If You Are On Coumadin

I hope no one minds if I post this. I've gotten 2 or 3 questions in private messages about Coumadin and it's effects on VSG surgery. I thought I'd post this so others can find the topic if they have questions.

If you are on Coumadin before VSG surgery, you definitely need to talk to your cardiologist as soon as possible. There are a couple of ways they can handle the coumadin. If you are near the time that you are supposed to come off the coumadin (usually they have you on it three months at a time), then the cardio may be able to take you off the coumadin before surgery. If not, you need to talk to your surgeon, asap.

What they do from there on in will depend on why you are on coumadin. I am on it because I developed Deep Vein Thrombosis in my leg in June, 2011. That threw two clots into my lungs, or pulmonary embolisms. MY surgeon had a filter installed before my surgery to keep any clots from floating into my heart and lungs. I'll give details if you tell me you're on coumadin for the same reason. And, I had the filter removed after my VSG.

I had to stop taking the coumadin a few days before the filter installation surgery, maybe 3 or 4? IIRC, I started giving myself shots of Lovenox on Monday, had the filter installed Friday (no shots on Friday), gave myself shots on Sat, Sun, Mon morning, nothing on Tuesday (VSG surgery day), and then continued to take the shots until Thursday morning and started taking coumadin again Thursday night. I didn't have to take Lovenox before the filter removal three weeks later because my pulmonary doc took me off coumadin in between there.

I had a d-dimer blood test after a month with no coumadin, which showed I was still at risk for clots, so I'm back on coumadin until at least January 2012.

My blood clot delayed my surgery from August 12 to August 30 because I had to be more than 3 months past the date the clot formed for safe surgery.

If you have a choice between waiting until you are off the coumadin and taking the shots, wait. Lovenox injections WITH insurance cost me over $1000 for the days I was on them. My VSG surgeon did offer to have his nurse give me heparin shots instead of the Lovenox, but they couldn't let me inject myself and that would have meant two trips per day driving 1 hour north of where I live.

DO inform your surgeon about the reasons you are on coumadin. A blood clot can be very serious, even fatal. Your surgeon may wish to place a filter or stent before or during surgery. My vein doctor wanted the filter instead of a permanent stent because I'm only 45 and he felt the risk to leave it in was more than the risk to take it out. BTW, if your surgeon acts like your being on coumadin is no big deal, please look for another doctor. IMO, blood clots are one of the quickest killers after any surgery and your doc should follow up on why you're on this med.

In case you didn't know, most VSG/WLS surgeons do give their patients a shot of either lovenox or heparin during the surgery to help reduce the risk of clots. That's why I didn't take my shots the day of surgery.

If your doc does decide a filter/stent is necessary, feel free to message me for more info. It sounds intimidating because the filter install and removal are both surgical procedures. That means I had THREE surgeries to get my sleeve. However, I don't regret one second of it and it was totally worth it to me!

Good luck!!