Success!
I am happy to report that Mom and I have successfully survived our first shot. The volume was large but the technique was worse, as challenging things go.
By the way, the story about the shots is that Mom is now receiving low moecular weight heparin shots so that the coumadin can be discontinued. But why start the shots if the coumadin was working?
Well, Mom needs to remain on medications to prevent thrombotic events until 5/16 (the 3 month anniversary of the DVT diagnosis). Coumadin works excellently to prevent blood clots from forming. It is cheap ($4), inexpensive (even including all the blood tests that run about $90 a visit), a pill, and very effective. It is not, however, rapidly reversible and is non-specific.
Mom needs to have surgery on her ear. This involves cutting things, which involves bleeding. As you can imagine, being on a non-specific blood thinner is considered suboptimal when one is about to have surgery.
Low molecular weight heparin, on the other hand, is quite specific and rapidly reversible. As such, it can be discontinued 12 hours prior to surgery and uptoward effects can be avoided. Blood testing is for the most part unnecessary and the risk of catastrophic bleeding is very low.
Now you wonder why coumadin, and not heparin, is most commonly used.
Well, low molecular weight heparin cannot be taken orally and remain effective. In addition, it is incredibly expensive (about $100 a day).
So Mom had to choose to between having the surgery after 5/16 or taking the shots for a week prior to and a week after the surgery. For a huge variety of reasons, Mom picked the shots. So a'shooting we will go...
By the way, the story about the shots is that Mom is now receiving low moecular weight heparin shots so that the coumadin can be discontinued. But why start the shots if the coumadin was working?
Well, Mom needs to remain on medications to prevent thrombotic events until 5/16 (the 3 month anniversary of the DVT diagnosis). Coumadin works excellently to prevent blood clots from forming. It is cheap ($4), inexpensive (even including all the blood tests that run about $90 a visit), a pill, and very effective. It is not, however, rapidly reversible and is non-specific.
Mom needs to have surgery on her ear. This involves cutting things, which involves bleeding. As you can imagine, being on a non-specific blood thinner is considered suboptimal when one is about to have surgery.
Low molecular weight heparin, on the other hand, is quite specific and rapidly reversible. As such, it can be discontinued 12 hours prior to surgery and uptoward effects can be avoided. Blood testing is for the most part unnecessary and the risk of catastrophic bleeding is very low.
Now you wonder why coumadin, and not heparin, is most commonly used.
Well, low molecular weight heparin cannot be taken orally and remain effective. In addition, it is incredibly expensive (about $100 a day).
So Mom had to choose to between having the surgery after 5/16 or taking the shots for a week prior to and a week after the surgery. For a huge variety of reasons, Mom picked the shots. So a'shooting we will go...
posted by Jacqui at 4:56 PM
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