Surgery and blood thinners

Before your surgery, how long did you have to stop taking your blood thinner?  I am susceptible to blood clots since my triple heart bypass in 2005, and my cardiologist says I need to stay on coumadin for the rest of my life, because I developed many pulmonary embolisms after the heart bypass. What was your doctor's recommendations concerning your blood thinners?

Most of the time, they take you off of coumadin 5 days prior to surgery and have you do lovenox or another injectible for a few days prior to surgery...and then again after surgery until you get back to being theraputic. BUT.....coumadin can and will lower your white blood cell count. It takes 10 days for the coumadin to get out of your system so your doctor really needs to have a cbc with diff done at least 10 days prior to your surgery so that if the results come back with a lowered white count they can take you off of it ASAP so that your white count has enough time to go back to normal prior to surgery. How do I know this?? I was scheduled for surgery (hernia repair) Jan. 23rd. It got postponed until March 3rd because my white count had dropped to 2.5 (norm is 4.0-10.0). It did take the full 10 days for mine to return to normal. I am now on Arixtra (injectible..like lovenox****il I have my surgery...and for 2 weeks post-op. After that, I'll restart the coumadin and will stay on the arixtra until I am theraputic again. They are waiting the 2 weeks to ensure that my white count stays up during the initial healing stage.  I am going through the Indiana Hemophilia Center for it. They said that although they knew that a reduced white count was listed as a possible side effect for coumadin, I am the first patient they've had that it has actually happened to. When they do restart up the coumadin, they'll be having weekly cbc's drawn. As soon as the white count reduces (if it does), they'll be taking me off the coumadin. They will also be using this data to document me as being one of the rare ones for this to happen to. Aren't I so special? lol. So...you may not have an issue at all...but just in case, I would definately ask the doc about running a CBC at least 10 days prior so that you don't run the risk of your surgery being postponed. You are welcome to print off this post and bring it to him if you'd like. Should he prefer to contact the IHC about this, my doctor at IHC is Dr. Anne Greist. Because of privacy issues, I doubt they'd discuss my particular case...but my full name is Sherri Johnson. They, I believe would suggest the cbc as a precaution though. Sherri

Thank you for your reply, Sherri, and for all the information in your reply.  I did print it out for a future reference for my lap band surgery.  I'm still in the very initial stage of the lapbanding.  I called the only bariatric surgeon from Ft. Wayne, Dr. Sloan, about setting up an appointment for a consultation with him about having the lap band done on me.  But his nurse (or receptionist) told me that Dr. Sloan is in the process of Medicare paying for lapbanding at the Fort Wayne, Indiana hospitals, and hasn't been approved as of yet.  I'm to call back the last of this month and every month thereafter, to see if he was approved by Medicare.  So this is my first step, and many more to follow....so patience comes into play now.   I'm anticipating setbacks because of the blood thinner and the surgery.  I am scheduled for a colonoscopy this Thursday, and had to go off of my coumadin and aspirin, and just started the lovenox injections this morning.  First time for me giving myself injections, but it went okay for the first one.  I assumed that the lap band surgery would entail the same process with the lovenox, but wanted to ask someone who may have gone through it, too.  I had no idea the coumadin lowered a person's white blood cell count...my doctor never mentioned this to me....so thanks for the "heads up" on this. Right now, I'm concentrating on the colonoscopy to be over with, then I'll put my full attention on the upcoming (hopefully) lapbanding.  But I need all the information I can get before my final decision....which is why I am here on these boards.  I have already learned soooo much from all of you, and hope to learn more in the months to come.  Thank you, Sherri, for replying to my post.

Not a problem. You might want to talk to your cardiologist about this..and about possibly being referred to a hemophia center near you so that they can oversee your blood thinners, etc for any future surgeries & procedures. I was told that since I now have a history of blood clots associated with surgeries, I am to go through the hemophilia center prior to and/or after having any surgery that would impede full movement. Since my blood clots were directly related to imobility following asurgery, I only need to be on blood thinners for 6 months ****il ~April). So...in the future, say if I had say a nose job (yeah, my big nose, probably not a bad idea! LOL!) then I would not need to go on any blood thinner post-op. If I had an appendicitis, I would and therefore would need to go through the center to be put on coumadin & it monitored. Not all bariatric programs are alike..not in the US, not in Indiana, not even in Indianapolis. Some require lovenox injections post-op, others don't. Since you are on coumadin, I would bet you will be one who does do them in order to get you back to theraputic levels. Again, that is something that if I were you, I would want either my cardiologist or hemophillia center to monitor. Best of luck! Sherri ps..remember, not everyone has the reduced white count like I did..you may be of the majority and have no problem at all