Broken ankle - surgery canceled due to high aptt

m648c
on 8/29/14 1:51 am - Binghamton, NY

Hi need help and advice- sorry it's long! I am 5 years post op RNY - maintaining my weight loss and following vitamin, calcium recommended by Bariatric Assoc. Have blood monitored yearly and because I do not absorb Iron I have has a few infusions. 

I fell Saturday, slipped actually, dr said bones are good just a weird accident and broke 2 bones and dislocated ankle. It was set in soft splint cast by orthopedic and I was scheduled for surgery 9-2. Got a call today my aptt which should be 22 is 43. Meaning I am clotting to slow and primary care will not approve surgery. Have appointment with hematologist 9-2 surgery postponed.

Anyone have anything like this? Any advice?assuming this is vit K deficiency and can't be fixed will I be crippled as my bones will not be pinned and screwed as needed because they are afraid I will bleed out.

Thanks Melissa  

RNY 10-26-2009   
PSW 265 / SW 249 / Goal 145 / CW 137


  
RNY 10-26-2009   
PSW 265 / SW 249 / Goal 145 / CW  137


  
AndreaLin
on 9/6/14 5:11 am - Vestal, NY

My first thought is B12 deficiency over Vitamin K.

Vitamin K deficiency is rare. It is more likely that you would have a B12 problem due to the RNY and lack of intrinsic factor (I am assuming you know what that means in relation to needing iron infusions)

A PT test should be 9.5 - 13.5 seconds. Normally aPTT tests in a person with prolonged coagulation (such as someone on Heparin) is 2.5 times that in  seconds. So it looks like your doctor is focusing on that 2nd test.

Did the doctor def state Vitamin K?

There are several disorders that can also lead to a high aPTT. Liver disorders are pretty common causes. Have you had liver studies done?

These are common liver function tests:

  • ALT. 7 to 55 units per liter (U/L)
  • AST. 8 to 48 U/L
  • ALP. 45 to 115 U/L
  • Albumin. 3.5 to 5.0 grams per deciliter (g/dL)
  • Total protein. 6.3 to 7.9 g/dL
  • Bilirubin. 0.1 to 1.0 mg/dL
  • GGT. 9 to 48 U/L
  • LD. 122 to 222 U/L
  • PT. 9.5 to 13.8 seconds

 

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