Re: TKR Surgery. Not as bad as I thought.

patticakes · ‎03-10-2010

To Ditzydori-First of all, thanks so much for your post. It's great to hear you are doing so well and sounds like your experience was a very positive one.

I, too, am probably going to have to have TKR in the very near future and I'd love to know about the preliminary process and well as the actual experience. What do you have to do preparing to have the surgery, such as clothing, living arrangements, medical testing leading up to the surgery, etc.? Also, what about the surgery itself? My doctor says that they inject some kind of a pain med that reduces the initial pain and what about afterwards? What are the usual pain meds? I know it's important to take them and many have said especially before physical therapy. I'm concerned because I don't always respond well to pain meds. I'd appreciate any and all responces--just no horror stories or negative experiences, please. I've already heard enough of those and they really don't help someone that's in the position of having to undergo this surgery.

Thanks, again, Ditzdori, for this thread and wishing you continued success in your healing!

hckynut · ‎03-10-2010

@mustang66lady wrote:

@hckynut wrote:
I am not questioning the doctor, it just seems strange to me, to mix both Coumadin and Celebrex when both thin the blood, which is the soul purpose of Coumadin/Warfarin.

hckynut(john)
@hckynut

Hi john,
The best attempt I can explain this, is my guess that Gream's DH was given Celebrex to take on a scheduled basis, such as once daily. While non-steroidal anti-inflammitories such as Celebrex, Advil, Orudis, Aleve, etc. do in fact thin blood, they do not do it as easily as aspirin or Coumadin. The Celebrex would be given as part of inflammation/pain control for a period of time after surgery. As long as the medicine is taken as prescribed-i.e. no missed doses, when the PT/INR is drawn, that would factor in the dose of Coumadin prescribed, probably resulting in a lower dose of Coumadin because of the blood thinning quality of the Celebrex. If doses of Celebrex are missed, it would have a negative effect on the PT/INR causing it to bounce all over the place, thus resulting in frequent adjustments of the Coumadin.

Again, this is just my general assessment of the situation, not knowing the patient or doctor prescribing. Hope this helps.

Hi back at ya @mustang66lady,

Thanks for you reply. Coumadin/Warfarin I am more familiar with then I ever wanted to be. Spent over 7 years taking it, plus a few years of Plavix after heart attack #2. Took Celebrex for my arthritic ridden body until my 1st heart attack. I knew about Vioxx and was no way I was going to knowingly put my heart through any extra risk factors.

Over those 7+ years of Coumadin/Warfarin, I drove to the hospital for full blood draws no less than 3 times every week. Many weeks I drove there all 7 days. Blood draw/INR sent to my Pulmonologist/ he called after each draw to tell me what dosage for that night. Much change? Back the next day for another.

Too many times I also had to shoot myself with Lovonox, as a just in case INR went up too high, or to going too low. Probably at least 200+ injections, and boy that stuff does bad things to an abdomen.

Was on the Coumadin because I had PE twice before either heart attack. Nixed the Celebrex once I had the heart attack in 2003, and take no NSAID/or narcotic Opioid meds, just the Tylenol meds. Do take a daily 81mg aspirin for my heart issues.

Fortunately all my joints, except my spinal column are in good shape. Had L-3/L-5 and S-1 ruptured and removed. Some bad arthritic days, but ain't no way I am going through anymore blood transfusions and Iron Infusions than absolutely necessary.

Rather deal with the pain than those risks. If I someday need a joint replacement, will have to deal with it without the Coumadin or Anti-inflammatory meds. May have to go the Lovonox route again. No Coumadin or those, what I see as dangerous new thinners on the market.

Thanks again for your reply,

hckynut(john)

mustang66lady · ‎03-10-2010

@hckynut wrote:
@mustang66lady wrote:

@hckynut wrote:
I am not questioning the doctor, it just seems strange to me, to mix both Coumadin and Celebrex when both thin the blood, which is the soul purpose of Coumadin/Warfarin.

hckynut(john)
@hckynut

Hi john,
The best attempt I can explain this, is my guess that Gream's DH was given Celebrex to take on a scheduled basis, such as once daily. While non-steroidal anti-inflammitories such as Celebrex, Advil, Orudis, Aleve, etc. do in fact thin blood, they do not do it as easily as aspirin or Coumadin. The Celebrex would be given as part of inflammation/pain control for a period of time after surgery. As long as the medicine is taken as prescribed-i.e. no missed doses, when the PT/INR is drawn, that would factor in the dose of Coumadin prescribed, probably resulting in a lower dose of Coumadin because of the blood thinning quality of the Celebrex. If doses of Celebrex are missed, it would have a negative effect on the PT/INR causing it to bounce all over the place, thus resulting in frequent adjustments of the Coumadin.

Again, this is just my general assessment of the situation, not knowing the patient or doctor prescribing. Hope this helps.

Hi back at ya @mustang66lady,

Thanks for you reply. Coumadin/Warfarin I am more familiar with then I ever wanted to be. Spent over 7 years taking it, plus a few years of Plavix after heart attack #2. Took Celebrex for my arthritic ridden body until my 1st heart attack. I knew about Vioxx and was no way I was going to knowingly put my heart through any extra risk factors.

Over those 7+ years of Coumadin/Warfarin, I drove to the hospital for full blood draws no less than 3 times every week. Many weeks I drove there all 7 days. Blood draw/INR sent to my Pulmonologist/ he called after each draw to tell me what dosage for that night. Much change? Back the next day for another.

Too many times I also had to shoot myself with Lovonox, as a just in case INR went up too high, or to going too low. Probably at least 200+ injections, and boy that stuff does bad things to an abdomen.

Was on the Coumadin because I had PE twice before either heart attack. Nixed the Celebrex once I had the heart attack in 2003, and take no NSAID/or narcotic Opioid meds, just the Tylenol meds. Do take a daily 81mg aspirin for my heart issues.

Fortunately all my joints, except my spinal column are in good shape. Had L-3/L-5 and S-1 ruptured and removed. Some bad arthritic days, but ain't no way I am going through anymore blood transfusions and Iron Infusions than absolutely necessary.

Rather deal with the pain than those risks. If I someday need a joint replacement, will have to deal with it without the Coumadin or Anti-inflammatory meds. May have to go the Lovonox route again. No Coumadin or those, what I see as dangerous new thinners on the market.

Thanks again for your reply,

hckynut(john)

@hckynut

You sure have been thru the wringer and back! I can understand your resistance to taking certain medicines together. Hope you are much healthier now or at least on that road.

hckynut · ‎03-10-2010

To the person that just started their thread on Total Knee Replacement. This might interest you, lots of info.

hckynut(john)

twinkies · ‎03-11-2010

I was on Celebrex for a while years back . I stopped taking it because of a rapid heart rate and arrtymia , In the year 2005 Celebrex received a' black box' warning because it was causing heart attacks and strokes. It should have been taken off the market , if you experience any chest pain or fast or irregular heart rythum or stroke symptoms call your doctor right away , I do not understand why they think its safe to give people now.The same with vioxx.

cathy from ma