post surgery: blood thinners?

[mendi]

i'm sure this has been addressed before, but i'd like to hear from as many as possible.
i've read of many who have had to take coumadin (wayfarin).
is this STANDARD treatment? is it age/health related?
i had major back surgery (lots of fun hardware and my own/cadaver bone graft, it's kind of cool), and they had me in those lower leg squeezy things to prevent clots, but i didn't have blood thinners.
i'm concerned also that, because i can't take celebrex, i take 800 mg of ibuprofen 3 X day (plus the usual suspects, flexeril and percocet), prescribed by my back surgeon. i remain under his care until his partner does the hip.
i don't know if ibuprofen acts like aspirin, but i would really hate to schedule surgery only to find out i have to have it out of my system (i'm not to give blood this time, because our time frame should be only a couple of weeks from now).
i guess that's two questions. yes, i should be asking my doctor. i have a hunch he's getting tired of me calling twice a day!

any thoughts?

 

[Annemarie]

Hello mendi. At 65 I have just had my second THR within 4 months of the first one, and both times I have been given blood thinners during the 7 day hospital stay as well as a prescription to continue with blood thinners for 4 weeks once home. While at the hospital for the first THR I was given blood thinners by pill, during the second time I was given a daily needle as well as daily blood thinner pills. I must also have a blood test once a week for 4 weeks in order to check the INR which is presently at 2.1. Not sure what that means. Last time this INR number fluctuated too much and they had me going 3x per week. Here in Mississauga, Canada we too take Cumedin /Wharferin. Annemarie

 

[Annemarie]

Hello mendi, once more. In regards to pain killers, (they ain't killin nout exept the the physical body) I have not taken any once out of the hospital. I found that an awful nausea crept through my body for about 10 to 12 days after each operation which made me suspect all those chemicals, general anethetic, antibiotics, countless pills etc. for my discomfort. Whenever possible I stay away from drugs. As soon as I read about the side effects of pills I see red, as the side effects appear more severe then the symptoms they are claiming to cure.

 

[mendi]

hi, annemarie!
thanks for the reply. i actually got to talk to the surgical coordinator yesterday (it took forever last year). i do have to be off the ibuprofen, and coumadin is on a case by case basis.
i've been pretty lucky with the serious pain meds (the REALLY weird thing? even though they are supposed to clog you up, i've been more "regular" this past year than in my whole life!), at this point they're aren't working as well,but i am also pushing myself very hard to build up some muscle. i had to take an oxycodone last night, but that's a pretty rare thing. it's going to be hard enough going w/o the ibuprofen, there's no way i can go off the pain meds before hand.
thanks again!

 

[kim1313]

I had a THR just 5 weeks ago, and they gave me Heparin shots while in the hospital as a blood thinner, then sent me home on Cumadin. A home nurse came 2x per week to check my INR, which if I understand correctly, gives them a numerical range of blood anti-coagulant so they can adjust the medication to the optimal range to prevent a blood clot. This was just a simple finger stick blood test - no big deal. Based on the varying results, I took it for a few days, then they took me off for a few days, then I had to go back on for another 10 days, then when the prescription ran out, they switched me to a plain 325 mg Bayer aspirin per day. I attended a cl*** offered by the hospital on joint replacement prior to the surgery (both knee and hip) and it seemed as though just about everyone could anticipate some sort of blood thinning therapy according to the nurse that conducted the cl***. Mine lasted only 3 weeks, but I am 40 and I don't know whether age has anything to do with it or not. I was in terrible pain prior to the THR, but I did have to go off all the ibuprofen a week before surgery, and I was not allowed to take anything stronger for a month prior. My doctor said you build up such a resistance to pain meds very quickly (needing more and more to obtain same pain relief), and I would need to have good pain control after surgery; therefore, he didn't want me to build up a resistance to the same drugs I would need after I got home. This makes sense, but it was difficult to suffer until my surgery date. A heating pad became my best friend and it did help a great deal!

 

[JGosse]

My surgeon told me I would be put on blood thinners (Coumadin) for about a month. I'm only 55 and very healthy (other than arthritis). I think this must be pretty standard. I was also told to go off the NSAIDS a week prior, so no Naproxin but they gave me Viocodin to replace it. I'm not taking the full dosage I could as I don't like it much and I am concerned about it's losing affect when I might really need it. The side effects of some of these drugs are unpleasant, but the side effect of a blood clot can be death, so putting up with slight nausea seems worth it.

One week until the first THR...wish me luck!

 

[mendi]

the blood thinners were also a concern for me. basically, you take it for a couple of weeks, they test you 3 times a week (you can have someone come to your home). it's just a safety precaution.
my personal advice, TAKE YOUR PAIN MEDS! don't suffer. i agree, vicodin is a huge pain, but if you don't take it for a long period, you'll be okay.
i took percocet for a year, 3X/day, and it still worked. i also was very concerned with addiction, there is a history in my family. i had the back surgery in october '05 and was off most meds until we found out about my hip. THR in september '06, and i was off the vicodin by the two week mark.
i still take darvocet and flexeril, but am cutting down the amount. depends what my day holds.
ANYWAY, the blood thinners don't really thin your blood that much. i shaved my legs, i had syringes stuck in me, my clotting was not really a proble. and i didn't experience any side effects (other than the annoying home nurse). eh, it's SOP, and not a bad idea!

AND GOOD LUCK! i was 46 at my surgery, and panicked. at this point, as long as i move slowly, i can do anything. keep me posted??

 

[Annemarie]

Hello JGosse. I was on blood thinner for nearly 6 months. Afte the first op. I took a daily dose of 5mg Coumadin which lasted until I had my second op 4 months later at which time 5mg did not seem good enough anymore and I was told to vary the daily dosage between 5mg, 10mg or even 12.5 mg. My blood did not stabilize at all after the second op with readings fluctuating between 1.3 and 3.6. I finally got fedup with those twice weekly blood tests ordered by my family doctor. My surgeon felt it would be ok to stop the blood thinner as I was by now active enough for the blood to regulate itself. I have had no side effects so far and had no need for pain medicin either. Good luck with your first THR, you'll be glad you did.

 

[JGosse]

Having all this input and first-hand information is really helpful. I am looking forward to my surgery in six days. It's a big first step in becoming pain-free and getting back to activities I love. I'll take the drugs the doctor orders and see what happens with the pain killers. I am wary, as my mother (who has also had a THR) is as damaged from decades of drugs as she is from arthritis. The prednisone was particulary damaging, pretty much destroying the joints in her hands and feet. I agree with Kim1313, going without the usual pain meds this week is hard, but I know it will be worth it.

Judy

 

[kanoneli]

You've probably had your surgery by now, but I wanted to impress upon you how important blood thinners are. I am 52 and last summer went in for emergency surgery on my right knee. I had developed an infection after a cortisone shot. (My own good luck) They had to clean out the infection in my knee, but it was also systemic (Staph and Strep)> I ended up having IV antibiotics for about 6 weeks in and out of the hospital (visiting nurses...doing my own IV, etc>) and also was re- hospitalized a week after my surgery when they discovered a blood clot in my upper calf. I was put on heperin IV in the hospital , and coumadin when I got home, for a couple of months. Fortunately the blood clot dissipated but it was really a nightmare, and really scary...YOU want blood thinners when you are immobilized. I need both knees replaced very soon and I will definitely insist on blood thinners! Good Luck!

 

[Lolly]

My surgeon told me I would be put on blood thinners (Coumadin) for about a month. I'm only 55 and very healthy (other than arthritis). I think this must be pretty standard. I was also told to go off the NSAIDS a week prior, so no Naproxin but they gave me Viocodin to replace it. I'm not taking the full dosage I could as I don't like it much and I am concerned about it's losing affect when I might really need it. The side effects of some of these drugs are unpleasant, but the side effect of a blood clot can be death, so putting up with slight nausea seems worth it.

One week until the first THR...wish me luck!

Good luck - everything will be alright!
While in hospital you will also be wearing the TED stockings.
12 days after my THR surgery, I was sent home and a community nurse drops by to continue dispense the blood thinner (Clexane) everyday for 14 days. The hospital may require you to do it yourself. I was told and trained; however, I do not have the courage to poke myself with a needle. As soon as it is injected to my tummy, I felt just a one minute sting and there was NO side effect whatsoever.

Stay positive and follow doctors orders, especially the simple exercises (foot and breathing exercises) while you are not yet mobile. All will be well . I will pray for you.

Lolly from Australia