Surgery and Blood Thinners

mtguy

In all of the reading I have done prior to my surgery, I found little to nothing on having surgery if you are on blood thinners. As it turned it, that became a problem in my surgery and resulted in a 12 day hospital stay, another opertation at night to address a problem, and 2 blood tranfusions.

My surgeon was well aware of the thinners I am taking for an artifical heart valve and he did talk with me about the risks and complication potential. While he has close to 1000 Da vinci procedures under his belt, he has had only 4 that had thinners involved. That surprised me as I thought there were a fair number of people on thinners.

So, the purpose of my posting is to be sure to take into accout whether you are on thinners or not in making your treatment choice. In my case, I still choose the operation since my prostate was enlarged and presented an issue that would still need to be addressed with radiation. As it turns out, while they were doing the first surgery they found two hernias that he fixed and would have to have been addressed somehow in the future. Not sure how radiation treatment would have impacted treatment for an enlarged prostate and hernias.

Kongo

Good Point
mtguy,

Good post and I'm sure it's one that many men should add to their check list of things to ask about before underoing treatment of any kind. Whether its robotic or open, removing the prostate is major surgery and has all the incumbent risks associated with that. Even going into it well informed and with your eyes wide open as you did can still lead to complications.

I'm glad you emerged from all of this in what seems to be good shape and humor. I'm wondering, since you had two transfusions, if they asked you to bank blood in advance of the surgery or not? Seems to me it would be a good idea, particularly if you were on blood thinners.

BTW, how big was your prostate?

mtguy

Kongo said:

Good Point
mtguy,

Good post and I'm sure it's one that many men should add to their check list of things to ask about before underoing treatment of any kind. Whether its robotic or open, removing the prostate is major surgery and has all the incumbent risks associated with that. Even going into it well informed and with your eyes wide open as you did can still lead to complications.

I'm glad you emerged from all of this in what seems to be good shape and humor. I'm wondering, since you had two transfusions, if they asked you to bank blood in advance of the surgery or not? Seems to me it would be a good idea, particularly if you were on blood thinners.

BTW, how big was your prostate?

Blood banking
We did not do the blood banking route although I asked about it. In all of the surgeries he had done, none required a tranfusion...until mine. So while I seem to be a "rare" case, it is still something to be aware of.

I have the pathology report and need to study it more but recall his verbal description as a very good report. He was concerned about being able to spare the left nerve bundle but after surgery he told my wife I had "impressive" nerve bundles and had a protective fat layer around them. They also acted well when stripped away which is a good sign they were not impacted by the cancer yet. My gland was 47g and was crowning into my bladder.

Gleason score moved from 3+3 to 3+4
Estimated tumor size 2.8cc
Extent of invasion limited to prostate with focal extra-prostatic extension
No seminal vesicle involvement identified

steckley

Blood Thinners
mtguy,

Glad to hear you were able to make it through your surgery and hernia repairs. Best wishes and good luck on your recovery.

My question is, "Didn't the surgeon take you off of the thinners before the surgery?"

I was on blood thinners (Comedin) for a few years. I had a pulmonary embolism and the thinners were to help prevent a recurrence.

I would go off of the thinners before any medical procedures (2 hernia repairs), and tooth extractions ... usually went off thinners five days before the procedures, and went right back on them following the procedure.

When I was DaVincied, about 1.5 years ago, I went off of the thinners before I had the procedure and haven't been back on them since (doctors concurred). I hope for no recurrence of the PE. I've lost weight (20 lbs), made significant diet changes, exercise more, and take supplements (including baby aspirin).

By the way I also had an enlarged prostate. One of the benefits of the surgery is that I no longer have to get up at night, can void in ten seconds or less, and have enough pressure to wear away the enamel on the back of a urinal.

mtguy

steckley said:

Blood Thinners
mtguy,

Glad to hear you were able to make it through your surgery and hernia repairs. Best wishes and good luck on your recovery.

My question is, "Didn't the surgeon take you off of the thinners before the surgery?"

I was on blood thinners (Comedin) for a few years. I had a pulmonary embolism and the thinners were to help prevent a recurrence.

I would go off of the thinners before any medical procedures (2 hernia repairs), and tooth extractions ... usually went off thinners five days before the procedures, and went right back on them following the procedure.

When I was DaVincied, about 1.5 years ago, I went off of the thinners before I had the procedure and haven't been back on them since (doctors concurred). I hope for no recurrence of the PE. I've lost weight (20 lbs), made significant diet changes, exercise more, and take supplements (including baby aspirin).

By the way I also had an enlarged prostate. One of the benefits of the surgery is that I no longer have to get up at night, can void in ten seconds or less, and have enough pressure to wear away the enamel on the back of a urinal.

Blood thinner prep for surgery
Yes, I was on a prep program to get off the blood thinners prior to surgery. I had to do this in prep for the biopsy also. I stopped taking the pills 5 days out and 3 days out had to give myself shots twice a day of Lovinox (sp?). The idea of giving myself a shot was way worse than the actual shot so if anyone ever has to do it - don't get over excited about it.

They brought me back with Heprin shots twice a day which may have been a little fast and caused the internal bleeding. From what I understand, it is a tight rope between too much and tool little when it comes to getting back to normal. I am still in the risk category yet in my recovery and must be very careful not to strain anything that might cause some bleeding.

I hear ya about the enlarged prostate and the "benefit". At least that will be a positive outcome. One week off the catheter and I feel I am pretty much in control for flow. Another positive sign.

ob66

mtguy said:

Blood thinner prep for surgery
Yes, I was on a prep program to get off the blood thinners prior to surgery. I had to do this in prep for the biopsy also. I stopped taking the pills 5 days out and 3 days out had to give myself shots twice a day of Lovinox (sp?). The idea of giving myself a shot was way worse than the actual shot so if anyone ever has to do it - don't get over excited about it.

They brought me back with Heprin shots twice a day which may have been a little fast and caused the internal bleeding. From what I understand, it is a tight rope between too much and tool little when it comes to getting back to normal. I am still in the risk category yet in my recovery and must be very careful not to strain anything that might cause some bleeding.

I hear ya about the enlarged prostate and the "benefit". At least that will be a positive outcome. One week off the catheter and I feel I am pretty much in control for flow. Another positive sign.

Blood Thinners
I took coumadin for three years from 1998-2001 and went off because my hematologist thought I was getting to the point where I could have a bleeder so I used ASA. Reason for the coumadin was that I have Factor V clotting tendencies (5-7X greater chance of throwing a clot than those that don't have it---mom died in my brother's childbirth from it).Went in for my daVinci and two days later I had shortness of breath. Thought it was all over when they said I had multiple clots in my lungs, but it turned out it was multiple small clots. One week in the hospital and a lot of heparin followed by coumadin and I was nicely let go.
Then 11 months later I went back for my AUS and was scared to death about the clotting issue. Went off the coumadin in advance but injected lovatoxin 2X daily up to the day before surgery. My urologist was really worried about me bleeding out. Again made it through. Point is, even in my sketchy case they took me off before, but played it close to the vest with the lovetoxin (sp?).