Inferior Vena Cava filter presurgery?!

[Readyforchange]

Hi, everyone! I'm scheduled for my DS with Dr Smith on the 17th and have my pre-op tomorrow (Weds, 9th). I was told this afternoon that I need to have an IVC filter inserted before the surgery. Either that or I will need to have meet with a hemotologist and have a work up to confirm no genetic predilection to blood clots, which wI'll postone the surge --something I can't do due to work. I did have blood clots in the legs in 2010 that migrated to the lungs, but that was cleared and I was off blood thinners in 6 mos. I haven't had a recurrence since. Based on research on IVCFS. They are "relatively" indicated for bariatric surgeries if the BMI is above 55 (I'm close, but not quite there) and/or had a history of clots. But the research also indicates great disagreement regarding the costs/benefits of inserting an ICVF and the complications seem to outweigh the benefits. I've had 2 much lengthier surgeries (8 hrs each) with longer hospital stays and recuperation times since the blood clots with no problems and no discussion of using an IVCF.

So my question is, has anyone here run into this issue and can shed any light on it? I plan on a lengthy discussion with surgeon tomorrow about this and plead to not have to go through it, but it would certainly help to have some personal experience to consider instead of the impersonal medical studies I found on the Internet. I tried searching IVC and related terms without finding anything.

Thanks for any insight you can provide!

 

[hilary1617]

I had a sordid history of Deep Vein Thrombosis (DVT) and Pulmonary Emboli (PE), so prior to DS I had an Inferior Vena Cava ("Greenfield") Filter inserted. They took me to radiology, sedated me a bit and went in through neck. It came out about a couple of months after the DS.

I later learned the reason for my DVT/PE incidents (which at the time of DS was a great mystery) and am very grateful to have had the filter.

Edited to add: One of my prior DVT/PE incidents followed an abdominal surgery (panniculectomy and hernia repair). By the time I returned to hospital with the DVT, both of my legs were entirely clotted thighs to toes and the PE were manifold - the radiologist labelled them as "multiple filling defects". They couldn't give me clot-busters because they were worried about a bleed from my surgical wounds so they sedated me and told me not to move. They asked me to fly in my family on the next flight presumably to say goodbye as there was a 48 hour window where they thought catastrophic failure was likely. Took me a month in the hospital to recover. I had a history of DVT prior to that surgery and the nightmare could have been entirely avoided with a filter.

 

[aaa]

I know of a man who had a very high BMI who had it done when he had his DS.

 

[DSRIGGS]

When Cameron was in the Children's Hospital of Illinois in a St Jude bed getting chemo, had a clot form on his central line that was in his Superior Vena Cava and that turned into a PE after a chunk broke off and flowed through his heart into his lung. He was in very bad shape and spent the week in PICU getting TPA. Fun times.

 

[Readyforchange]

Wow! Thanks for all your information! I certainly don't want to go through anything like that. My issue was not understanding the risks associated with bariatric surgery. My other 2 surgeries were spinal and I had no problems with them. I guess it didn't help that it came up the way it did. Thanks for sharing your knowledge and experience. I feel better prepared to address the issue this morning!

 

[DSRIGGS]

Wow! Thanks for all your information! I certainly don't want to go through anything like that. My issue was not understanding the risks associated with bariatric surgery. My other 2 surgeries were spinal and I had no problems with them. I guess it didn't help that it came up the way it did. Thanks for sharing your knowledge and experience. I feel better prepared to address the issue this morning!

It is the risk of any general surgery (anesthesia) and the DS can take 3 or 4 hours for a virgin and up to 10 on a revision, so the duration and BMI raises questions. It is one of those better safe than sorry scenarios from what I understand........



....and I just reread your post. With your history this is a no brained.

Good luck with your surgery. We will be waiting for you over here on the losers bench.

 

[Readyforchange]

It is the risk of any general surgery (anesthesia) and the DS can take 3 or 4 hours for a virgin and up to 10 on a revision, so the duration and BMI raises questions. It is one of those better safe than sorry scenarios from what I understand........



....and I just reread your post. With your history this is a no brained.

Good luck with your surgery. We will be waiting for you over here on the losers bench.

Thanks, Diana and everyone. After much discussion today with Dr Smith, he explained that the difference between the longer spinal surgeries and the bariatric involves the inflation of the stomach and pressure placed on the vein that slows blood flow and can cause clotting during the surgery or later. This is why he views it as a higher risk, esp with my history. So as you said -- it's a no brainer. He is very nice and took a lot of time to work with me on some additional requirements he wants in addition to answering several questions his staff couldn't. That said, the staff was great, too, and went the extra mile to put things in place to meet the extra requirements. So things are still set for next Thurs.

I am so grateful to have found you all. I feel so much better prepared because of information and resources shared here. The PA complimented me on my questions and knowledge --and a lot of that goes to you!

 

[Elizabeth N.]

Yup, I got one a few days before my DS and elected to keep it. I consider it to be a form of life insurance. I don't take any blood thinners with it, but get my PTT/INR tested every time I get blood drawn to make sure they stay fairly low. If that ever changes, I'll revisit the issue of blood thinners.

 

[Readyforchange]

Got my IVC filter put in yesterday and the go-ahead for the DS on Thursday, so it's soon to be. The IVC procedure was very simple-had a great doc. The pain at the insertion point seems more painful than what I remember the heart cath being. Stillnot bad though. I wish the surgery were tomorrow. ...

Thanks, everyone for the support!

 

[Clematis]

You're on your way! Good for you.

 

[duh_Mom]

just reading this and IT'S THURSDAY! Hope all is well and you are doing great.