After a stroke, my father is on Coumadin. He needs surgery now - is there another way?

1 answer | Last updated: Oct 08, 2016
Kevin45 asked...

My 85 year old father who lives with me has mostly recovered from an ischemic stroke 3 years ago. Atrial Fibrillation was deemed the cause. He takes Coumadin for the Afib.

His hearing is terrible. I took him to get new hearing aids and after a lengthy exam the doctor said they would do no good. He did say my dad would be a good candidate for Cochlear Implants. My concern is going off Coumadin for even a short time for the surgery. I'm guessing that there was only one month between the onset of Afib and his stroke.

Is there a safe way to have the simple surgery, maybe heparin or some other drug as a bridge?

Expert Answers

James Castle, M.D. is a neurologist at NorthShore University HealthSystem (affiliated with The University of Chicago) and an expert on strokes.

The best way I know of to cover a patient coming off Coumadin for surgery is for them to switch to Lovenox shots twice a day for the days preceding the surgery, then hold one or two shots of the Lovenox just before the surgery, and then restart the Lovenox just after surgery. The Lovenox can be stopped once Coumadin is back in the system. Lovenox is an injectable medicine similar to Coumadin.

It is a bit tricky to do this, but with the help of your Primary Care Doctor can often be accomplished smoothly. It will still leave your father with a short window of time during which he will be without medication, but that small risk it is probably worth it if it can restore his hearing.