[angieD]

I posted sometime ago (about a year I think),about my gynaecology appointment.
I was supposed to have a D & C , laparoscopy & hysterscope ( hope these are the correct spellings)The doctor told me weeks not months.
Anyway , I hadn't heard anything so thought maybe everything was okay & I didn't need these procedures.
At one of my many Gp appointments ,my husband mentioned the fact we never heard anything after I had the ultrasounds.The Gp hadn't recieved any letter from the consultant and said everthing must have been alright. She said she'd phone the hospital & I got a follow up appointment for today.
I've just come back.
It turns out I was supposed to have recieved a follow up 2 weeks after my scan last year. The consultant hadn't got my records & had to phone for my scan results, it turns out I'd got a thickened endometrium , fluid , varices & cysts. She said she was going to be having me in hospital as soon as possible, I've got to have an emergency scan , D&C, laproscope & something else. I've got to go for a pre op assessment. I asked why they hadn't sent for me and she didn't know( she's not my consultant)She was angry about the fact she hadn't got my records & said I could make a complaint if I wanted.
I'm quite worried about the procedures because of the APS & warfarin!
I'll post later
Love
Angied

 

[Lupo30]

Hi AngieD

It depends on a lot of things really, it may be nothing to worry about.

I would just get the investigations over and done with first and really stress the point that you have had to wait a lot longer than you should of because of some clerical problem and therefore they should get in touch with you by telephone as soon as the results are available. That's the least they can do for you.

Good luck and let me know.

Kind regards

Lupo30

 

[LolaLola]

Just wanted to say I have had a couple of Hysteroscopies etc. and am in a similar position to you. If you do need a Hysteroscopy don't listen to any scare stories. I was a bit apprehensive but found the procedure to be perfectly bearable. Felt a bit shaky afterwards but really it did not hurt.
x Lola

 

[angieD]

Thanks for your replies , as always I'm very grateful for your time.
I recieved my ultrasound appointment today for the 28th of this month. I've been on the web all day trying to find information about surgical procedures with Aps , lupus anticoagulant & warfarin.
I must admit I'm getting very anxious.

love
Angied

 

[Clare.T]

Dear Angie

You shouldn't have to be looking it up for yourself on line ! It is unlikely you will find anything helpful for one thing
Your doctors should be discussing it in advance - rheumy with surgeon with GP so pester them mightily ! Ask too on the forum about what usually happens pre op. You may need to change meds in advance.

As you can see from the shocking failure to proceed on last year's recommendations, one really has to keep on with these people like a maniac. No reproach there mind you, because I know you have so much on your plate with family and kids and all.

Many Hugs and all best wishes
Clare

 

[greenhaggis]

Angie,

I too would advise you to speak to the specialists and perhaps what may be more useful the departments that will be carrying out the procedures (they will be the ones that deal with procedures daily).

Medications are very important to discuss with the people doing the procedures, as some can need to be stoped a few days before.

Definately bring up the subject of warfarin , as this one is important for your continued health and get their advice on how they deal with the med and the APS.

Hugs Lesley

 

[angieD]

Thanks for your replies.
My husband phoned the secretary of my local rheumy this morning to see if the rheumy will be able to give advice.My local rheumy is at a different hospital to my gynae .
I don't know whether St Thomas' should be contacted because they diagnosed APS & prescribed warfarin therapy.
I'm all confused & quite anxious.
A few weeks ago at my appointment with a surgeon who was going to do banding of hemmorhoids , he decided with advice from a haematologist that the risks outweighed the benefits, so he advised me not to have it done unless I had persistent heavy bleeding & this was a very minor procedure.
I'll keep you posted
love
Angied

 

[Maia]

You must make sure the person doing this procedure knows at least 10 days in advance about the meds you are on, especially the blood thinning medications. Many here have surgery when needed and they just need to modify their meds for a short while (possibly 10 days to 2 weeks) and have some extra precautions taken during recovery (for instance I worse those lovely leg air compressor stockings up to my upper things while in hospital for 1 day after surgery).

I might be inclined to ask if they can do the banding type procedure at the same time if that problem is bothersome to you. Take care of both problems all at once and only worry about going off the blood thinning meds one time that way as well.

Good luck with everything.

 

[Zoi]

Hi Angie,

Yes, St. Thomas or the rheumatologist in charge of your care should be contacted in order for them to give instructions regarding the warfarin. Sometimes warfarin is stopped a few days before surgical procedures and then something called bridging therapy is used (basically heparin shots for a couple of days) until the warfarin starts working again and your INR rises to therapeutic levels. However all that depends on how easily you clot and how fast when you come off your blood thinners. Most people have very little troubles with being off coumadin for a couple of days but some clot almost as soon as they come off their blood thinners (I'm in the latter category personally). Your doctor is the only person who can guide you in this case; you really do need to get in touch with your rheumatologist prior to surgery.

Of course the hospital staff where the pre-op assessment will take place need to be informed of what's going on with your warfarin too as they may need to monitor your INR before surgery and arrange for the bridging therapy immediately afterwards, but they will do this in accordance to your rheumy's instructions.

Here is a link to an article about patients on warfarin & surgery:

http://www.ccjm.org/content/70/11/973.full.pdf+html

Hope everything goes extra smoothly with your surgery

:flowery:

Zoi

 

[angieD]

Hope everyone is okay.
Thanks again for your help & advice
I followed the advice & my hubby phoned Dr D'Cruzs' secretary but she said the hospital doing the procedure would have to get in touch with them if they wanted info & advice. So my hubby left a message with the lupus nurse (St Thomas') she phoned back & said she will speak to Dr D'Cruz but he's away for a few days but she'll definately call me back.
My hubby also phoned my local rheumys' secretary last week but we didn't hear anything until today, my rheumy phoned at lunchtime.She didn't think there'd be anything to worry about as long as I tell the hospital at my pre assessment about medications & illnesses.
I don't think I'll be happy until I've heard from St Thomas' though.
Thanks again.
love Angied