stopping blood thinners for medical procedure

[Harefieldfan]

I’m expecting to have a steroid facet joint injection for super painful sciatica caused by bulging disc. To do this, I have to stop blood thinners a week before the procedure so that I don’t bleed into the joints. No problem stopping Ticagrelor, though I’m getting conflicting messages from different cardiologists on this. But the spinal surgeon is afraid I’ll have a heart attack if I stop aspirin for a week so is now saying he won’t do the procedure. My question is: has anyone stopped aspirin for a length of time to have a medical procedure? I’m so sick of fighting and so sick of being in constant pain. I don’t think I’ll have a HA as I have two stents and neither does my GP. Thank you!

[Hidden]

Hello

After my heart attacks and Bypass operation I had been suffering with shoulder pain which was very painful

I was on Ticagrelor and Aspirin and had to wait a full year before I could stop Ticagrelor once I had I was on and still am 75mg of Asprin and then I was allowed to have the steroid injections it seemed for me the Ticagrelor was the one they wanted me of before they would do the injections

Nothing worse though than when you get conflicting opinions especially from the professionals

I hope you will soon be pain free and feeling better

Let us know how you get on x

[Harefieldfan in reply to Hidden]

Thanks. I think this orthopaedic surgeon doesn't really know much about it and is just scared. It's good to know that aspirin doesn't have to be stopped but if he doesn't agree... Scream!

[Hidden in reply to Harefieldfan]

Hello

For me they did not have an issue with the Aspirin so hopefully will be the same for you

Fingers crossed you don't have to scream ! x

[Flissy100 in reply to Hidden]

Get your injections. I had HA had 3 stents in May 2018 where they also discovered cancer. Waited till the November stopped Ticagrelor week before lobectomy VATs procedure and started week later on Ticagrelor .Been fine heart wise ever since. Just to add was on Ticagrelor for 3 yes.

[Hidden in reply to Flissy100]

Hello

I am not sure if this reply was for me

I did get my injections though after I came of the blood thinners and was disappointed as well as they did not work maybe I will try again

I am sorry what you went through and hope you are doing well now x

[10gingercats]

Ask for some hydrotherapy sessions at your local hospital if the injection does turn out tobe a no,no.Warm water and exercises cured my 3 year old sciatica. and I was screaming in the street with pain at times. It worked wonders.At first I had physio. in the water and then did the exercises on my own. I had 16 sessions twice a week.

[Harefieldfan in reply to 10gingercats]

thanks. Sounds good. I use a heating pad. It works wonders but only while I’m sitting on it.

[Milkfairy Heart Star]

Pain is a stressor. I know how challenging living with pain can be!

For you the possible slightly raised extra risk of having a heart attack is acceptable if your pain is relieved. It's about your quality of life.

Can you ask for a second opinion,

from a Cardiologist or Cardiac Pharmacologist who can quantify the risk?

Otherwise ask for a second opinion from a more sympathetic orthopaedic surgeon.

The National Orthopaedic Hospital at Stanmore has a Cardiologist who reviews heart patients prior to treatment.

rnoh.nhs.uk/health-professi...

[Harefieldfan in reply to Milkfairy]

Wow, thanks Milkfairy! My GP is on the case (though she's away this week). Will try all of that.

[Milkfairy Heart Star in reply to Harefieldfan]

Do say how you get on.

[scentedgardener]

I can't offer advice about aspirin but I wondered if any of your medical people have considered any type of pain relief that targets neuropathic pain. My physio has just suggested this for me, telling me that it will help reduce the inflammation, as well as being effective for the pain. You may have already tried this, but I have had incapacitating back pain and sciatica for over 20 years and it's the first time this has been suggested for me.

[Ghost-233 in reply to scentedgardener]

Hi like you I can’t offer advice re the aspirin as I’m not allowed to take it. However re spinal pain I have always suffered with this having had paralytic polio as a child and have Scoliosis. When I was young I could cope but now I’m older I’m struggling. I first had spinal nerve root injections 2 years ago. The first lot gave me some minor relief but the second lot which I had in March this year made a massive difference. I had pain relief for about 8 months and what a difference it made to me. The numbness and tingling at the bottom of my spine has not returned although I suspect it will eventually.

I don’t know how many of these injections you are allowed but I would happily have them every year if I had this relief every time.

Good luck with yours go for it,

[Mentdent]

everyone is so risk averse nowadays that I’m amazed anything gets done. No win no fee lawyers have a lot to answer for.

[Mountwood]

At Christmas 2 years ago I had sciatica so painful that I couldn't cope with the planned visit from my daughter and her family. My GP was useless, telephone only, home visit refused, useless painkillers and a friend suggested a chiropractor who had helped her previously. I was so desperate I would have consulted a witchdoctor. The chiropractor visited me at home on Christmas Eve - there was no way I could have gone to her, or to the surgery - and it was the best thing I have ever done. Altogether, she did 4 home visits, and after that I could visit her at her clinic. I have seen her every so often ever since, and she keeps me mobile and pain free.

I know many doctors don't approve of chiropractors, and the cause of my pain and yours is different, but it's just a thought worth considering.

[Qualipop in reply to Mountwood]

I have chronic spinal pain from multiple herniated discs, scoliosis, spondylitis and a whole section of spine that's been pulled out of line. Constant pain and take the highest dose of painkillers possible but sciatica was something else. A chiropractor who does not do strong manipulation sorted it out in one treatment. Don't go to one who claims to "crack your back" but one who will work on muscles attachments. The steroid injections have never done a thing for me. They must be under x ray guidance to be certain they have the exact spot. If he doesn't do x ray guidance- run a mile.

[Mountwood in reply to Qualipop]

Like you I have had steroid injections in the past, in my shoulder, coccyx and knee. None was really any help.

[Qualipop in reply to Mountwood]

I had one that was so painful just getting the local anaesthetic in I shot off the table and kicked the doctor. He had refused to even do sedation. The woman before me had 5 and I can still hear her screams. That doctor was a sadist I swear. And no, they have never worked for me. A new surgeon has now suggested burning away the nerve because i have a terrible reaction to steroids. I don't think so.

[Caledonia1944]

Hi, I am in the same boat as you. Went into hospital On Friday morning to have the same injection. However, the doctor wouldn’t proceed not only because of asprin but also I have to get written clearance from the cardiologist because of other medication I am taking. I had a stent in June and have an aneurysm in my aortic root. Disappointed but always best to get it approval. Good luck with your procedure.

[KCKoh]

You need to stop taking blood getting medicine for at least a week before your operation surgery and it is a must. Otherwise the bleeding will be very difficult to stop. Stopping over a week will not not cause any issue on your heart. I done my gastric operation and my doctors also advised me to stop taking a week for the operation.

Note I too have heart disease

[Afibflipper]

the Ticagrelor is an anti-platelet and aspirin assists it in keeping the blood flowing freely and both are often given together - especially if you’ve had stents fitted.

When you say you don’t think you’ll have a HA - the stents were probably fitted to widen a narrowed vessel and these drug are to stop the blood clinging to the stent then breaking off as a clot - especially in the first 12 months of fitting. Please don’t stop either until a concrete decision is is made by both consultants liaising with each other - shouldn’t be decided on “I don’t think ….”

I empathise & sympathise with you. I have similar back issues (as part of the catalogue) & pain is very draining and somewhat disabling at times. Bleeding into the joint or spine area is just as concerning as stopping the meds - but the professionals need to communicate (they are all very skilled in their own fields)

I wish you all the luck in getting pain free.

[MountainGoat52]

Hi Harefieldfan,

This is where the NHS falls down on its face. The Orthopedic surgeon should have sought advice and clearance from your Cardiologist immediately the back operation was arranged. Liaison is the key to being efficient.

I had my bypass operation 11 months after my heart attack (when I had two stents inserted) and I had to stop Prasugrel (anti-platet med) and aspirin one week before the op. I don't see it being any different for your back operation.... whenever that may now be.

Hopefully the situation can be resolved soon and you can get the relief from pain that you need. My best wishes for that. Let us know how you get on.

Gerald

[Hidden in reply to MountainGoat52]

There are a number of theses 'NOAC' drugs-Novel oral anticoagulants, and while they are good, there is little help for surgeons from the people who prescribe them

I was 'piggy in the middle' some years ago, having been prescribed Edoxaban- a NOAC after an isolated episode of AF.(I have to take it for the rest of my life!) When I needed a gynaecologist procedure the surgeon would not tell me when to stop the med-(it's half life is 17 hours, so now I know that generally, 2 days is sufficient)-but back then I didn't know and no-one would make the decision. I ended up having to inject myself with warfarin for 4 days after taking tranexamic acid which counteracts the action of the NOAC! I did make a formal complaint, as I was hospitalised twice after haemorrhaging, so now our health trust is meant to advise surgeons how long a patient needs to be off different types of blood thinner. Make a complaint, if you need to-we are at the sharp end here, and it is our lives at risk!

[VelvetSky]

Hi, I had an umbilical hernia operated on earlier this year, local anaesthetic as he didn’t think my heart would like a general anaesthetic. I take Edoxaban and other stuff, not aspirin. I just had to stop taking it all the night before, a lot of local anaesthetic, quite a large incision, a lot of internal stitches and then sealed with a rubber sort of superglue and no excessive bleeding. I was surprised how laid back it all was. Of course take it very easy for some weeks after but all through not any problem with bleeding.

Also with my dentist, I discussed a procedure with him and the risk of bleeding, again he was very laid back, said he had many years experience, he was a qualified surgeon and not to anticipate problems, if I had a bleed he could cope with it.

The only thing different was that I paid for both procedures and nothing was rushed.

[Abbacadabra]

I really sympathise with you on this. I've recently started on blood thinners and was told that if ever I have to have a medical procedure then I will have to stop taking them. If I was you I would take the advice of the consultant, good luck.

[firstlight40]

The antiplatelet medicine is very important for the first twelve months after stents to allow them to 'bed' in. After that it seems more preventative if you are kept on ticagrelor/aspirin for longer as I am. If I personally needed a surgical procedure now I would have no problems stopping both for a week and resuming them after the op.

But everyone is different and your own medical history and the specialists are the experts here, not us, and I guess it depends if your particular operation has more chance of bleeding than others.

[jerry12953]

I had a very thorough written report from a senior cardiologist after asking for a second opinion. He told me that if you have not had a heart attack taking aspirin as a preventative is very much 50/50, as possible side-effects could outweigh the possible benefits. If you have had a heart attack he would recommend continuing to take it. This must be based on evidence somewhere in the scientific literature. As I hadn't he said I could stop taking it. Hope this helps you make a decision!

I'd also recommend a chiropractor/osteopath for back problems.

[Harefieldfan in reply to jerry12953]

hi Jerry and everyone else for your considered replies. Wow! I think I need a cardiologist to tell me what to do re the aspirin. I’ve been given the name of a private physiotherapist for the sciatica so I guess I’ll try her as an interim measure. Osteopath or chiropractor or physiotherapist…. Which one??? I’m not keen on painkillers as I take so many drugs, as we all do, and I’m afraid of side effects. If you’ve never had sciatica , I hope you never get it as it’s very very painful. The physio was recommended by my Pilates teacher — she went to a lot of trouble finding her(unasked!) so I feel bound to try. And these private practitioners get very expensive. Thanks so much again everyone.

[Mentdent]

The trouble with the no win no fee system we now have is that even if there is no case the lawyers get paid and that they string things out delaying resolution and increasing costs. Also a lot of tests and even treatments are done for legal reasons rather than clinical ones.

[Mentdent]

True but it is being badly abused by the legal profession. Cases are taking far too long to resolve, fees are being padded by both sides and the lack of impartial judicial oversight is a real problem. People with genuine problems are having to wait for years for resolution even when there is dispute over the problem.

[Geoff47]

I was on Rivaroxaban and Aspirin after a minor heart attack. But my cardiologist said I don't need the Aspirin with Rivaroxaban, so I stopped taking it. I have stopped Rivaroxaban several times for two days prior to other procedures and had no problems. But of course everyone's situation is different.

[Lizbeth61]

Hi Harefieldfan I didnt see your message 5 days ago and only looked at your profile as you commented on my post today. I had two steriod injections in my back two weeks ago for the same condition you have ie a bulging disc. I was advised to stop Ticagrelor (anti platlet) but to continue with my aspirin and statins as normal. I didnt take the aspirin on the day of the procedure. The procedure was over very quickly no pain they give you a local anaesthetic and my heart was absolutely fine. Two weeks on and it has helped I would say around 50% but....I sit at a desk 7 hours a day 4 days a week and I still have some discomfort just trying to keep getting up and down more. It hasnt taken the pain away completely but I would say go for it and dont worry about your heart

[Harefieldfan in reply to Lizbeth61]

that’s reassuring, Lizbeth61. It’s up to the doctor, unfortunately, who is refusing to inject. I’m fighting this…

[Lizbeth61]

Good luck keep us posted!

[Harefieldfan in reply to Lizbeth61]

Went for private physio session today. Quite painful massage-type treatment. He said he thought I'd need 4 treatments but I don't know. He said I'd feel worse for a few days and that on Monday, bingo! And expect lots of bruising. So I'll wait. It's a bit expensive.