Heparin

[nogutsnoglory]

Do you guys accept those booties and heparin in the hospital to prevent blood clots?

I cannot sleep with those damn things on my legs and hate being injected 3 times a day with heparin.

I know it's critical if we aren't walking but if we walk a bit how necessary are they?

 

[M West]

I refuse both.

Will only take heparin if I cannot get out of the bed.

Socks? Never.

Miles

 

[nogutsnoglory]

The booties are worse than the shot! I guess it's just scary because with IBD we are at increased risk for blood clots and combining that with a hospital stay we are all at risk.

 

[PsychoJane]

While I was hospitalized, the only occasions where they would put the inflatable leg cuffs and heparin were post surgery.

 

[vonfunk]

I've had blood clots in the past (both calves at the same time). I always accept the heparin, in fact quite often I will do the injection myself (nurses tend to just *** as opposed to pinching the fat and injecting, it just hurts less when I do it).

Always take the heparin, because of IBD we should never take warfarin (coumadin) as it can trigger GI bleeding (far worse than NSAIDs). Should you get blood clots your only real option for treatment is self administered heparin. Which in Canada (without insurance) is roughly $30-40 an injection (1 per day) for 3 months. I assume the US would be more expensive.

 

[nogutsnoglory]

So the treatment is heparin. So why not just not take the shot and it it happens use the heparin at the first sign? I guess I just don't like to take anything unnecessarily.

 

[vonfunk]

It's a prophylactic, like post-surgery anti-biotics.

It's not like loading up on vitamin C when you start catching the sniffles, you don't slightly get blood clots. Once they pop up it's the full treatment for at least 3 months.

The cost of heparin (w/o insurance) for treatment of blood clots is a minimum of around $2700 in Canada (assumed to be more in the US). My view is of someone who has had clots that developed during a period of inflammation, would much rather take the shot in the hospital than have myself go through it ever again.

 

[nogutsnoglory]

I see, thanks for clarifying vonfunk I didn't realize it's a mess once it starts.

 

[DustyKat]

Matt has had 3 admissions which resulted in varying levels of immobility (he hates the TED stockings too):

First admission was TED’s only until pretty much walking for everything, including ambulation about every 1-2 hours whilst awake.

Second admission - Clexane injections twice daily, no TED’s. This was a different hospital and the colorectal ward, so predominately surgical. It was stock standard but by the 4th week I had to insist they stop the injections because I had Matt off the ward every day for most of the day and we were walking copious amounts, his flare was under control and his INR was fine.

Third admission - Surgery, so TED’s and Clexane for basically the length of the admission, 8 days.

As von has said ngng, they are a necessary evil. If you are able to walk sufficient amounts then you should be able to negotiate the TED’s but accept the Clexane. A DVT (Deep Vein Thrombosis) is bad enough, and yes it does require ongoing treatment, but also the last thing you want is for that clot to mobilise and lodge in your lungs. That is a pulmonary embolus and they are life threatening.

Heparin is IV
Clexane is SC
Warfarin is oral

Dusty. xxx

 

[nogutsnoglory]

Thanks Dusty. Wow so even the shots with being a marathon hospital walker? How much walking is enough to get by without the leg "massager"?

 

[DustyKat]

I negotiated with Matt and the hospital staff and we settled on 10 minutes about very hour. Impossible to stick with it strictly so use common sense. Like if Matt was asleep in the middle of the afternoon I wasn’t going to wake him so just did a bit extra when he did wake up.

TBH I think unless you are bed ridden or your mobility is severely restricted then doing the TED’s with the Clexane is a tad overkill and seeing Matt hated the stockings it kept him happy to have them off and the staff happy to see him mobilising.

If you are in hospital because your Crohn’s is flaring then it makes sense to have the Clexane.

Dusty.

 

[vonfunk]

The usage of the socks varies by place. I've never been given them to wear regardless of the length of stay. My first stay was close to month, and I've had countless week long stays. Generally, I've been given heparin usually starting the 2nd or 3rd day (unless surgery related).

 

[Lisa]

I've never had either, but also no surgeries due to crohns.....

Something I have noticed over the past few years it that I will apparently "blow" a vein, usually in my calf- and end up with a big, sore bruise....just had one apart on my arm a couple days ago actually....

Anyway, even with my c-section there were no socks or other drugs....

 

[nogutsnoglory]

I never had socks but I get these booties that inflate and deflate to keep the circulation going. It's like those floaties kids wear in the pool except it's for the legs and hard to move or sleep in.

 

[DustyKat]

Whoa, I don’t see the point of those unless under very specific circumstances, like when in theatre or for some other acute conditions, but not for a ward admission. Seems extreme to me or is there something you aren’t telling us ngng?! :lol:

Dusty. xxx

 

[Jennifer]

I've never had to wear the leg massagers even with hospital stays for over 2 months but that was decades ago and I was able to move around. After my resection I stayed in the hospital for two weeks total and still didn't have to wear them even though I moved around a lot less yet again this was over a decade ago. I'm sure the standard procedure is a lot different now days. I didn't have heparin for either stay. The only time I've received heparin daily was when I had a central IV/Port which was injected into the port only.

If I weren't moving around much at all then I would use both even though the leg massagers are unpleasant because they get so hot and uncomfortable. Use that as motivation to get up and move around if you can.

 

[nogutsnoglory]

It must be standard here because every hospital I have stayed at has them and they are really strict about it post-op until I have the energy to yank them off and they see me walk enough. They really suck lol!

I also never received heparin by IV. I'd prefer that to being injected several times a day!

 

[M West]

Examine your hospital bill and the reason for heparin as standard practice becomes obvious.

Just saying.

Miles

 

[vonfunk]

If the reason behind heparin was to solely squeeze money out of a patient it would not be administered in countries with universal healthcare.

 

[nogutsnoglory]

Yeah I don't agree with that Miles. I think it's overdone to protect the hospital from liability issues but basically it's a known problem due to sedentary patients.

There are plenty of ways hospitals are charging crazy amounts for gauze pads and everything under the sun but I dont think this is one of those tricks. Like von said it's not only the evil capitalist health system but also in socialist nations.