Occipital nerve block postponed

[SteveRN]

Hi all I was due to have my nerve block this week but when I contacted them asking when I should stop my warfarin I was told to stop 3 days prior and order clexane from my gp. However Gp was unsure of dose of clexane and the surgery in-house pharmacist said that I was a high risk patient with aps so GP contacted the haematologist. Of course I am still waiting to see the haematologist although I did speak to the secretary who said I should get an appointment in september and he is on the approved list. Anyway after many emails between GP and haematologist/neurologyI have now stopped my warfarin and I am on 7 days of clexane at a dose of 1.5mg/kg with alt day INR’s and having my nerve block next week. At least it will be easier to sort out in 3 months when I go through it all again.

[MaryF Administrator]

Best of luck with this procedure, I hope it goes really well for you. Hopefully your Haematology appointment will come through soon, so all the dots can be joined for you regarding your ongoing medical care. Let us know how it goes. MaryF

[SteveRN in reply to MaryF]

Hi MaryF

Many thanks for you kind words of support I will keep you updated.

SteveRN

[MaryF Administrator in reply to SteveRN]

Great, keep well. MaryF

[SteveRN in reply to MaryF]

Hi MaryF sorry for any delay in getting back to you have not had internet access for the last 10 days. I finally received my nerve block on the 27/08 after the nurses cut off was an INR below 1.4 mine at that stage had dipped to 0.9 so as you can imagine my aps was playing up. At the moment I am still on clexane injections and 7mg of warfarin the doctors at my GP surgery say continue with this until INR is above 2.0. They are reluctant to change the warfarin as they say I was fine on 7mg before but all they need to do is titrate the warfarin for a few days to bring the levels up, they say it could take a few weeks to get back up to 2.0 I will be glad when I see a haematologist I am going to contact the secretary again to chase the appointment.

SteveRN

[MaryF Administrator in reply to SteveRN]

Good, you are on the right path with this, being proactive and pushing things along. MaryF

[ndstephens49]

Hello SteveRN. I just had a left occipital nerve block ten days ago. Initially I was told to stop coumadin. I can’t do that without risking a clot so we compromised that I would get my INR DOWN to approximately 2.7 instead of usual target of 3-4. Everything went fine.

I’ve had 4 pacemaker changes and just got INR down to high 2’s. No problems.

I have poor circulation to jawbones (avascular necrosis) due to clotting issues, so even with dental extractions I just remain on usual dose of coumadin when tooth removed.

While this works for me, it may not work for everyone.

Good luck on your nerve block!

Nancy in West Virginia

[SteveRN in reply to ndstephens49]

Hi Nancy I understand how difficult it is they will not do my nerve block unless my inr is below 2 then after I will restart my warfarin and also continue with the clexane until inr is back up above therapeutic level 2-3

SteveRN