Aspirin vs. Warfarin/ Xarelta/ Lovenox

25 Days...

by donr - 2016-10-29 12:08:35

When I did it for a major surgery, it was only about 10 days.  Granted, Rat Poison is a weird med & doesn't act quite like other meds because of the nature of the clotting process, but 25 days is a BIT MUCH.

wHEN i WAS IN THE HOSP BETWEEN MY FAILED COLONOSCOPY & THE RESULTING SURGERY, THEY EVEN LET ME STAB MYSELF IN THE BELLY W/ THE lOVENOX TWICE A DAY.  OF COURSE, THEY WATCHED ME LIKE AN EAGLE!

If aspirin works so well, why not replace Warfarin w/ that on a regular basis?

Don

Exactly

by Grateful Heart - 2016-10-29 12:51:12

That was my thinking.

And that was why I chose Lovenox, I didn't want the rat poision.  But no one told me the Lovenox was injections until it was too late.  Then, I thought it was only while I was in the hospital....until they had me inject it myself for the last 3 days in.  So it was 4 days while in the hospital and then 21 days more at home, twice a day.

After 2 weeks I asked the Ortho if I could stop it and he said it was extremely important to finish it all....so I did. 

Aspirin has been around since.....the beginning of time!  All of a sudden it has the same efficacy?? 

They only went to a conference on this 2 WEEKS ago!  I asked questions and he tried to assure me it would be fine.  He said he would be in a lot of trouble if it didn't work well.  I told him I would be in a lot of trouble if it didn't work well.  

And the way they want to handle my defib is a whole other issue.  The new thinking now (from the anesthesiologist I met with) is they don't turn it off, they let it be and if it needs to defib you during the procedure it will.  WHATTTT??

Nothing like a little extra stress right before major surgery when they have to use a tool box full of power tools on you.

I didn't want to bother my Cardio so I haven't seen him in a while but I will be asking questions next week.   

I need to rethink this.  

Grateful Heart

Anticoagulants and Antiplatelet

by BillH - 2016-10-29 13:33:56

Asprin is an antiplatelet. It is used to stop clots from forming do to an "injury" such as a rupture of plaque in a blood vessle. Thus it is used to help reduce/prevent heart attacks.

Warfarin is an anticoagulants. Stationary/slow moving blood can form clots. Which can form in "stagnet" blood in the atria from AFIB. And likewise from limited movement after surgery.

These are two separate clotting systems.

Current research shows that asprin has no affect on reducing strokes (clots) in people with AFIB.

We all have different risk-factors

by IAN MC - 2016-10-29 14:32:18

Hello GH    I can understand you asking about other people's experiences but the choice of "blood thinner " cover for orthopaedic surgery  ( whether it be anticoagulant or antiplatelet ) really does depend on YOUR individual risk-factors.

Age, blood pressure, diabetes, atrial fibrillation, vascular disease, a history of strokes , your likelihood of bleeding  etc. etc etc. will all help the Dr arrive at a decision as to what is best for Grateful Heart .  Always at the back of the surgeon's mind is  " is it worth increasing the risk of a bleed for this patient just for the sake of a tiny reduction in the likelihood of stroke ? "

Aspirin is probably fine for someone under the age of 65 with no relevant medical history, only you and your doctor know your age, medical history etc.

Your surgeon attended a recent conference where data re prophylactic aspirin cover  was discussed. I would be asking him exactly what the patient profiles were in the study. If the patients all had similar medical issues to yourself, fine : but I doubt it !

You need to discuss your individual risk factors with the medics

Best of luck

Ian

Thanks for the response guys

by Grateful Heart - 2016-10-30 11:33:26

I respect the knowledge and expertise of all 3 of you.  I know you bring a wealth of information from your backgrounds.

My concern is they are now using only aspirin across the board....not case by case.  It doesn't seem like a good approach to me (a lay person).   

To be continued...

Grateful Heart

Apparently they each do it a little different...

by Lurch - 2016-10-30 13:55:00

I am having a hip replacement Thursday, fortunately my first and hopefully only.  Just met with my OS who told me I will be placed on Xarelta for thirty days.  I asked about my ICD and was told they would use a magnet over it.  I know that he and my Cardiologist have conferred and I hope that they get it right!!  I also made sure that he did not use a mono pole knife during the procedure - I did not want a grounding plate behind my ICD!

Good luck GH!

Lurch

by Grateful Heart - 2016-10-31 16:38:48

I know someone else who had to take Xarelta for only 10 days post surgery but aspirin only is a new one. 

I'm a charter member of "Murphy's Law" club so I try to avoid/ forsee problems in advance.  The anesthesiologist reviewed my past records and asked why I needed a lead revision. I explained and he said he never heard of someone's diaphragm being paced by their device.  Exactly.... ya gotta laugh...and we did.    

Last time they wanted to put the ground plate on my back, right behind my ICD.   I talked them out of that and they agreed to put it much lower on my back/ butt, away from my device.   

Good luck with your hip replacement too.  Prayers and keep us posted.

Grateful Heart   

Update

by Grateful Heart - 2016-11-05 20:56:54

I met with my Cardio and he agrees with me, an aspirin twice a day is not gonna cut it.  He also said he will request the device rep be there to take care of the defib before and after surgery.  That was the plan the last time but the rep had other ideas.  Hopefully, this device rep will be willing to stay until the surgery is over without a struggle...we'll see. 

I find it extremely frustrating that some doctors take the easy way out when it comes to the safety/ management of our devices and the use of electrocautery.  That is not to say they don't care.....I believe they do.  But when it comes to protecting our devices (and therefore the patient), more and more chances are being taken.   

When last checked, I had 2 more years left on my device.  So if my device needed to defib me during this surgery, it would use up much, if not all of the battery that is left.....and I would be facing a replacement (my first), with basically back to back surgeries.  I would rather they use the external pads if needed and save my battery if possible.    

I'm just the patient.  These men are good doctors.....but....my Ortho told me he doesn't get involved with PM/ ICD issues.  I get it...he is focused on the bones/ joints.  The anesthesiologist has his own concerns.  So it was up to me to make sure my CRT-D was cared for....afterall, it is an important part of me....and it's keeping me going.  :)

Thank God my Cardio was on my side.  Stress and my pain level was getting high and I didn't want to have to back out of this surgery.  I need to get this hip fixed.  It would be so nice to be without pain.  It's been a long time.

Grateful Heart