horrified that I had been told to take the tablet. I pointed to the little tablet dispenser on the locker, still containing the tablet, and he was very relieved.

I used to have a sign on the wall behind my desk at work which read

“Trust no-one, check everything “ and that is now my motto!

Kittyca profile image
Kittyca in reply to Vanna-C

Sounds impressive. I have always tried to follow this motto but sometimes people do silly mistakes: I felt strong pain, fever 39, early hours after midnight with nearly 6 hours of waiting for a doctor, my husband in the hall who also has some health problems and on top the nurse’s words that now’ I was in a place where I could relax and only listen to the doctor …..’Definitely it is my mistake 😁

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