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I postponed TKR; Anti-clot shots in abdomen?

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lnich

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Hi, Everyone:

I posted several weeks ago about whether I should cancel or postpone TKR. I've known for several years that I'm a candidate for knee replacement, but I've been managing reasonably well on synvisc injections. However, in October I had bad pain in the knee that prompted me to schedule TKR for Dec. 17. However, since then the pain has subsided considerably, and I'm pretty much back to how I was before the October episode. Thanks, Josephine, for your comments about how you had occasional episodes of pain--probably caused by a cartilage "floater"--and you recommended that I not rush into TKR if the pain has resolved.

I just talked to the OS this morning, and he agreed that if I'm not in major pain, then we should postpone the TKR. He'll see me in 3 months, and we'll decide what to do then, or if the pain gets really bad in the meantime, then we'll deal with it when it happens.

I did attend a TKR class at the hospital yesterday. One thing that I hadn't heard about before -- shots in the abdomen! The instructor said that clots are a major concern, and while we were in the hospital they would give shots of an anti-clot medication in the abdomen twice a day. Then when we were discharged from the hospital, they would give the patient pre-loaded syringes to give themselves these shots once a day for two weeks. She showed us one of these syringes, which had a rather small (perhaps 1/2 - 3/4 inch) needle. Several of us in the class almost fainted, for we can't stand needles.

Did you TKR veterans have to give yourself these shots?

Lois
 
O yes! But not a big deal. Just grab ahold of some stomach skin etc. and in it goes. Not painful at all for me.
Cheers, Ross
 
I took coumadin pills by mouth in the hospital and in rehab. One day in rehab they came in with a needle instead of the coumadin tablets. I asked the nurse what that was for and she explained ani-clotting. I refused to take the shot and insisted they give me coumadin tablets as I had been taking. I didn't want any shots. Just another place for bacteria to enter. As your doctor about coumadin pills.
 
I had DVT and a pulmonary embolism following a knee scope in 2003. I was on Coumadin for 3 months after. Then, since I was traveling internationally with long flights, I had to use the needles before each flight over 3 hrs in length. At first it was a real chore, but it got easier as time went on. Since retiring I done very little flying, so I got out of the habit of self injecting.

Then when I had my TKR this past Aug. I was put on Fragmin shots for 30 days. I was OK having someone else (i.e. hospital staff) administer them, but had a real hard time giving them to myself. I agree, the needle is small, and it doesn't really hurt that much, but for me it was a real battle. To add to the misery, the manufacturer of the Fragmin changed the needle arrangement. They added a big case to the outside which automatically retracts the needle after you withdraw it. The actual needle remains the same size; it's just the housing that is much bigger. Half of my prescription had the older small style. The new ones really freaked me out and I had to have my wife search various pharmacies to see who had the older style in stock, then get another prescription for the older style.

I fully understand your concern about the needles. But as one old crusty nurse said to me. "Kids 12 yrs old use this type of needle for diabetes. Just be a man; suck it up and DO IT"

Vern
 
I only had to do the shots for about 7 days after I got home from surgery. First thing in the morning!
Hey Vern, where are you located??
Cheers, Ross
 
My sister gave hersef these shots after both her knees. The needle is very fine and short and should be no more than a small insect sting. As Vern said, people use such things on a daily basis for diabetes. But I remember when we would teach the youngsters to inject themselves, sometimes it would take then ages to pluck up the courage for that first time. But when they finally made it, what a celebration there would be!
 
I did the Lovenox shots twice a day for ten days after each TKR.

It really wasn't hard at all. Often did not hurt a bit. My tummy was a bit bruised by the end, but it's really not very hard.
 
I had the lovenox shots as well. I give myself nightly injections for a pituitary problem so it really was no big deal. When the time comes, you will be fine.
Judy
 
Like Gretchen and Judy, I was given Lovenox as well... 2 times a day, the day after surgery, while in the hospital and one time a day for 10 days at home. Lucky me, my husband gave me the shots, also in my stomach area... no way I could have given myself the shot! Didn't hurt going in but stung a little afterward and later, around the shot area, it gave me a black and blue mark.
Sandy
 
I took pills - Warfarin. No needles, thank heavens. I'm not good with that stuff and would have had real difficulty. I agree with others who have said if the needle idea bothers you, ask for pills. I can't think anyone would require shots.

Josephine, is there any benefit to the shots versus coumadin or warfarin???
 
Jamie,

Regarding your question directed to Josephine about difference between Coumadin and shots, I believe the biggest difference is that with the shots you don't have to have your blood tested on a regular basis. So you avoid the dull needle that some technicians use to extract that test tube full of blood. Some people on Coumadin have to have there blood tested every couple of days.

Sorry to hi-jack the question.

Vern
 
When they first told me I'd need to self-inject Lovenox for 21 days after discharge, I nearly fell off the bed. But I found it really wasn't that big of a deal due to the super tiny needle. I discovered if I pushed the "plunger" in very slowly, there was no pain at all when the medicine went in. If I did it quickly (which was my natural inclination - just get it over with!!), there was some burning. I took a ridiculous amount of pride in myself the first few times I did it. [Bonesmart.org] I postponed TKR; Anti-clot shots in abdomen?

I think you'll be fine. Anything's better than risking blood clots!
 
I always felt some burning. I guess I pushed it too fast. I only had to give myself 5 once I got home from the hospital. The first one I messed up as I did not wait for the nurse to arrive and teach me how to do it.
I looked at it and said ...How hard can it be?...

Judy
 
I took pills - Warfarin. No needles, thank heavens. I'm not good with that stuff and would have had real difficulty. I agree with others who have said if the needle idea bothers you, ask for pills. I can't think anyone would require shots.

Josephine, is there any benefit to the shots versus coumadin or warfarin???

Can't say, I'm afraid. Mostly I avoid questions to do with medications as it's not my field. Sorry.
 
Jamie,

Regarding your question directed to Josephine about difference between Coumadin and shots, I believe the biggest difference is that with the shots you don't have to have your blood tested on a regular basis. So you avoid the dull needle that some technicians use to extract that test tube full of blood. Some people on Coumadin have to have there blood tested every couple of days.

Sorry to hi-jack the question.

Vern

That might be the difference. A person does have to be routinely checked when on Coumadin or Warfarin. If you are persistant with your doctors, you can get a finger stick test instead of the blood draw. That's what I have. My blood levels stay in range really well and I only have to go for that finger stick once a month. My home health nurse forgot the finger stick machine one day and tried to convince me that I should have blood drawn, but I flat refused and told her I'd drive up to my doctor instead. I am a VERY DIFFICULT stick for any IVs or blood work and I try to stay away from needles unless absolutely necessary to protect my poor sad tiny little veins! I was just curious about the difference. Thanks, Vern!!!
 
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