surgery

Coumadin And Surgeries

Deanne Stein Health Guide February 10, 2006
  • I’ve worn glasses for as long as I can remember. I got my first pair of contacts in the fifth grade. I felt so free with those contacts, but after so many years of wearing them, I developed Dry Eye Syndrome. You're probably wondering what this all has to do with my stroke. Well, before I had my massive stroke in 2001, I was considering LASIK eye surgery. LASIK is an acronym for Laser-Assisted In Situ Keratomileusi, a refractive surgery procedure performed by ophthalmologists. In my case, my eye doctor said the procedure would correct my vision to 20/20 or better. Then, I had my stroke. Naturally, the surgery had been put on the back burner ever since.

    Actually, it wasn’t even on the back burner. In fact, up until about a month ago, I basically forgot about it completely. My eyes were beginning to bother me again.

    At first, I figured I shouldn’t even ask my doctor about it, given my condition and the fact that I was taking Coumadin, a blood-thinner. Then, I decided, what the heck, I’ll see what my neurologist thinks. It turns out, since LASIK is considered a bloodless surgery (a laser is used), my doctor told me I could safely have the surgery. I don’t even have to change my dosage or stop taking it beforehand. I was so happy about this news, I thought I would research other surgeries for people wondering the same thing.

    Is surgery safe when taking Coumadin? Well, I found out, that it all depends on what type of surgery you want or need to have. It can be potentially dangerous to undergo some elective operations while anticoagulated. For instance, brain or eye surgery can be dangerous while on blood thinners. Fortunately, my eye surgery is safe, again because of the lasers being used. But, even less serious operations, such as prostate or joint replacement surgery, can be associated with serious bleeding in a fully anticoagulated patient. The best advice is to check with your doctor or surgeon, and let them know you are taking Coumadin.

    Before any planned procedure, a Pro-Time should be checked. For those of us on Coumadin, we know all to well about this. It’s a blood test done to measure the clotting time of plasma. In some cases, it will be safer to temporarily stop taking the medication around the time of the upcoming operation. In most situations, a temporary stoppage of Coumadin is all that will be needed.

    However, in some situations, anticoagulation should not be completely stopped. Some heart valve patients should remain on blood thinners (except during the actual elective surgery itself). In these patients, the Coumadin is usually stopped several days before surgery, and substituted with intravenous heparin. That’s because heparin has a short life span in the body and will be cleared rapidly after stopping therapy. The patient typically can return to Coumadin after the surgery. As long as you continue to talk to your surgeon or cardiologist, they can decide which option is the safest during your surgery. I’m having my eye surgery on Saturday, so wish me well and I will let you all know how it goes.