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THis is Dr. David
she needs a good general surgeon who can do another hernia operation
her warfarin has to be bridged to lovenox or IV heparin while in the hospital where it can be stopped prior to surgery.
her situation is tough because she needs the anticoagulation so her mitral valve will not cause blood clots
but she also needs a large hernia surgery which is risky while on blood thinners.
this is not an easy situation.
there are good surgeons at large academic university medical centers which could help her do another hernia surgery.
where is her hernia? is it a ventral or umbilical or inguinal hernia?
there are many good surgeons in Boston at Mass Gen or Brighams and Womans hospital and others