Discrepancies before Surgery

Hi - Heidi here - David is getting conflicting doctor's orders as to how to handle his meds before surgery - which is coming up in just 4 days. He's been making a lot of phone calls to his cardiologist's office, to his surgeon's office, to his primary care doctor's office and to the coumadin clinic as to when to get off coumadin and whether or not to replace it with a shorter-acting anticoagulant (like Lovenox or Heparin) in these next few days.

As non-medical personel we don't know exactly the significance of making one choice over the other (although we do know he's on coumadin to keep him from having another stroke but also that his blood levels need to change before surgery). Right now David is in the position of having to decide for himself which doctor's advice to follow.

We'd been told for months now that 5 days before surgery he would need to stop the Coumadin and replace it with self-administered shots of Lovenox. This is what the coumadin clinic and his primary care doctor maintain he needs to do, but his cardiologist and cardiac surgeon have told him just to stop the coumadin 3 or 4 days before surgery and not replace it with anything. Of course, the specialists should know best, but not only does it conflict with what his primary care doctor is ordering and the coumadin clinic is stating, but it is also conflicing with what we'd been told for months.

Maybe there is not a significant difference. We are not trained in this area and thus don't know how big a deal this is. It would be helpful to us, however, to have David's doctors on the same page so that we have a clear direction FROM THEM rather than being left in a spot to have to make a decision about something that seems to us to be significant.

(And you know how those calls can go to doctors: you call, you get the nurse, the nurse talks to the doctor, at some point later you get a call back from the nurse, if you are not in they leave a message asking you to call back but leaving no information (HIPPA, you know), so you have to return the call, usually end up leaving a message again, etc., and he's got multiple calls like this that he's making, and he's making them from work. This is Friday. Surgery's Tuesday. He really needs to know what to do TODAY one way or the other.)