Worries about having a stroke

[Julie_O]

Hi everyone, this is my first post. I’m a 51 year old female and I had mitral and aortic valves replaced last year so am on warfarin for life.

I have real anxiety about having a stroke after having a TIA after having the Astrazenica vaccine. I need to have surgery on both of my knees, probably partial replacements in the next few years and I worry about stopping warfarin for an operation. I’m scared I’ll get a blood clot and die.

Has anyone else had anything surgical done with metal valves? Your experiences would really help. I guess I need my mind put at rest from someone who’s been through this.

Please help! Hopefully you can tell me C about your experiences.

Thanks, Jules

[Hidden]

Hiya Jules,

The only thing wrong with my heart is Atrial Fibrillation - nothing like your issues. However, I am on Warfarin for life. I was diagnosed with AF in January 2010 and put on Warfarin immediately, so now I've clocked up 12 years on Warfarin. In that time I have had 3 medical proceedures which have required me to stop Warfarin - then restart it again. Some time after the 2010 diagnosis I bought myself a Coaguchek XS INR self testing device. So now I self test my INR and I also self dose although that isn't really an issue for me as I am blessed with a tendency to stable INR, probably 90% or more most of the time. That means my dose is pretty much stable too.

The three medical procedures were Sept 2012, CT Scan, Nov 2015 - partial knee replacement, right knee - medial compartment and finally April 2022 cortisone injection into right shoulder.

At no time did I have an issue. None at all.

Now the bit you'd be interested in would be my partial knee job. I stopped Warfarin about 6 days before going on the slab for General Anesthetic and about 3 hours of surgery I guess. As soon as I came too after surgery and was back in my room nurses administered a bridging anticoagulant - Fragmin. This was an injection, well more of a stab really, into my tummy. I had two stabs. This is to ensure there is some immediate protection against a stroke. That evening I resumed normal Warfarin dose for a Friday evening, eventually after a good few days my INR eventually returned to normal. no sweat, no problems and even my AF failed to kick in ..... much to everyones relief ! The return to normal is a slow process - just like when you started with Warfarin for the first time, it takes quite a time to get back into range. Maybe 2 to 3 weeks.

So, as I say although I don't have your heart issues I am well experienced with Warfarin. I took some statistics about the behaviour of Warfarin and from memory now it was about 29 days from my last in range INR reading and when I stopped Warfarin to when I returned to being in range with a normal INR reading. I simply had no issues at all and I am sure your experience when the time comes will be identical.

If you have any questions just ask - I'm no expert for sure but I have been through the mill.

May the force be with you.

John

[daisyd]

When on warfarin patients are usually bridged with clexane or similar injection of an anticoagulant before the op when they stop warfarin and again after the op until inr in range, I would speak to your anticoagulant clinic or who ever looks after your Inr for reassurance

[Julie_O in reply to daisyd]

Thank you for replying. I’m worrying myself sick thinking about this as I am a worrier. I’m seeing my surgeon on 21st September so I will ask him what the process is and gi from there!