N.B. although medical-related threads typically belong in IMHO, this is actually a request for factual information; hence, its placement in GQ. I will not strenuously object to a move to IMHO, if it is deemed necessary.
Last month kaylasmom underwent hip replacement surgery. As part of her discharge instructions, the orthopedic surgeon wrote that she was to discontinue her current anticoagulant, Plavix (clopidogrel) and switch to Xarelto (rivaroxaban). Okay, what the heck, I’m easygoing about following doctors’ recommendations. That said, the discharge paperwork didn’t make it clear that it was the ortho guy who made the switch, and I had presumed that it was a recommendation by her cardiologist (who did look in on kaylasmom during her hospitalization, both before and after the surgery).
So, we had an appointment with the cardiologist last week, and when I asked him about the switch, he said that the surgeon ordered it as standard practice for hip replacement patients. And that it was supposed to continue for two weeks, after which kaylasmom should resume taking Plavix. Which was something else the discharge instructions failed to mention. I’m pretty sure it’s not a big deal to take the Xarelto for more than two weeks, as long as it’s the ONLY anticoagulant she’s taking.
I can understand why a post-surgical arthroplasty patient be put on anticoagulants for a couple of weeks. My research has led me to understand that this recommendation is followed for ALL hip replacement patients, even the ones not currently taking a blood thinner. But my question is, why was it considered important that she be put on a different anticoagulant following surgery?
(I tried googling “Why do orthopedic surgeons recommend that heart patients switch their blood thinner to Xarelto for two weeks following hip replacement?” but I didn’t get a satisfactory response.)
Plavix is NOT an anticoagulant (nor a blood thinner). Xarelto is. I suspect the surgeon is working to prevent a deep vein thrombosis post operatively. Plavix helps keep artery stents from plugging up but does not prevent venous clot formation anywhere as well as an actual anticoagulant, such as coumadin, heparin, and xarelto do.
Short answer, no time to post more about antiplatelet agents vs blood thinners/anticoagulants
IANA doctor but if I remember the conversation with the docter the advantage of Xarelto over something like coumadin is that you can stop taking it and the effects quickly go away. So in the event you need more surgery it can be done quicker.
Thank you, that’s very informative, and suggests to me that I need to ask kaylasmom’s cardiologist some more in-depth questions than I have been.
See, when she had her angiogram in 2016, the findings were that her arteries were too narrowed for balloon angioplasty to be successful. Also that she didn’t have enough “clean” spots on her coronary arteries for bypass surgery to be successful. So the recommended course of action was going to be to monitor and control her hypertension, and medicate her to make blood flow through her arteries as easy as possible. The medications for this were going to be Plavix and isosorbide mononitrate (along with her four other antihypertensives – since trimmed back to only carvedilol).
I just made an assumption that the Plavix was a blood thinner (which was supported by the fact that she is bruising far more easily than ever before, which I have been given to understand is a side effect of taking a blood thinner).