Lovenox & Epidural or/C-section Question?

artistmamma

Okay, I'm on 60mL a day of the blood thinner Lovenox, via a shot in my belly. The side effects pamphlet says you cannot have an Epidural while on this blood thinner because of a risk of developing a spinal hematoma that can leave you temporarily or even permanently paralyzed. I was told I'll most likely need a c-section due to all my health issues & high-risk complications, but don't you HAVE to have an epidural during a c-section? I have a bi-weekly OB appointment tomorrow, so I'll be talking to my doctor, too. But I wondered if any of the Pregly ladies here have experience with this situation, & how did being on Lovenox affect your delivery? They say if you stop taking it 24 hours before an epidural is needed, it's "supposed" to be safe, but what if you go into labor fast & unexpected, & require an emergency c-section? It just scares me!

sands3

I hope you get the answers you need! I had a c section and I doubt the Dr would do it without a spinal...unless they put you under. Good luck!

kcoolzchic

I think if you have to get an emergency c-section and don't have time for an epidural I believe they put you down under "to sleep".

[Deleted User]

I talked to my OB about this. He said that they will do an INR test (the same they do to check your levels regularly when on blood thinners) if it is in the 'safe' range, you can do an epidural--vaginally or c-section. He said typically its usually 24 hours from the last injection that you need to wait before it is normally in the safe range; otherwise you can have IV pain killers (Demerol & the like) or a spinal (he said these are slightly different than epidurals) for a c-section. I hope this helped!

artistmamma

@tiff87124: Thank you so much! I guess I'm just looking for that, "Hey, it happened to me & I'm fine," kinda reassurance. Lol! This pregnancy has been SO rough & it truly is a miracle that baby & I have made it this far. (7 & 1/2 months.) I really appreciate your support, & I'm sure everything will be okay!

@MrsDelRae: I was hoping you'd pop in, cause I know you have tons of insight into this issue! Thank you for sharing with me again. Were you on Lovenox with your last child, & if so, how did it affect your delivery? If you don't mind me asking.

@sands3 & @kcoolzchic: I'm a first time mom at 31 years old, & my first two pregnancies ended in miscarriage. My sister had to have a c-section, but all I know about them is they medicate you enough that you don't feel anything, yet you're awake & lucid. So I was really scared about how that works if I can't have any sort of spinal punctures. I didn't know if it was safe or possible to put a woman all the way under to give birth. I hope it doesn't come to that. I don't want to miss my baby girl being born!
Plus, surgical anesthesia makes me horribly sick upon waking. Ugh.

catben

Thank you so much for asking this question. I also need the answer. I have to take 100mg a day. I cant stop taking it because if I do my baby will most likely die because I clot so quickly and easily. I wanted a natural birth but was curious about the csection because if something goes wrong Im sure they will have to do one. Im also worried about excessive bleeding.

[Deleted User]

No, I didn't develop clots until after I had her, but my cousin has had Lupus her entire life, my aunt has clots (runs on her dads side of the family) so they both went thru pregnancies while on shots. They both said the same thing--they had no issues, that when it came down to it, they would rather intervention than anything going wrong, so they just took the meds & prayed for the best. I know that doesn't help much, but there isn't much you can do about it make sure you ask your doctor, mine said I can't go off them at all, it'll put me at too high of a risk of getting a clot, so I am hoping there is no issue for delivery. I suppose this is where I should be glad I never did an epidural with any of my kids, or I would definitely be freaking out! How are you doing with the shots? Are you handling them better?

artistmamma

@catben: I am SO sorry to hear of your situation, too. It's scary...we just want our babies to be healthy & safe, & ourselves, too! I'll pop back in here ASAP to let you know what my OB says tomorrow, but definitely talk to yours at your next appointment, as well.

@MrsDelRae: Thank you again for sharing your knowledge with me. So you had all natural births, with no epidurals, I take it? Kudos to you, I know that ain't easy!
I'm still a big wussy with these shots. Lol! My boyfriend has had EMT training so he's really good at giving them to me. I don't feel the needle, only the burn of the medicine. We found that when he injects it slowly, it doesn't burn as long. But my belly is looking like a battlefield of bruises!

[Deleted User]

Poor thing!! My hubby & I made an agreement--he goes on my random food runs at any hour plus the very first injection & I have to do the rest myself. Yup, all natural, no pain meds. I kept thinking it would get worse, but while I kept thinking it would get worse to where I couldn't handle it, I was fully dilated. I had long labors, I was mostly scared if I got pain killers it would prolong things. How are you feeling otherwise? I found these shots make me nauseated, doctor said its normal, but it drives me nuts!

catben

@artistmama I have found with the shots that if you stick the needle in slowly & inject it slowly it doesnt burn as much or bruise as much. Hope that helps.

JerseyMommy

@artistmamma I also have to take lovenox 80mlg twice a day via my legs but my docs said Nothing about not getting an epidural so I'm going to ask them about that at my next appointment

artistmamma

@MrsDelRae: I'm feeling pretty crappy & the shots seem to have enhanced that for me. Definitely increased nausea/vomiting. More than normal, as I never got a 2nd trimester break from morning sickness. And it could be a coincidence, but I've had issues with swelling in my calves & feet since I started them, though it may also just be my time to start experiencing pregnancy edema.
How far along are you and how are you feeling these days?

artistmamma

@JerseyMommy: Definitely ask. It's worded slightly different in the pamphlet my pharmacy gave me, but there's also a warning about Lovenox & epidurals on their website: www.Lovenox.com. I'm going to get back on here sometime tomorrow afternoon to let everyone know what my OB has to say, just in case ya'll are curious. We can compare notes, but def ask your doctor as well!

[Deleted User]

I have never swelled before, but now I find I have to put my feet up every couple hour or they resemble sausages My hands have swelled from Lupus, but I haven't had any flare ups since being pregnant until I started the shots. Maybe it is the Lovenox. Lame. I am almost 6 months (23wks), been exhausted! I am on Zofran, it helps a ton, but it sucks that out of nowhere I feel so nauseous & I can't make it stop. Ugh. The doctor said baby is measuring small (right on track for development) but small, but I have small babies & he said the Lovenox causes smaller birth weight. They estimated he will weigh 5lb 8oz if he makes it to 40 weeks. I don't want him as small as my last child, who was 4lbs 1 oz; but she was almost 6 weeks early; but I don't want a 8lb baby either. I would tear from elbow to butthole (TMI, lol). Are you hoping for more children? How far along are you now?

artistmamma

@MrsDelRae: I will be 31 weeks on Saturday & am currently at 7 & 1/2 months. I would love to have one more child, but it's not realistic. I get way too sick whilst pregnant, & unless I can work from home, I can't take a 9 month break from earning money. I'm still on UC from being laid off back in August, but that will be running out soon after I give birth & I'll have to begin aggressively job hunting again. I tried to find work from August thru December (I got pregnant in early October), until I started feeling too sick to work. So I gave up & felt grateful to have UC money coming in at a time where I was too chronically ill to work. I want to start some classes to further my education, but I'm limited to online stuff, cause being so miserable sick would make classroom learning just about impossible for me at this moment. The future is so scary & unclear right now...I just hope things get better soon. And unless I win the lottery, there's no way I'll be able to do what I REALLY want: be a stay at home mom until my daughter is at least 4-5 years old.

[Deleted User]

Oh my! I couldn't imagine...its so heartbreaking when I hear these sort of stories, I know medical advancements happen all the time; I just wish it could be more. I know it sounds selfish, but I can't help it. I'm very glad to hear you at least got blessed with one beautiful child, she will definitely be doted on I'm sure. This baby I am carrying is nothing short of a miracle as well, so I fully understand. I always wanted a big family which I am blessed to have; but I wish it weren't so difficult to achieve. They are worth everything, don't get me wrong, I mostly just worry about their well-being during it all. Like for instance, when I was extremely ill almost 2 years ago. I wasn't worried/scared/upset over my health. I was heartbroken over my daughters being so sad & scared, having to deal with their mommy near death. It still makes me very sad. I was asleep during the worst, I am an adult so it wasn't as traumatic for me, plus I am stubborn (don't tell my husband I ever admitted this; LOL!) But my sweet little girls...they literally would bawl their eyes out in videos my dad would make to play for me while I was still in CCU (step higher than ICU) since they couldn't go in. When I was strong enough to be wheeled out in my bed the nursing staff would pack me up to bring me outside to see them. It would be for an hour, but it felt like 5 minutes. I missed them so much. I admit they can drive me crazy but I would never trade them for the world. I hope one day they can find a way to help our special medical cases. Maybe, somehow, you'll be able to have at least one more child you will remain in my thoughts & prayers. We definitely should keep in touch as its hard to come across others who are going thru or even understand what we are experiencing. Do you have a name picked out for your little princess?

sands3

My friend had to be put under for her c section so they can do it. It would suck though because you would miss everything. She said she didn't feel close to him at first because she didn't feel anything or get to hear him cry when they pulled him out.

JerseyMommy

@artistmamma thanks a lot n ill do that

artistmamma

@sands3
@kcoolzchic
@MrsDelRae
@catben
@JerseyMommy
@tiff87124
A quick update: I saw my OB today and this is her plan: At week 36, they're going to take me off the Lovenox & replace it with Heparin, which leaves your system faster than Lovenox - in about 12 hours. When I go into labor, if there's at least 12 hours between then & my last shot, I'm in the "safe zone" for spinal punctures & can have an epidural if needed, for either vaginal or c-section delivery. If not, my choices are to delivery vaginally the natural way, with no pain management, or if a c-section is required, I'll be put under full surgical anesthesia. If I would go into labor before my meds are switched & I'm still on Lovenox, then they have to deliver by whichever method is safer and will NOT involve a spinal puncture of any kind.
Now, if you're in this situation with blood thinners, your OB may do things entirely different, so make sure you talk to him/her about your birthing options. I just wanted to share what I had learned today with my wonderful fellow Preglys!

[Deleted User]

Whew! Now you can check that off the worry list like being pregnant doesn't have enough things to worry about! I'm on such a low dose of Lovenox I am good to go I hate Heparin, it burned insanely more than the Lovenox does & I bruised horribly. I hope you have a better experience with it Best wishes to you & your baby girl!

kcoolzchic

Glad to know that you got that all cleared up and that's one less thing for you to worry about

catben

Thank you so much for the info! My mom was put under for all of her csections and she hated it. I guess I will just go all natural, hopefully.

momof5

I took lovenox during my while pregnancy. 4 weeks before my due date I was switched over to heparin three times a day. I must say I liked the heparin shots soooo much better than the lovenox. Lol. Since I was on that dr decided to just induce me 2 weeks early that way we wouldn't get into no complications. I was taken off the heparin 36 hours before induction to make sure that it was all out of my system. After the baby was born I was started back on coumadin and lovenox 12 hours after baby was born. And haven't had a problem so far. Thank God.

artistmamma

@MrsDelRae: Do you have a Facebook account? I'd like to stay in touch with you for sure, & you're right about it being hard to connect with other women suffering these similar health issues. I was so sad & touched by your story & all you've been through. I must say what a strong woman you are for enduring what you have & still being positive. I admire your tenacity!

artistmamma

P.S.~ @MrsDelRae: My baby's name will be Camilla Autumn Wagner.

artistmamma

@tiff87124: Yes, they do have me on baby aspirin. I take the 80mg Bayer heart health aspirin. My most recent bloodwork showed I'm anemic, so I have to start 325mg of Iron supplements, as well.

[Deleted User]

Antoinette Del Rae look me up I love her name by the way. Adorable!!

P.S. Anemia runs hand in hand with Lupus.

artistmamma

@momof5: I was just wondering, what did you like about the Heparin better than the Lovenox? I've found the Lovenox makes me nauseated, & though the needle doesn't hurt, the medicine injected under my skin burns & stings like crazy. It leaves big bruises all over my belly, too. I am not a fan of Lovenox!

momof5

@artistmamma. The heparin didn't make me feel nauseated and the needles were so small that I didn't even feel like I was giving myself a shot and the heparin didn't burn either like lovenox. Down falls to the heparin was I did bruise just not half as bad as I did with the lovenox and I was on such a high dose that it made me itch at the injection site. I also like the fact that if you go into labor unexpected then heparin can be reversed easier. Lovenox is horrible for bruising. I wanted cute belly pics taken since this was gna be my last baby and I didn't get them done since I had big bruises everywhere.

artistmamma

@momof5: That sounds WAY nicer than the Lovenox shots for sure! And smaller bruises would be better than the big, dark purple ones Lovenox leaves us with. I wonder why they can't just give us the Heparin instead? I'll ask my OB when I see her again in 2 weeks!

I'm sorry you didn't get your cute baby belly photos. I won't be either, cause these bruises just look horrible. Everyone I show them to is always like, "Those are really bad!" Umm...yeah, I know! Lol!

momof5

Heprarin was way better. And for the belly pics its ok cause I have the best part of it all. I have my little boy. Yeah I hated showing my belly to ppl cause I always had to explain why I had big bruises. Ppl prolly thought my husband was beating me. Lol.