What can I do while I am on warfarin to prevent bleeding?
You can do several things to help prevent yourself from having problems while taking warfarin. These include the following:
Regular Blood Tests
Have your blood checked as ordered by your health care provider.
Stay in Touch with your Provider
Tell the health care provider that is helping you with your warfarin about any changes in your health, medicines, or diet.
You are more likely to bleed when you are on warfarin. A minor injury, such as a little bump or bruise, could cause you to bleed. To avoid this, take actions to help prevent falls and trauma. If you have to go to the emergency room, tell the emergency room staff that you are on warfarin.
You can do things to prevent yourself from falling. Check your house and workplace for fall hazards. The following are things you can do to reduce your chance of falling.
Tack down or remove loose rugs. Rugs can slide and cause you to fall.
Clean up clutter, especially clutter on floors.
Remove anything that you could trip over. This includes things like furniture in major walkways.
Make sure your home and workplace have good lighting so you can see any hazards.
Prevent falls in the bathroom. Install handles by the tub. Use non-skid bath mats.
Check for sharp edges in your home or workplace. Remove or cover them where you can.
Use a walker or cane if you feel you are unsteady when you walk.
Use extra caution in rain, ice, or snow. Walk on paths where the ice has been removed.
Prevent Accidents and Injury
Take precautions to prevent injury from accidents.
Wear seat belts.
Wear a helmet when riding a motorcycle, skiing, or doing other activities when a helmet would prevent injury.
When doing sports (such as skiing), stay within your abilities. Do not take unnecessary chances.
Stay away from any activity that may cause serious injury. This includes action sports or sports with a lot of physical contact. Any activities where you may fall or be tackled could cause bleeding problems.
How can I prevent clots?
One thing you can do is wear compression stockings. Compression stockings or T.E.D.® hose are tight stockings that keep pressure on your legs and help prevent blood clots and their complications. Being less active or having surgery raises your chance of getting a clot. Ask your health care provider if you should wear compression stockings. Compression stockings come in knee-high and thigh-high lengths. Ask your doctor which is right for you. Wear compression stockings:
For six to eight weeks after surgery and remove only for bathing
After a blood clot
When you are up and walking around, or if you have swelling
You can get compression stockings at your local medical supply store. They are usually not available at your local pharmacy. You may want to get at least two pairs.
You can get compression stockings with or without a prescription. If you have a prescription from your health care provider, your insurance may pay for them. If you want to buy compression stockings, they will cost around $35 for one pair. You need to get compression stockings that provide 30-40 millimeters of mercury pressure (label may also say 30-40 mm Hg). Read the label carefully or ask for help.
To put compression stockings on, bunch or roll them and slide your toes in. Gradually pull the stocking up, making sure that they are as smooth as possible. If any areas are bunched up, the stockings may cut off blood flow to your feet.
If you do not wear your compression stockings, or do not wear them the right way, you may develop a blood clot in your leg that could be harmful.
What if I need to have a procedure or surgery while I am taking warfarin?
Be sure to tell the health care provider managing your warfarin of any planned dental work, medical procedure, or surgery as soon as it is scheduled.
Be sure to tell the health care provider doing your procedure or surgery that you are taking warfarin. Contact your health care provider who takes care of your warfarin and tell them if another doctor has asked you to change your warfarin for a procedure.
You do not need to stop warfarin for most dental work. However, major dental work may cause bleeding problems. Check with your dentist and health care provider before making any changes to your warfarin.
For some medical procedures or surgeries, you may be asked to skip warfarin doses. Examples include biopsy, endoscopy, or colonoscopy. Always tell the health care provider managing your warfarin if you are being asked to skip or change your warfarin doses. Make a note in your log.
For major procedures or surgeries, you may be asked to stop warfarin before and after the procedure or surgery. While you are not taking warfarin, your health care provider may give you a different medicine to protect you against blood clots before and right after your surgery or procedure. This is called “bridging.” Bridging is often needed for procedures because warfarin lasts a long time in the body and can increase the risk of bleeding during a procedure. Medicines used for bridging act quickly and do not last as long as warfarin. This makes them safer to use during the time just before and after your surgery or procedure. Medicine used for bridging is usually given as a shot one or two times a day. Some patients may need “bridging” for a few days before and after the procedure.
Common medicines used for “bridging” are enoxaparin (Lovenox®) or heparin. Warfarin will be started again after your procedure. You will keep using the shots until your INR blood test is back in your goal range. This means you will be taking both medicines for a few days.