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Blood thinning injections or pills after in USA?

Posted , 17 users are following.

debbi1949
debbi1949

I'm in USA and was assuming I would be taking cumaden or some such blood thinner in pill form after hip replace next month. I read some of you are injecting yourself for a couple of weeks. Is that in UK only or USA too? I have a needle phobia! Thx

1 like, 46 replies

46 Replies

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  • renee01952
    renee01952 debbi1949

    Posted

    hi debbi,  

    wow - see, so many different approaches -

    I live in Holland and had 2 THR surgeries - both times I had to self inject blood thinning stuff for 6 weeks - still feel bruised on the inside of ample belly ...

    I asked my surgeon if I could get tables and he said no .... 

    I think I agree with the preference of the surgeon, no matter where you live - 

    looking back it was not that bad, but I would be lying if I told you it was "nothing"-

    let's say it is doable and one feels victorious afterwards ...

    big warm hug

    renee

  • Tech78
    Tech78 debbi1949

    Posted

    I think in the UK it comes down to cost, it is cheaper for the NHS to give people the injections however you do have a choice. I refused the needles and they had to give me the tablets. Now I know there is an alternative I request them at every pre-op appointment.
    • HollyHop9
      HollyHop9 Tech78

      Posted

      I would be very surprised if injectible anticoagulents were chosen on the basis of cost, they are very expensive! 
    • bini31328
      bini31328 HollyHop9

      Posted

      Hi Holly

      Did some reading around this yesterday as was interested -cost of - low molecular weight heparin like tinzaparin us approx £1.98 per syringe so a 28 day course is £55.44 - cost of a NOAC like Rivaroxaban for same period is about £58 so not much in it . NOACs work out cheaper for long term therapy ie 6 months to a year. There aren't any major studies looking at cost effectiveness in post op prophylaxis treatment by each - and TBH I doubt most orthopaedic surgeons know or care - they tend in the NHS ( in my experience ) to insist on what they believe is best for their patients . Each NHS trust has a pharmaceutical formulary which lists which drugs can be used in which circumstances - this maintains cost effectiveness and balance in prescribing and is based on NICE guidelines etc

  • gwen81475
    gwen81475 debbi1949

    Posted

    Hi Debbie,

    I'm in France so a bit different here. A nurse comes to the house and gives the blood thinning injection twice a day, at least 8 hours apart, for 2 weeks. Our an opt to have them in the stomach or thigh. I had one in the thigh once and found it extremely

    painful, so now go for the stomach option. True out do get little bruises appear,but they soon go. I don't think I would like to self inject though!

    • renee01952
      renee01952 gwen81475

      Posted

      interesting Gwen ... twice a day ? I could not have done this - once a day for 6 weeks was hard enough ... 

      at first I had a home health nurse come to give me the injection - I was her last patient on her route - then I felt silly  and did it myself eek

      - 

       

    • gwen81475
      gwen81475 renee01952

      Posted

      Hello Renee,

      I usually take a pill form anticoagulant called Previscan but had to stop this so many days before the op (to reduce the possibility of haemorrhage) and then I was given the Lovenox injections and after that weaned back onto Previscan.

      Maybe they had to act faster than usual because my heart is not working properly, and there is a greater risk of clots forming.

      Gwen xx

    • debbi1949
      debbi1949 gwen81475

      Posted

      it's so Interesting how different countries approach this surgery. Thanks so much
    • bini31328
      bini31328 renee01952

      Posted

      I know what you mean - I hated doing them - luckily my very kind other half offered to do them for me and my daughter ( also a nurse) did them when she was staying . Twice a day would have been horrendous! Was just reading up on it all and Rivaroxaban seems to be considered the best choice of NOAC , as proven to be the most effective in reducing DVT/ PE etc post op - although interestingly there,s also quite a lot about obese ( which many hip patients are due to reduced mobility etc) patients not being given the correct ie a big enough dose for their weight of many anti thrombotic agents , injections or tablets. Also the risk of GI bleeds with oral NOACs - Just goes to show how complex the decision making is around what anti thrombosis treatment to use! Am sure cost effectiveness does also come into it as well - certainly within the NHS treatment pathway - as it should do as its our National Insurance payments that are being spent ! Hope you are doing OK Renee ? Xxx
  • Soos2016
    Soos2016 debbi1949

    Posted

    What a variety of replies, Debbi! My son is the hippy & all I remember is baby aspirin for 6 weeks. Best to you on your upcoming procedure.
    • linda38528
      linda38528 debbi1949

      Posted

      We are constantly staggered by the variations a crosses practices and countries. But, some of these also relate to characteristics of the patients too.

      Have you been for a pre-op orientation or assessment yet? Worth asking about our surgeon's usual practice, esp as time with your surgeon is often brief or when you are groggy.

      Best of luck with your operation and recovery.

      L

  • lorna69887
    lorna69887 debbi1949

    Posted

    Hi Debbi I'm on wk 4 after surgery, THR I've had the surgical stockings on since surgery I believe I've another 2 was to wear them! ( hubby has removed/washed/put back on within 2hours)!! On me that is hahaa!! I've had to do injections for the last 4wks again I've 2 was left I also had a finial in fact I was terrified!!! BUT the nurse in the hospital showed me how to do it & I promise you can do it !!! It's a small needle you just need to pinch a good bit of fat and as you do this you won't even feel the needle go in, I couldn't believe it!! Then let go as you remove needle, you'll amaze yourself.!! Good luck with Op & recovery xx 
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