Colonoscopy with coumadin

[EVELYN]

Hi All....

Just a note to ask for your prayers for Tyce on Monday. He's having a routine colo and is NOT going off coumadin. Our pcp and gastro have both said they're in favor of him staying anti-coagulated and if there's a problem, then they'll have to go back in and remove any polyps.....

However, I always worry about bleeding, etc., so any advice or thoughts you can give us are greatly appreciated......

Thanks again.

Evelyn

PS....IMHO the worst part is drinking that s*&t twice prior to the procedure!!!! YUCKO!!!

[warrenr]

Good luck:cool:

Sounds like your Gastro and PCP know what they are doing:)

[geebee]

I will be saying prayers that all goes well. I think you have made the right decision in doing an "exploratory" procedure while still on coumadin. Unless the doctor is very rough with the probe (and is unlikely to be knowing about the coumadin), the chance of any serious bleeding is practically nill.

I would not do a colonoscopy every again unless it were this type. I went through bridging and all that stuff for my last one and there were no polyps so the bridging was a waste of time, energy, money and danger of going offf coumadin (even with bridging there is still some danger).

Hopefully there will be nothing to remove and this first procedure will be it.

[Eowyn Rose]

I will be thinking of you.
The same procedure worked very well with me. I stayed on Warfarin while they gently surged for what ever they were looking for.
Good luck
Eowyn Rose

[Rich]

I went off my Coumadin but only for two days, and by two days I mean exactly 48 hrs.
This was agreed to by my cardiologist and my gastro guy.
They removed five polyps( biopsies showed nothing to worry about) and I had no bleeding or any other problems.
As soon as I arrived home I took my Coumadin dosage for that day.
Rich

[catwoman]

Evelyn:

Tell Tice good luck. Glad that his doctor is sharp.
Will be looking for a post-procedure progress report.

[EVELYN]

Thanks, all, for your notes.....He had his piece of chicken on a slice of white bread this morning and that's it for the day, except for some ices and hard candies......and, of course, lots of clear liquids......I had a colo/endo done in September, so I can fully sympathize with him.....I love our gastro guy, but, of course, always worry about any bleeding.

Will let you all know how he does tomorrow.
Right now we're off to the new vet for my old guy....My old vet (who moved upstate NY, near Moravia) recommended him highly. He practices both eastern and western medicine and from what Kerry says, is brilliant. While we know my old Tank dog has cancer, if we can give him a few more months with NO problems, then that's what we'll do. We've opted NOT to do chemo, but as long as the herbs keep him eating, comfortable, etc., then we're going to give it a shot.

Please put us in your prayers.

Ev

[BDMc]

I doubt there is much to worry about if the doc know he's on warfarin. I think I'd rather do it that way, and do it again if they find anything. I just had my annual check-up with my PCP, he wants me to schedule one of these delightful procedures as I have a family history of colon cancer. He wants me off the warfarin, and using Lovenox. I've used Lovenox before for gum surgery, and certainly don't look forward to doing it again. What's the consensus here? Brian:(

[geebee]

I doubt there is much to worry about if the doc know he's on warfarin. I think I'd rather do it that way, and do it again if they find anything. I just had my annual check-up with my PCP, he wants me to schedule one of these delightful procedures as I have a family history of colon cancer. He wants me off the warfarin, and using Lovenox. I've used Lovenox before for gum surgery, and certainly don't look forward to doing it again. What's the consensus here? Brian:(
Brian,

At least you have a doctor that suggests Lovenox instead of stopping coumadin and using nothing. That being said, you should talk to him about what YOU want to do. If there is a really good chance you have polyps, then maybe doing it in one fell swoop would be best. However, if this is merely a screening test and you are having no symptoms (i.e. bleeding, diarrhea, etc.) then ask him to simply do the intial colonoscopy while on the coumadin. Make him understand that you realize there will be another one should anything be found that needs to be removed.

As I said earlier in this thread, I will never go off coumadin again for a screening colonoscopy.

Good luck.

BTW - how is your Bjork-Shiley valve doing?

[BDMc]

Gina, Thank you for your comments and thqe question. I've had surgery in the past where they just took me off the warfarin. Once for knee surgery where my thoracic surgreon gave instructions to the orthopedic, and once for gum surgery. In both cases I was put back on the warfarin too soon, and had bleeding problems. With the knee, I was supposed to stay off for 24hrs. The Orthopedic surg. put me back on in the recovery room. It was out patient surgery. I was supposed to return to work in a week. I ended up spending 5 weeks in bed! I'd rather do the Lovenox for ten days than risk that again! As for the Shiley, I guess it's doing fine. My PCP doesn't think it warrants annual visits to the cardiologist, and I haven't had an echo in at least three years, probably more like five. Any advice? Thanks, Brian

[EVELYN]

Hi All

Thought I'd update everyone. Tyce is home and doing fine.....procedure went like clockwork and no polyps were found, so he's good for another 5 years.....YAY!!!

The gastro guy even premedicated Tyce with antibiotics, because he said if he premedicates for dental procedures, HE SHOULD PREMEDICATE FOR COLONOSCOPYS......SOMETHING TO REMEMBER FOR EVERYONE OUT THERE WHO IS HAVING ONE SOON.

Actually, premedication was something I'd never thought about---I'm just glad Dr. Duva initiated it.

Of course, when he had his blood work done on Thursday, our Coaguchek said 3.2......the quest lab draw said 2.1.....I'm sure it sat around for a bit, but I'm going to have our Coaguchek checked with our cardio's clinic, just in case.....yes, Al???????

Thanks for all your support.

Evelyn

[Mary]

Evelyn,
I'm glad that everything went well and you can forget it about it for another year or so.:)

[geebee]

Evelyn,

Great news and the gastro doctor sure seems to be on the ball.

Brian,

Happy to hear your BS valve is doing well. I have no suggestions other than you should have regular checks to make sure there is no sign of strut failure. I am not sure what tests they are doing these days for those valves as there are probably less and less implanted ones out there. Mine was replaced during my last OHS. It did not seem to have any fractures but we decided that we would replace it anyway as long as we were in there. I feel better having it out. Is yours of the size that you can choose to have it replaced under the lawsuit guidelines? Mine was smaller than the "problem ones" so I could not get my surgery paid for. Take care.

[allodwick]

It never hurts to double check the meters. We do ours every three months.

[EVELYN]

Hi Al......

Just got back from our cardio's clinic and Tyce was 3.4......on our machine today he was 3.0, so I'm ok with both of those......it does matter if it sits in a lab, doesn't it???/ even if it's in an airtight vaccutainer???

ev

[allodwick]

As long as the red cells don't break (hemolyze) it doesn't matter if it sits. The blue top Vacutainer has a known amount of an anticoagulant in it. When this is put on an analyzer, the anticoagulant is deactivated so that the PT/INR can be run.

[Marty]

It never hurts to double check the meters. We do ours every three months.
Al, Exactly how do you check your meters? About once a year I test Alice and if it comes out 1.1 or 1.2 I consider that a satisfactory check on the meter.

[allodwick]

Marty, Your way of testing Alice is valid.

We do two different things, routinely.
1. Every 6 months we get 5 unknown samples from the WisconState Hygienic Lab. We run those just like blood and have to report the INRs we get. We almost always get 5 of 5 within ranges. Once we only got - but we have done it at least 16 times.

2. We get people to consent to a venous draw. We do this about every six months too. They get blood drawn and we put one drop on the CoaguChek and send the rest to the lab for testing. We almost always match within 0.2 units of the lab.

3. We occassionally see someone who is then admitted to the hospital. We check our resuilts against the lab on an informal basis.

[Granbonny]

I just told my Hubby that I needed to check my Protime tomorrow on him..:p He said, Oh, NO, you are NOT going to prick my finger.:D And this is a man who just walked across our roof ..replacing spot lights, hanging upside down..:eek: What a wimp:p :p Bonnie

[Howie07]

After a lot of research I decided to do a "virtual colonoscopy" which is basically a CT scan and non invasive, so there was no chance of bleeding.

Previous experiences in coming off comumadin and going on Lovenox for surgery made that procedure something to avoid if I could.

Much to my surprise - backed up by a letter from my cardio - and from my pharmacist (explaining how much 10 days of Lovenox costs), my insurance company paid for the "virtual."

[allodwick]

Way to go Howie.

This is how insurance companies change their policies to adapt to new technology.

[EVELYN]

You're absolutely right, Al.....Insurance companies should pay for virtuals.....a heck of a lot safer than coming off coumadin.

We consider ourselves very lucky that we have a good pcp and gastro guy......they both agreed that because he had no prior history of polyps, he probably would not again and they agreed to do the scope fully anti-coagulated......

Of course the worst part isn't the colo, as we all know!!!!

Evelyn

[Granbonny]

Any good Insurance company will also know, that by..paying for a home-testing unit and supplies ..they come out cheaper in the long run......compared to all the lab draws that a person will need in their lifetime on coumadin...Not to put you out of business.:D ..I figure..they pay about $320.00 a year on my supplies.. Don't know the cost of a lab draw(or finger-prick)in a clinic or doctor's office?..Plus, I am lucky that I don't have to test that much..but, many others must do.......I'm sure that the cost of machine..plus supplies..is a lot cheaper for them..(Insurance)over one's lifetime.I was so lucky..my Cardio signed for me one 2 months after surgery..I have never asked for a comparsion on my Protime when I visit my Cardio twice a year..I wonder if my Insurance would pay for it... Probably, because I doubt if the person working up the fee would even notice I have one.(Protime)...Bonnie

[perkicar]

Brian,

At least you have a doctor that suggests Lovenox instead of stopping coumadin and using nothing. That being said, you should talk to him about what YOU want to do. If there is a really good chance you have polyps, then maybe doing it in one fell swoop would be best. However, if this is merely a screening test and you are having no symptoms (i.e. bleeding, diarrhea, etc.) then ask him to simply do the intial colonoscopy while on the coumadin. Make him understand that you realize there will be another one should anything be found that needs to be removed.

As I said earlier in this thread, I will never go off coumadin again for a screening colonoscopy.

?

I emailed my cardiologist at Cleveland Clinic about his reco's for bridging. I would love it if I could do the virtual and just have a CT scan!!!! But I don't think my insurance would cover it. I'll let you all know what Dr Griffin says. The idea of going off coumadin is pretty scary, I don't think I want to take that chance.

[EVELYN]

Carolyn....

Talk with your PCP and your gastro guy....if you have NO history of polyps, request---no DEMAND, nicely, of course---that they do it without your going off coumadin. Tyce's had absolutely NO problem with that. IMHO it's alot safer than going off coumadin or doing the bridging. I'm just glad it only has to be done once every 5 years. You might be surprised, and what's the worst thing that can happen.....they say NO???

Evelyn

[perkicar]

Carolyn....

Talk with your PCP and your gastro guy....if you have NO history of polyps, request---no DEMAND, nicely, of course---that they do it without your going off coumadin. Tyce's had absolutely NO problem with that. IMHO it's alot safer than going off coumadin or doing the bridging. I'm just glad it only has to be done once every 5 years. You might be surprised, and what's the worst thing that can happen.....they say NO???

Evelyn


Sigh, when I had my last colonoscopy 3 years ago I had polyps removed. Plus my brother is being treated for colon cancer, so I don't feel real hopeful that they'll let me do that......But hey, I'll ask, what can it h urt!

[allodwick]

I'd tell you what, but this is a G-rated site.