1.8!

[Mileena46]

Somebody needs to tell me I will be ok! I am freaking! I had to lower my dosage because when I started my low fat diet and began to lose weight my normal dose shot me up to 5.9! Over the holidays when I ate fatty foods and took the reduced dosage....I am 1.8! I dont take another dose until tonight....should I go ahead and take my dose NOW? Would it help? My doctor is acting unconcerned and just upping my dosage! HELP ME! I am at work and scared!

 

[wcasey5]

I went down to a 1.4 when I forgot to take warfarin for 4 days. If you have an aortic valve the doc said it wasn't such a problem because the blood moves faster through it and is less likely to clot. I have had a number of 1.7's and 1.8's in the past year. It freaks me a little but comes into range after adjusting the dose and waiting 3 or so days. You don't want to go overboard with increasing your dosage. and it takes 2 or 3 days to matabolize.

 

[AgilityDog]

You may not really have an issue if your range is 2.0 to 3.0 and you have an aortic mech valve.
If your range is 2.5 to 3.5, then you might have more concern.

As it takes 3 days for the increased dosage to take effect, you can (should?)ask your doctor to call in some Lovenox injections for you (ask for generic), at a rate of 1mg per kg body weight, taken every 12 hours - injected into the fat of your tummy, in the 4 o'clock and 7 o'clock positions. i.e., 60 mg = 60 kg person = 132 lbs. 70 mg = 154 lbs, etc.

Then keep some on hand for those times you may fall below 2.0.
The shots are a PITA, but it sure helped me sleep at night on those rare occasions!

 

[Mileena46]

I have a mitral valve and no insurance. No way to pay for any Lovenox. I will just have to up my dose and hope for the best!

Mileena

 

[JimL]

Relax, take a little more coumadin, and go about your life. Big changes in dosage or diet are hard on the INR, so don't up your dosage too much. The rule is to raise or lower your dosage 10% per week, but I rarely change more than 1 or 2 mg per week. I have taken my coumadin dosage earlier when I was low; it made me feel better.

 

[dick0236]

I have a mitral valve and no insurance. No way to pay for any Lovenox. I will just have to up my dose and hope for the best!

Mileena

Forget about the Lovenox, 1.8 is not a big deal and is probably related to the dietary change. Increase your dose per your docs recommendation and recheck in a week. My guess is that he increased your dose by +/- 15%, depending on your range. Be wary of making large dosing changes, it will cause a "yo-yo".

 

[Mileena46]

Thank you all! I guess I knew I would be ok....just needed to hear it!

Mileena

 

[DanielB]

My range is 2.0-3.0 and I have only been above 2.0 twice since my surgery in October -- I have been as low as 1.5, with most around 1.8. The coumadin Clinic that manages my dosageseems to have it squared away now as I am finally in the 2.7 range as of my last check. I was worried too when I was getting low readings so much, but the doctirs told me that my coumadin use will change as I heal, but will stabilize as it seems to have now.

Best of luck to you.

Dan

 

[Jkm7]

Don't panic and take a big increased dose. You'll put yourself on a bad pattern of chasing your INR around. Make small increase according to your doctor's/coumadin manager's instructions.

Mitral valve requires a slilghtly higher INR but you should be fine.

 

[sarahsunshine]

Sorry to take so long to reply, glad you got a whole bunch of good advice. Don’t panic, and follow your doctor’s advice. In a couple year’s time you will look back and laugh at yourself!

My step son has been on warfarin for 12 years with a mechanical mitral valve, and in a kid things fluctuate (diet, exercise, antibiotics, etc…) Going down to 1.8 is really not that big an issue. We self-dose and monitor. When he gets down to 1.8 for no particular reason that we can tell, we give him an extra 1-2mg immediately (his usual dose is 8.25mg, alternating 8 and 8.5 every other day). After that we continue his usual dose. We test again in 4 days. If his INR is back to normal, we maintain the dose and treat it as an anomaly. If it goes up a little bit, we maintain it and test again in another 4-5 days. Usually it stabilises. If the INR level is still low, it likely means that he has grown and his dose needs changing. In this case (since 1.8 is a small change), we would up his dose to 8.5mg daily for 4-5 days and see what happens.

It at times like this that I am so glad we self dose/monitor. Do keep in mind that depending on your metabolism warfarin is in your system for 3-7 days, so any dose change accumulates over 3 days…

 

[yotphix]

For what it's worth, I read the other day that something like 6% of mechanical valve patients who weren't even under ACT would suffer a stroke. (I can't remember if that was in a given time period, or in a lifetime, but it definitely wasn't in a week or month or anything scary like that.) That would seem to indicate that these little fluctuations don't put us at frightening risks. The well respected clinic which was dosing me before I got my monitor figured they were doing a good job if their patients were in range more than 60% of the time!