The Clot Catchers
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Sometimes no choice. When anticoagulants are contraindicated. But I agree they can be problematic.
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Is Coumadin pretty much out nowadays with things like Plavix and Eliquis?
“Cry havoc and let slip the DOGE of war!”
Those who cheered as J-6 American prisoners were locked in solitary for 18 months without trial, now suddenly fight tooth and nail for foreign terrorists’ "due process". — Buck Sexton
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Sometimes no choice. When anticoagulants are contraindicated. But I agree they can be problematic.
@bachophile said in The Clot Catchers:
Sometimes no choice. When anticoagulants are contraindicated. But I agree they can be problematic.
Exactly. There are lots of reasons to avoid anticoagulants, and if you have a history of DVT, or PE, there's no alternative.
Sometimes the enemy of "bad" is "less bad."
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@Jolly said in The Clot Catchers:
Is Coumadin pretty much out nowadays with things like Plavix and Eliquis?
Coumadin is a nightmare from a management POV. It takes forever to get the right dose, and then requires frequent maintenance.
And then, if you alter you diet, you fuck everything up.
OTOH, drugs like Elequis and its type (of which Plavix is not) are a nightmare if you need urgent surgery. THere's no reversing the stuff, so, as @bachophile can attest, no doubt, there's lots of bleeding.
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@Jolly said in The Clot Catchers:
Is Coumadin pretty much out nowadays with things like Plavix and Eliquis?
Coumadin is a nightmare from a management POV. It takes forever to get the right dose, and then requires frequent maintenance.
And then, if you alter you diet, you fuck everything up.
OTOH, drugs like Elequis and its type (of which Plavix is not) are a nightmare if you need urgent surgery. THere's no reversing the stuff, so, as @bachophile can attest, no doubt, there's lots of bleeding.
@George-K now there is beriplex for reversal of eliquis. But it’s still a PITA.
Retrievable filters make a big difference because the previous ones were permanent and were paradoxically thrombogenic themselves to some degree.
In general, blood thinners are a surgical nightmare but obviously beneficial in cardiac indications.
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@George-K now there is beriplex for reversal of eliquis. But it’s still a PITA.
Retrievable filters make a big difference because the previous ones were permanent and were paradoxically thrombogenic themselves to some degree.
In general, blood thinners are a surgical nightmare but obviously beneficial in cardiac indications.
@bachophile said in The Clot Catchers:
beriplex for reversal of eliquis
That was approved in 2013 - a couple of years before I retired. When I went part-time in 2015, I didn't see many patients on elequis (because I ended up - by choice, I might add - the simpler, smaller cases).
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Speaking of Coumadin...
We had the most success with a Coumadin Clinic. We didn't use the ACT POCT test because of cost and accuracy.
The clinic was ran by a pharmacist, adjusting dosages to reflect what the infernal med guys wanted. I'd skip his guys to the head of the phlebotomy line, so we could keep the clinic moving.
We normally did about four patients/hr, sometimes more. Total clinic numbers for the day were 30-40.
There were some patients that I don't know if we ever got right.
