Today I met with Dr.Gross and Lee Webb for the pre-op appointment and was surprised to learn they have changed their post op protocol and effective this week they were no longer requiring the self administered injection of anticoagulation drug. They gave me the choice of still having the injections,  but both Dr. Gross and Lee recommended not.  Instead I will take regular aspirin. Dr. Gross believes the side effects of the drugs outweigh their benefits in low risk patients and the AAOS has issued new guidelines to not administer the anticoagulation drugs.  He believes there will be less bleeding and less swelling.  I'll not miss having to stick myself in the stomach.  ;D

Dr. Gross cited a lot of medical research to support the change and explained how they had been forced into this practice by the chest surgeons.  I felt at first that I going to be a guinea pig for this change in protocol, but Dr. Gross explained there had already been some large medical trials on which the academy based this new recommendation.

Pat,

This might be good topic for your next interview with Dr. Gross.  He feels pretty strongly about this being better for his patients.


Alan/Denver

Soon to be Gross Hippy:  Biomet Magnum R 3/16/2009 & L 3/19/2009

LOL

And after I stuck myself in the belly for 10 days in August..... just my luck.   It made me feel manly anyhow.

Oh well.   ::)


Good luck this week.

Chuck

Chuck,

Lee and Dr. Gross said to tell you hello as well.

It will be interesting to compare my recovery experience with this change to previous Gross hippies.  Of course everything on these forums indicate that recoveries vary widely even with identical protocols, so my experience probably wouldn't be meaningful.

Alan/Denver
Soon to be Gross Hippy:  Biomet Magnum R 3/16/2009 & L 3/19/2009

Alan,

Thanks for telling them I said hi.  I hope your mind is more at ease since meeting them, many Dr. Gross patients come away from their pre-op appointment feeling good about their upcoming surgery.

I've been telling Pat that we should do a comparison chart on the differing doctor protocols it's very interesting to me to note how each doctor is so different.

Pat.....we have to do that, I think people would be interested.


Chuck

Chuck,

I also learned about the change in consuming food or liquid before surgery.  At the pre-op class, the instructor stated it took an additional year before the Hospital for Special Surgery allowed drinking of clear liquids after 12 AM the evening before surgery.  Other hospitals had already changed.  They did their own study.  So I was able to have my morning coffee before checking in at admissions at 10 AM for my surgery at 12:45 PM.  I had a half cup coffee in the waiting area and I wasn't suppose to have any.  I told the anesthesiologist about it and he said it wasn't a problem.  So this is a hospital protocol.

Dr. Su prescribes a daily dose of regular strength aspirin for blood thinning and other doctors use warfarin or coumadin.  My roommate at the hospital (semi private room), who received a knee replacement from a different surgeon and was prescribed coumadin, said coumadin was "rat poison" and he was right, the chemicals have been used for rat poisoning.  I'll vote for the regular strength aspirin.

I used arixtra self injected..... us Dr. Gross patients are tough   ;D

That is interesting how doctors are swinging towards aspirin.   My family doctor would not sign off on my surgery until I told him that Dr. Gross used anti-clotting drugs post-op, he was against me even leaving town for surgery.  It took me 20 minutes of convicing to talk him into it.


Chuck

Dr. Gross explained that many other surgeons currently only prescribe aspirin after surgery for blood clot prevention and before the chest surgeons issued their blanket recommendation that everyone should be medicate with the stronger drugs, Dr. Gross used to only use aspirin.  The strong  anti-coagulants have lots of negative side effects and he believes this change is low risk and will make for a better recovery.  He and Lee described that considerable research had gone into the Academy's recommendation to not use the stronger drugs.

He did give me my choice, but his and Lee's recommendation was to forgo the injections.  Everything in Dr. Gross's protocol is well thought out and since I have no domain experience in this area, I decided to go with his recommendation.

I am still under the restriction of nothing after midnight.  I was going to withdraw from caffeine a couple of weeks ago, but I didn't get it done, so will probably enjoy caffeine withdrawal head aches as part of my post op recovery.  Hopefully I won't be too nauseous to drink coffee or a coke after my surgery tomorrow.

Awww... Oh well, I would like to say like Chuck that the shots made me feel manly but I would be lying! There is something counter-intuitive about sticking yourself in the stomach with a needle.  I think the thought is more difficult than the stick.  My post-op only "issue" which was relatively minor was the major swelling... now I wonder if that had anything to do with the lovenox shots...  (combined with me not using the ice on the way home  ;D) 

Turns out I don't totally escape the shots in the stomach. The nurse gave me my first anti-coagulation shot in the stomach and I will have another one on Friday. 

I just won't be giving them tomyself after returning home.