3.0

[ticktock]

4mg sounds good to me

4mg sounds good to me

I can't imagine.... that is really jumping to some kinda conclusion, making an adjustment when you are at 3.0 The range IS 2.5 to 3.5 I keep mine at 3.5 to 4... with Doc permission. I tolerate it well, and have been there for years. 31 years on Coumadin this month!!!

As our Coumadin Guru will tell you, you have to stay on a steady dose before determining stability. But I do understand a new patient wanting to follow orders.

 

[ALCapshaw2]

I can't imagine.... that is really jumping to some kinda conclusion, making an adjustment when you are at 3.0 The range IS 2.5 to 3.5 I keep mine at 3.5 to 4... with Doc permission. I tolerate it well, and have been there for years. 31 years on Coumadin this month!!!

As our Coumadin Guru will tell you, you have to stay on a steady dose before determining stability. But I do understand a new patient wanting to follow orders.

VERY GOOD POINT TickTock.

Carole - ask your Nurse WHY she made a Change in Dose when your INR was 'Smack Dab Center' of your Target Range!

Did you get her Dosing Recommendation in Writing?

 

[Ross]

Hmm, I do hope she's read our recommendations! I think she's so tickled with being at 3.0 that she done left us and went partying.

 

[Bina]

That's right, Ross.......Carole is partying at the salad bar.....buying rounds of spinach

 

[Karlynn]

That's right, Ross.......Carole is partying at the salad bar.....buying rounds of spinach

Spinach and V8 Shooters!

 

[CA Pigg]

HEY GUYS!!! I'm here!!! Yep, was excited about the 3.0 and no shots but I agree with what you are saying... I can't talk to her until tomorrow so I'm doing what she says, and then tomorrow I'm telling her I need/want to stay on the 4mg for awhile!! I would rather be on the high end myself as well!!! I just tested myself, YEAH, got to use the machine and yep, just like you said I am 2.2 today!! I did it right the first time, who hooo!!! She had me take the 2mg Thursday and and I'm supposed to take 2mg again tonight! I really want to take the 4mg but I'm afraid that will screw me over with her so I guess even though I don't want to I'll take the 2mg test with her tomorrow which I might be up some since I took the 4mg fri and sat and then talk to her. She just isnt very good at listening, to me she has the "I am right" attitude, and she is wrong alot to me!! I'll be so glad when I'm done with them!! How will I be done with them????? I don't quite get that... I'm going to send my paperwork into insurance tomorrow and hope they will cover it. It would be very nice for them to pay for the strips... I have a prescription from the doctor on base saying machine, lancets, and strips so hopefully!!!I just know I don't want to be on the low side and I don't want to keep yo yoing!! I just want to listen to you guys wha wha wha. Yep, I'm whining again!!! It has been very nice no shots, I still have so many bruises LOL!!! If anyone knows how it works to get on your own and away from them please let me know. I'll let you know how it goes with "Ms Trust Me" nurse!!! Thanks everyone!!! Hope everyone is having a HAPPY EASTER!!!

 

[Ross]

I'll tell you right now, your going to be below 2.0. If I'm right, tell her you want one full 7 day period on 4mg, then test again. Let's just see what she says.

 

[CA Pigg]

I bet you are right, I was just thinking with the 4mg two nights maybe??!! I am going to tell her I just hope she listens!!!! I guess I have to take the 2mg tonight, she aggravates me SO BAD!!!!!

 

[ALCapshaw2]

Carole,

DUH, NO Surprises there in your INR.

Did you keep a daily chart of Doses and INR?

If so, give a copy to your Cardiologist and hopefully HE will straighten out "Nurse Know It All".

'AL Capshaw'

 

[Herb M]

If I disagree with the doctor or nurse about my doseage, I just listen and then I do what is right. I don't say anything to them. I use the algorithm chart to determine what adjustment I need.

Most doctors and nurses do not know much about coumadin dosing.

 

[Bina]

Carole, make sure that you take 4mg on Monday....tell Nurse No-brain that the dropping INR is HER fault and you are going to stab her with Lovenox needles.

 

[Freddie]

Gonna give myself a pat on the back here people.
I think I said to stay on 4mg last week, but everyone was afraid of "Ms Trust Me Nurse"might think that Carole was being uncooperative.

Carole, if this nurse aggravates you, tell her so. Ask/tell her you would like to go for 7 days on 4mg then retest. Do what I have done, make this "nurse" you understand everything about warfarin, that testing everyday, adjusting the dosage isn't proving anything "lets try going a week on a steady dose then re-test" ah heck, you know what to say

 

[catwoman]

Carole, make sure that you take 4mg on Monday....tell Nurse No-brain that the dropping INR is HER fault and you are going to stab her with Lovenox needles.

And make her pay for the Lovenox!

 

[ALCapshaw2]

Gonna give myself a pat on the back here people.
I think I said to stay on 4mg last week, but everyone was afraid of "Ms Trust Me Nurse"might think that Carole was being uncooperative.

Carole, if this nurse aggravates you, tell her so. Ask/tell her you would like to go for 7 days on 4mg then retest. Do what I have done, make this "nurse" you understand everything about warfarin, that testing everyday, adjusting the dosage isn't proving anything "lets try going a week on a steady dose then re-test" ah heck, you know what to say

Freddie -

Have you forgotten that the Hospital referred Carole to her Coumadin Clinic as a patient who is "hyper-sensitive to Coumadin".

It's no wonder that the Nurse wants to test every day to be sure she is Not Spiking. Even one of your Fellow Canadian Members mentioned Daily INR testing for 16? days IN Hospital following surgery.

While I agree that continuing a constant dose (until proven unstable) is a 'better way', to go 7 days on ANY dose without more frequent monitoring of a New and potenially High Risk patient is IRRESPONSIBLE.

Can Carole Sue YOU if she develops a problematic Bleed?

Would she have any recourse against the Coumadin Clinic if she failed to follow their directions (even if misguided)?

Irresponsible and Cavalier instructions from non-medical people on the internet are exactly why Doctors tell patients not to go on the internet for medical advice.

We can make suggestions to pass through Medical Providers for their blessing, but telling a patient to disregard their medical providers instructions can have dire Medical and Legal Consequences (in my Non-Professional Opinion).

 

[Freddie]

I'll tell you right now, your going to be below 2.0. If I'm right, tell her you want one full 7 day period on 4mg, then test again. Let's just see what she says.

Al,
I was basically acknowledging what I and other members have also said.
As for being the hospital for 16 days, that's what they do best; come in at 5am everyday for blood work no matter how long your in their care.

This nurse of Carole's should be able to see by now that she is really not "hyper-sensitive to Coumadin" (sensitive maybe but not hyper) or else the 2.5mg that was taken would have made Carole's reading go higher - not drop.

Suggestions and support was all I was intending to do, I'm sorry if you see it otherwise.

 

[Ross]

If I disagree with the doctor or nurse about my doseage, I just listen and then I do what is right. I don't say anything to them. I use the algorithm chart to determine what adjustment I need.

Most doctors and nurses do not know much about coumadin dosing.

This is what most people have to do, so..........I've done it myself until they figured out that I actually knew what I was talking about.

 

[Ross]

Freddie -

Have you forgotten that the Hospital referred Carole to her Coumadin Clinic as a patient who is "hyper-sensitive to Coumadin".

It's no wonder that the Nurse wants to test every day to be sure she is Not Spiking. Even one of your Fellow Canadian Members mentioned Daily INR testing for 16? days IN Hospital following surgery.

While I agree that continuing a constant dose (until proven unstable) is a 'better way', to go 7 days on ANY dose without more frequent monitoring of a New and potenially High Risk patient is IRRESPONSIBLE.

Can Carole Sue YOU if she develops a problematic Bleed?

Would she have any recourse against the Coumadin Clinic if she failed to follow their directions (even if misguided)?

Irresponsible and Cavalier instructions from non-medical people on the internet are exactly why Doctors tell patients not to go on the internet for medical advice.

We can make suggestions to pass through Medical Providers for their blessing, but telling a patient to disregard their medical providers instructions can have dire Medical and Legal Consequences (in my Non-Professional Opinion).

Easy there partner. I told CA Pigg myself that her nurse was doing the right thing, right up until she lowered her dose at 3.0 INR! Now it's a whole different ball game.

 

[ALCapshaw2]

Personally, I agree with continued 4 mg dosing.

My concern was going 7 days without testing in a patient who in all liklihood has still NOT reached a stable INR. While testing daily seems a bit excessive to me, it is better to be "Safe than Sorry" until her history shows stability. She isn't there yet.

FWIW, I know of patients who have been dismissed by their Doctors / providers for not following their instructions. Then what? We / they can't write our/their own prescriptions...

It seems to me that our best recourse is to tell the provider "I'm not comfortable with that recommendation. How about XXX?
Then they can negotiate an agreement. If they can't arrive at a satisfactory agreement, they maybe it's time to find another provider.

Going on your own against medical advice puts you "on your own" which is probably not a good place to be...

 

[Bina]

It was ME who was in hospital for 16 days getting the INR balanced.
My system is very very sensitive, and they started me off at 5 mg which is double my current dose.
They tested INR daily and tweaked my dose daily. It did rattle me, but since then I have
been steady. My GP is very conservative in dosing suggestions, and I furthered my education right here.

 

[Ross]

It was ME who was in hospital for 16 days getting the INR balanced.
My system is very very sensitive, and they started me off at 5 mg which is double my current dose.
They tested INR daily and tweaked my dose daily. It did rattle me, but since then I have
been steady. My GP is very conservative in dosing suggestions, and I furthered my education right here.

.....And I still remember how hard it was to get you to realize we weren't full of bull.