Betty's Journal

Mark Wilbur  Good question. I would call your doctor to be sure of the facts as they pertain to you. Here's a link to an informative article on the subject of bridging that may help answer, at least, some of your question: http://www.zunis.org/Afib_Med_Rx/Lovenox%20Bridging%20Needs%20Paper.pdf
You will be in good hands at Cleveland Clinic. Best wishes to you.

  I think it depends on the what your doctors do and your individual medical history.
I take warfarin which I started a year ago because of AFib. (The newer anticoagulants are not FDA approved for valve disease b/c of rheumatic heart disease, so warfarin it is.)
I was told to stop warfarin 6 days before surgery; and days 3, 4 and 5 before surgery, I had to inject an anticoagulant (fragmin) in to my tummy. The day before and the day of surgery, I didn't have anything.
It sounds like you're bridging will be managed in the hospital and will be specific to you. It may be through IV. I had that type of bridging when a pacemaker needed to be inserted 4 weeks post OHS.
You are in good hands Betty.

Wanda Mroz  I was bridged with heparin after surgery prior to being on warfarin. It was administered through IV and blood tests done. When I came home I had to do Lovenox shots to get to the proper INR as well.

Betty Atwater  Mark, thanks for sharing the link to the informative article from the Cleveland Clinic Journal of Medicine. Although it was published in 2003, it still had some very helpful information about bridging therapy. Janet and Wanda, you provided a helpful clue that heparin may be administered via IV if one is in the hospital, whereas self-injections may be required when out of the hospital. (I’d definitely rather have it via IV than by injection!!) Of course I’m OK with whatever the procedure requires. I was just curious about details of the pre-surgery experience of others having heparin bridging.
I’m sending a special wish of good luck to both of you (Janet and Wanda) in getting your heart rate/rhythm under control.

Rita Savelis  Heparin is administered through an IV. There are very regular blood tests to make sure the dose is correct and it may be adjusted off and on. After surgery you will go back on your oral anticoagulant but stay on the IV until your INR is back where they want it. So usually it means a few days before surgery and a few days after.
I had to stay in hospital longer on a heparin bridge because my body took a longer time to readjust after surgery.

I spent a few days in hospital just sitting around (with my IV) before my last surgery (a breast biopsy) and then just sitting around for days afterwards.

You can not inject heparin but there are other drugs that you can inject (or someone can do it for you in your stomach or thigh) if the hospital lets you out before your INR is fine.
Take care.

Wanda Mroz  Betty I was on a heparin drip for about four days but when I was discharged my INR was not yet at 2-3 so I was given Lovenox to inject myself with for a few days. It iwas not easy for me and I found that injecting myself was hard... not painful but I had to get over sticking myself with a needle. The needles are very short and fine. I got thru them though and was able to stop when I reached an INR of 1.9 and the oral coagulants did the rest! Overall this was small compared to the rest that I got thru and is doable if it comes to that. The whole thing is doable and was not nearly as bad as I had imagined. You’ll get thru it all with flying colors. 🙏🏻💞