PATIENTS ON BLOOD THINNERS

. Posted in SPECIAL PATIENTS

Some people with congenital heart defects, including those that have had heart valve replacements, a stroke, a blood clot in the legs, or have had

complicated surgeries may need to take daily anticoagulants, popularly known as blood thinners. These medicines slow blood clotting and are used to prevent major complications, such as vessel or valve obstruction or strokes. Blood thinners include aspirin and other anticoagulant medications such as Plavix and warfarin (Coumadin). Each of these medicines works on a different part of the blood-clotting cycle. There are also many over-the-counter (OTC) holistic products and vitamins that are used to retard clotting mechanisms. All of these agents can increase your risk of serious bleeding problems should you undergo surgery. It is important that you inform your surgeon that you are taking blood thinners before scheduling your procedure and to let your prescribing doctor know that you are considering surgery. Bleeding after surgery may be a serious complication of taking these medications. You will also need to monitor yourself very carefully after surgery. Tell your surgeon if you begin to bruise, have bleeding gums, or have nosebleeds. Serious bleeding after surgery could lead to days of nasal packing; a second trip to the operating room; the need for blood transfusions; and, in rare instances, even death. For patients currently taking warfarin and planning on having sinus surgery, I work with the treating physician, who will recommend one of the following:

■ Discontinuation of warfarin 3-5 days before surgery

■ Lowering the warfarin dose during the procedure

■ Discontinuation of warfarin and treatment with intravenous heparin before and after surgery until the warfarin can be resumed

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