dose the diet and no-no's

[bbb]

Hi,
I'm beginning to understand the dose the diet, eat what you want and adjust the dose. Now that list I see of all the food, herbs, medications etc. that can affect your inr levels, those would come under that category? But for instance, alcohol, that can make you possibly bleed internally (with more than 1-2 drinks) is in the category of things you can not really dose the diet.

What are the foods, herbs, medications are in the "hands off, no-no" category? Is there a list somewhere?

Thanks, Betsy

 

[JimL]

Betsy, this thread might be what you're looking for:
http://www.valvereplacement.com/forums/showthread.php?t=18807
I used to have a lengthy list, but I don't refer to it anymore. Things I don't like very much anyway (broccoli, spinach) are on my avoid completely list. But asparagus is great when it's fresh, so I eat it then and take a few extra mgs, depending on how much I eat.
I put in a request for cauliflower for Thanksgiving, made with butter and cracker crumbs, very good, I'm still debating how much extra to take to cover that.

 

[geebee]

Unless you pig out on something, most foods will not affect your INR. I have been doing this coumadin thing for 27 years and have never altered what I eat or adjust my dose ahead of time (although I am not saying it can't be done). I love asparagus, cauliflower, etc. but the quality of the produce available is not consistent. Therefore, when I have these vegetables, it is sporatic.

If I am worried about eating too much (which rarely happens), I just test in 3 or 4 days to make sure all is well. Food has rarely affected my INR.

I have also found that alcohol consumption does not affect my INR but I usually only have a couple of glasses of wine or a Baileys or two when I do drink. I only drink once a week or so and have never had issues. Don't know what happens with overdoing the drinking thing because I just choose not to but coumadin is not the reason.

 

[Blanche]

Betsy:
I eat anything and everything that I like, including brocolli and spinach. But, I don't eat these things in the great quantities that I did before anticoagulation. I used to eat a large serving of cooked spinach. Now, I eat less spinach and include some other vegetable (eggplant, corrotts, corn, mushrooms, yellow pepper, etc.). I used to eat an 8 oz spinach salad. Now, I eat less spinach and include cut-up iceberg lettuce.

As for alcohol, unless you use it in huge qualtities, it is unlikely that you will suffer from internal bleeding. My husband's had numerous internal bleeds and was hospitalized for some of them. With or without Coumadin he would have suffered those internal bleeding episodes, but the Coumadin did make the bleeding worse. If you drink enough alcohol to raise your INR way above your range (I've been told above 7.0) then you could be courting an internal bleed too.

The biggest problem with drinking too much is that it makes people stupid. And people behaving in a stupid manner take risks and they fall or otherwise hurt themselves.

Hope this helps,
Blanche

 

[Ross]

There is no reason to avoid any American food whatsoever. Now the Japanese have a couple of instant INR killers that is not in your interest to eat and from what I understand, taste terrible too.

Eat as you normally eat and all else will fall into place.

 

[Karlynn]

I don't give any consideration to what I eat. I eat what I want. If I want a big salad, I eat it. It's been years since I stopped to think "Gee, wonder what this will do to my INR?" Because Gina is right - most of what we eat has little effect.

1 or 2, or 3 or 4 drinks is not going to make someone bleed if they're on Coumadin, unless they already have bleeding ulcers - in which case, they shouldn't be drinking anyway. Over-indulging in alcohol and the bleeding risk has to do with the fact that alcohol is very dehydrating when over consumed and your INR will rise because of it. If it goes above a certain level, then you are at risk for bleeding. As discussed in previous threads, you are basically in no danger with an INR of 5 or below. An INR above that depends on the person. I've been on Coumadin for 16 years and have had zero bleeding incidents. And I've had a few high INR's due to over consumption of alcohol, above 7.0. I try not to over indulge (because I hate the hang-over) but there have been a few occasions in 16 years I was just having way too much fun.

Here's the story of my INR's - some medical people will look at my INR's over the last several weeks and think - WOW she's all over the place, she's hard to stabilize, she needs to watch what she eats. I've been on the same dose for months without a change and I consider myself stable. I'm in or close to my range of 2.5 - 3.5 and the numbers are okay with me. If you were to look at a record of what I ate and drank, you might be able to see why there were some changes - but quite frankly - I don't care.

So here you go - from most recent going backwards:
2.8 3.2 3.8 2.7 3.5 3.5 2.7 2.4 3.6 2.5 3.7

Again, I didn't make one dosage change, didn't think "oops Coumadin" with any bite of food I put in my mouth or any glass of wine, or rum and Diet Coke I had. A warfarin manager may look at those numbers and say "What are you doing - your numbers are all over the place?" My answer would be "I'm in theraputic range, I'm living my life and these numbers are just fine."

 

[maggiemay]

inr

inr

I like the way you think and the longer I am on this the more relaxed I become. I have ate the most greens the last two weeks since my surgery in March, but only because I did get a home tester and feel so much more in control.

 

[KristyW]

Karlynn,

That is a great post!! I wish that the surgeons, cardiologists and AC managers would read that and understand.


Hey Ross...you think Karlynn's post could become part of the "New to Anti-Coagulation" sticky?

Betsy,

Just live your life, your Coumadin/Warfarin will occasionally need to be adjusted as your physical activity changes, but for the most part...don't worry too much about it.

 

[bbb]

Thanks, everyone. It is a big help to get info from real people on coumadin! Ross, what ARE the Japanese food items..as I really love Japanese food and don't want to eat one of them by mistake! And thanks Karlynn for the wisdom of living and eating.

I really appreciate this forum for all the caring, practical insight on the life I am about to be living in 2 weeks time. And it is especially good to know you will all be here for any questions that come up while I am getting used to the Coumadin.

Betsy

 

[wes]

japanese food

japanese food

Thanks, everyone. It is a big help to get info from real people on coumadin! Ross, what ARE the Japanese food items..as I really love Japanese food and don't want to eat one of them by mistake! And thanks Karlynn for the wisdom of living and eating.

I really appreciate this forum for all the caring, practical insight on the life I am about to be living in 2 weeks time. And it is especially good to know you will all be here for any questions that come up while I am getting used to the Coumadin.

Betsy

Betsy,
The Japanese food that Ross is referring to is natto (fermented soybeans). It's only available at Japanese supermarkets in the States, and the taste is......well, you can imagine. This is the only food my doctor said was off limits! The reason is because natto is a natural anti-coagulant, and probably one of the main reasons why Japanese people live so long. I was never a big fan pre-op, so taking this out of my diet was no big deal. All other types of Japanese food are OK! (miso soup, tofu, sushi, donbori, etc.) Soy is high in vitamin K, but I eat it everyday because it's such an integral part of my diet.

 

[Karlynn]

I wanted to clarify that the 7.0 was my INR - not my blood alcohol level.

I did want to add that the one thing I do watch out for is the prepackaged diet foods, or protein bars and drinks. Quite often the protein source is soy - a great product - but high in vit K, so if you add it, it should be regularly like Wes, because it will lower your INR and you will need to adjust your dose. Since I don't want to mess with that type of consistency (if I lived in Japan I'd mess with it!) I just make sure my protein bars and shakes are whey protein.

If you've ever been to a VR reunion, you'll see that those on Coumadin don't really pay too much attention to the alcohol warnings that are given.

Betsy - if you go with a mechanical - I highly recommend getting a home testing machine as soon as possible. Being the rebel that I am, I'd recommend just telling your doctor you absolutely want to home test, not asking if you can home test. I'm sure they will want you to call in your INR # (and you should until you learn how to dose yourself), but that's not a big deal.

 

[Freddie]

What are the foods, herbs, medications are in the "hands off, no-no" category? Is there a list somewhere?

Thanks, Betsy

Hi Betsy,
The Hospital INR list I received says to avoid:
- carrot Juice
- herbal remedies (all)
- herbal teas (all)
- horseradish
- Kale
- Licorice
- Mint
- Parsley

As for medication's to Avoid (from the same list from the hospital):
- Advil, Aleve, Alka-Seltzer, Anacin, Ascriptin, Aspercreme Rub, Aspergum, Bayer, ben-gay Rub, Bromo-Seltzer, Bufferin, Congespirin, Coricidin, Darvon Compound, Dristan, Ecotrin, Empirin, Fiorinal, Fizirin, Flex-All 454 Rub
Ibuprofen, Medipren, Midol, Motrin, Naprosyn, Nytol, Pepto-Bismol, Percodan, Sominex.

Hope this helps with some of your questions

 

[bbb]

home testing

home testing

Karlynn,

My cardio has already said he approves of home testing and has a few home-testers. He said it was hard to get insurance companies to pay. I think he also said it would be about 6 months until I get regulated (or maybe someone else told me that...)

In any case, should I try to get him to write a prescription for one (how does that all happen?) as soon as possible? I'm thinking right when I get back, as I imagine it will take a while to actually order one and make it all happen. also, what is the consensus on the best brand?

Thanks, Betsy

 

[Karlynn]

I drink herbal teas all the time. The only time I noticed a change in my INR was when a friend gave me some of her home grown mint that she dried for tea. It was Oh so good! But it did lower my INR after having it nightly for about 5 nights. Now I just have it occasionally. This probably applies to the licorice, kale, horseradish etc. If you eat a lot of it - it's going to lower your INR. Most people will not - and I doubt I'd have the stomach to eat enough horseradish for it to do much harm! If you do enough reading on what to avoid while on Coumadin, it would probably eliminate 1/2 of what I eat.

Some of the medications are just brands of aspirin. It's not good to use aspirin as a pain reliever if you're on Coumadin. But many people that take Coumadin do take low-dose aspirin as well. There are some things that Ibuprofen is a must for me and I take it - like cramps! But for most pain I take Tylenol.

A friend of my mother-in-law's was diagnosed with a-fib and was put on Coumadin. I sat beside her a few weeks ago at my in-laws 60th anniversary. She saw me eating my field greens salad and said "Oh, we're not supposed to eat that you know! I used to love salads, but my doctor told me I can only have 2 a week now, and I had 1 a day for years." Well, she's 88 years old, so I didn't bother explaining to her that she should have just continued on eating what she ate and let them adjust her Coumadin dose. I knew she followed every word the doctor told her. Then my MIL told me how they are having such a hard time getting her friend's Coumadin regulated. I guess I'm not surprised, if they took away her salads, I can imagine what else they told her not to do.

 

[Karlynn]

Karlynn,

My cardio has already said he approves of home testing and has a few home-testers. He said it was hard to get insurance companies to pay. I think he also said it would be about 6 months until I get regulated (or maybe someone else told me that...)

In any case, should I try to get him to write a prescription for one (how does that all happen?) as soon as possible? I'm thinking right when I get back, as I imagine it will take a while to actually order one and make it all happen. also, what is the consensus on the best brand?

Thanks, Betsy

Betsy, if you click on the QAS banner at the top of any of the forum pages, it will take you to their site and contact information. They will do most of the leg work for you in getting a machine and take you through the steps. Hopefully your insurance company will approve. I'm so glad your doctor does - that's a really good sign that he's up on Coumadin management. Truly the hardest part about taking Coumadin is people in the medical field that haven't moved into the 21st century in the warfarin management education.

Some insurance companies won't let you home test until you've been on it for a while. Some will let you go home from the hospital with a machine.

 

[Ross]

Hi Betsy,
The Hospital INR list I received says to avoid:
- carrot Juice
- herbal remedies (all)
- herbal teas (all)
- horseradish
- Kale
- Licorice
- Mint
- Parsley

There is no reason to avoid any of these if they are part of your normal diet, they will be accounted for in the dose.

The medications--I take what works. Even if it means a no no on the list.

 

[Ross]

I don't give any consideration to what I eat. I eat what I want. If I want a big salad, I eat it. It's been years since I stopped to think "Gee, wonder what this will do to my INR?" Because Gina is right - most of what we eat has little effect.

1 or 2, or 3 or 4 drinks is not going to make someone bleed if they're on Coumadin, unless they already have bleeding ulcers - in which case, they shouldn't be drinking anyway. Over-indulging in alcohol and the bleeding risk has to do with the fact that alcohol is very dehydrating when over consumed and your INR will rise because of it. If it goes above a certain level, then you are at risk for bleeding. As discussed in previous threads, you are basically in no danger with an INR of 5 or below. An INR above that depends on the person. I've been on Coumadin for 16 years and have had zero bleeding incidents. And I've had a few high INR's due to over consumption of alcohol, above 7.0. I try not to over indulge (because I hate the hang-over) but there have been a few occasions in 16 years I was just having way too much fun.

Here's the story of my INR's - some medical people will look at my INR's over the last several weeks and think - WOW she's all over the place, she's hard to stabilize, she needs to watch what she eats. I've been on the same dose for months without a change and I consider myself stable. I'm in or close to my range of 2.5 - 3.5 and the numbers are okay with me. If you were to look at a record of what I ate and drank, you might be able to see why there were some changes - but quite frankly - I don't care.

So here you go - from most recent going backwards:
2.8 3.2 3.8 2.7 3.5 3.5 2.7 2.4 3.6 2.5 3.7

Again, I didn't make one dosage change, didn't think "oops Coumadin" with any bite of food I put in my mouth or any glass of wine, or rum and Diet Coke I had. A warfarin manager may look at those numbers and say "What are you doing - your numbers are all over the place?" My answer would be "I'm in theraputic range, I'm living my life and these numbers are just fine."

Have I told you I love you lately?

Keep writing like this and you'll give tobagoboy a run for his money.

 

[Ross]

A friend of my mother-in-law's was diagnosed with a-fib and was put on Coumadin. I sat beside her a few weeks ago at my in-laws 60th anniversary. She saw me eating my field greens salad and said "Oh, we're not supposed to eat that you know! I used to love salads, but my doctor told me I can only have 2 a week now, and I had 1 a day for years." Well, she's 88 years old, so I didn't bother explaining to her that she should have just continued on eating what she ate and let them adjust her Coumadin dose. I knew she followed every word the doctor told her. Then my MIL told me how they are having such a hard time getting her friend's Coumadin regulated. I guess I'm not surprised, if they took away her salads, I can imagine what else they told her not to do.

I truly believe that without the vit k of greens and other things we eat in our diets, they sabotage any chance of stability. They need to stop thinking like that all together and think like we do. I bet a heck of a lot of people would suddenly be stable.

 

[Cooker]

I also eat what I want when I want. That includes a salad nearly every day. I was also lucky enough to convince my wife that boiled okra had enough vitamin K in it to kill me on the spot and that even being in the same room with it might cause a drastic drop in my INR Score one for the home team

 

[Karlynn]

I was also lucky enough to convince my wife that boiled okra had enough vitamin K in it to kill me on the spot and that even being in the same room with it might cause a drastic drop in my INR Score one for the home team

If you need corroboration on this, have her call me.