I'm having a real problem right now, as is my doctor, and we're not sure how to handle it. I'm sure there's got to be someone on here who has had a colonoscopy and needed to go off their blood thinner beforehand. Going off my Coumadin for 3 or 4 days isn't what concerns me - my doctor said if he had to remove polyps, I would have to be off of it for at least 10 days. I think the color drained from my face. I would be terrified to go off of it for that long. Has anyone else been in this position and was taken off of theirs for an extended period of time due to some kind of surgery? I mean, what do you do, just stop it and hope for the best?
I am absolutely terrified to stop mine so any suggestions would be greatly appreciated.

i just had a hysterectomy 5 weeks ago. i went off coumadin and plavix for a week before and a week after. i gave my self fragmin shots (low molecular haparin) in the belly everyday before and after until my inr was back up to normal. the fragmin only stays in your system for 24 hours. as soon as i stopped bleeding (which was the next day i started back on the fragmin shots. i started the coumdin on the day of the surgery because it takes so long to kick in. during the 48 hours which i had nothing they had me out of bed and walking constantly plus they put the teds stockings on me. i have a clotting disorder and have numerous strokes. all ended up weel, no clots no strokes.
janet

Thank-you Janet, but I'm a little confused about what you did. You say you went off coumadin a week before surgery and a week after, but then said you started back on coumadin the day of surgery. Can you maybe explain everything a little better so I can show it to my doctor?

yup, sorry about that. this was the schedule my hemotologist made me.

7 days prior to surgery take last dose of coumadin
6 days nothing
5 days nothing
4 days one 18,000 ui fragmin shot
3 days one 18,000 ui fragmin shot
2 days one 18,000 ui fragmin shot
1 day one 18,000 ui fragmin shot
day of surgery, that night a double dose of my regular coumadin dose
1 day preop regular dose of coumadin plus 5,000 ui fragmin shot
the regular dose coumadin and 5,000 fragmin shots continue till inr is at the levels you need.

the reason the 5 and 6th day prior to surgery you take nothing is because you inr is still within therapudic ranges even though you arent taking the coumadin.
hope this is a little clearer.
janet

Thanks Janet, yes that's a little clearer, although I don't think that would work for something like polyp removeable where you would have bleeding afterwards. In that case, I wouldn't be able to be on anything, coumadin or otherwise, otherwise polyp removal would just continue to keep bleeding instead of healing. I guess I'm not sure if something like this would work for me so I will have to talk to my doctor about it. But thank-you for at least giving me an option.
I will tell you one thing though - it's alarming to know how many people on this blood board don't have colonoscopies done like they should as NObody replied but you. That is very disturbing.

well i had a vaginal hysterectomy and i doubt there is more bleeding with a polyop removale
janet

You know, that's a good point. But I think when you have a polyp removed, it's more of an open sore that would continue to bleed if the blood isn't able to clot. I assume that's why he would keep me off of it for several days, because those spots wouldn't be able to clot and heal otherwise.

im guessing you would be ok though. every time i have an angiogram they pierce the artery in my groin and i start back on blood thinners the next day. ive never heard it be neccesary to stay off more than the next day after any procedure. i even had major dental work done last fall and went back on the coumadin the next day. i did start to bleed after my hysterectomy (3 weeks later) but it is not a massive amount of bleeding. get your docter to talk to a hemotologist. he will write up a schedule for you.
janet

hi last night i was thinking. i dont know your backround but mine is a clotting disorder and many many strokes. you need to weigh the risks....a little bleeding or a stroke. for me....bleeding was way way better than having another stroke.
janet

I have a clotting disorder too, but have never had a stroke, thank God. And I have to agree with you - I would much rather take my chances of bleeding somewhere than have a stroke. I did find out on another board that a gentleman did something very similar to what you did, he called it 'bridge therapy', and gave himself shots too.....he had a colonoscopy and didn't want to bleed after a biopsy, although he did say that the doctor cauterized the area where the polyp was removed and waited for the bleeding to stop before continuing on. Which in my opinion is the right way to do it. After reading your response and his, I feel better at knowing that at least there's a way to have it done now.

Hope you're feeling better and again, thank-you.

I will tell you one thing though - it's alarming to know how many people on this blood board don't have colonoscopyc done like they should as NObody replied but you. That is very disturbing.

Well, I will tell you one thing... I REFUSE to have a colonoscopy.

I've taken Coumadin for 15 years due to a mechanical aorta heart valve. I'm not going to get off Coumadin and take a chance on having a stroke for a colonoscopy. That is not only my thinking but the recommendation from my Cardiologist!

Oh trust me, I understand where you're coming from, but if you go to the colon board and read my posting on there and the reply I received from the gentleman I mentioned earlier, you'll see that it certainly can be done with no risk of a stroke. I did have a virtual last year and am still not 100% sure what I will do in the future. For those who don't wish to go off the coumadin for an extended length of time, like yourself, there are other testing methods that can be done - virtual, a sigmoidoscopy with yearly fecal occult blood test, even a barium enema which is probably one of the safest. So even though I understand why a colonoscopy would be refused, there are other ways to be tested safely.....they just aren't as accurate. And you may also want to keep in mind, which I didn't think much about until recently, that as we age, the risk of needing some kind of surgery increases, and it's inevitable that at some point, we will all need it for something or other. And at that time, going off coumadin will not be a choice. This discussion isn't just limited to colonoscopies but to any kind of surgery. I've come to realize in just the last few weeks that popping this little peach pill every day for the last 20 years isn't something to be thought of lightly as I did when I was only 30.

I fully understand the importance of the colonoscopy, my wife has had them and I would have also had I not been on Coumadin. I just feel the risk is too great to perform a "test", especially at my age. I had much rather be dead than suffer a severe stroke and be left in a nursing home.

Another thing in my favor...I have no family history of colon cancer although before I had valve surgery I had a severe bleeding ulcer... so I know what blood (black) in the stools looks like. Fortunate for me I've had no more ulcer problems since that time.

I didn't find your post about someone that said it can be done with "no risk". Sorry, I don't buy that for there is always going to be some risk.
Now days, just being a patient at a hospital puts one at risk.

BTW, I notice from your other post that you're young compared to me, I'm 70. :)

It's under the bowel disorder board. I agree, there's a risk no matter how careful you are. And yes, you are a little older than me, although not having colon cancer in the family doesn't mean we won't get it. I do the fecal occult blood test every year, but have just found out that it's not reliable anymore as it will only detect hidden blood about 50% of the time. As for the other gentleman, he posted a website url that explains testing for those on a blood thinner, and I was a little confused as it states high risk procedures and low risk, and a colonoscopy even with biopsy removal falls under low risk. Not sure what to think about that. Actually, I'm not sure what to think of any of it, seems like the more I research, the more confused I become. Life was definitely much easier before 50 :)

I have come to find that whoever it is you're talking with will promote their own kind of test - the virtual colonoscopy place pushes theirs as the best/less invasive/safer/finds just as many if not more polyps as regular colonoscopy/scans complete pelvic area, not just colon/ etc etc, and the colon doctor I saw had his own views about virtual - not as accurate/radiologist wouldn't know a polyp if it hit him in the face/etc etc.
You go to these doctors for reassurance and guidance as to what's best for you personally, and most of the time I walk out thinking which car payment is my test going to pay for them. Actually, I was fairly comfortable with the virtual I had last year but did find afterwards that it was only 2-dimensional, and the most accurate is 3-dimensional. I actually found that out by accident when reading my Prevention last September, and they had an article in there on virtuals and which ones are the best, and this particular machine that was the subject of the article said there were only something like 13 centers in the country who use it, and there was only one here in my state and it wasn't where I had my test done. I was pretty upset considering they had led me to believe it was 3-dimensional when in fact it wasn't. The only thing I'm not comfortable with is that it's a scan so it uses radiation, but I guess in my situation I would have to weigh the risks for everything that's on my plate. And right now, I think I need to talk with a hemotologist and get his opinion on what he thinks is safest for me, and even then, I'll have to go with what I feel is right for me. It's just too easy for a doctor to recommend something, have that something go wrong, and for the doctor to simply say 'Oops.'
Isn't there anyone else on here who has an opinion on this? Certainly there has got to be other members who've been faced with some kind of testing or surgery and can contribute?

I agree with you... if they are pushing their favorite test it will always be low risk. Although my wifes doctor (GT) didn't recommend me haven't a colonoscopy without the approval of my Cardiologist which in my case he didn't approve the procedure.

Sorry, I couldn't provide more help or info. I think there is plenty people out there that could help but are not reading your post.

Good luck with your decision, what ever you go with.