5.5 INR antibiotics, continued infections... not sure what to do...

[stilldreamin]

I haven't been much for posting, my continued battle with infections and pain have put me in mental state far from what I'd like everyone to see me in.

As some of you already know, I had a hysterectomy in late October, full abdominal. I had complications following the hysterectomy, a hematoma and severe infection... which I apparently have not recovered from. I'm still on antibiotics, and the pain has increased rather than decreased. I'm waiting for a CT scan so they can see what the problem is.

My INR has suffered because of all this, although I had more issues with it being too low. I've been testing once a week, four weeks ago i was at 1.5 (at 5mg), three weeks ago 1.3 (at 8 mg), last week 3.3 (stayed on 8mg), and today my results came back at 5.5. I tried to use the calculator, but I'm not getting any results. I know I shouldn't hold a dose, so I'm considering taking 4mg tonite and tomorrow, and then increasing to 6mg.

I desperately need your input here... I can't seem to form a rational thought in my head.

Thanks once again for your help and continued support.

Jen

 

[Bina]

Howdy, sorry about all your troubles with infections and such.
Hopefully the antibs are finished ? and you can get your INR on a steady run.
I would half dose today (4), half dose tomorrow (4), then continue on the 6mg or 5mg depending on what other meds u are taking.

 

[njean]

Ooooo, I feel for you! I had a full-abdominal hysterectomy many years ago & I still remember the pain! I'm sorry to hear that you are still experiencing so much pain & are still on antibiotics. That's worrisome. I hope that you get some clear answers when you get the CT scan done!

As for your 5.5 INR, yes, the antibiotics will greatly affect your INR readings. But I too would not hold a complete dose even with a 5.5 reading --- like Bina said, 1/2 dose tonight, 1/2 dose tomorrow night & I would even be tempted to take a little more than a 1/2 dose on the 3rd day & then resume my normal dose. (Do you have any 2mg coumadin tabs? On the 3rd day, I would take 4mg + 1mg (cut the 2mg dose in half).

I would re-check my INR again, Saturday evening or early Sunday morning to see where it's at.

Best of luck to you & I hope you find some relief from your pain.

P.S. I hope you're not trying to run a vaccum, push broom or any lifting of any sort! Take care.

 

[KristyW]

Jen,

I'm so sorry to hear that you're still struggling. I was hoping that it would all have worked out by now. Are you still on the antibiotics? If so, you really do need to reduce your overall dose per week by 5.5 mg (10% reduction) until you're off of them.

Remember, none of us is a doctor, but we have worked with this medication for quite a while.

Currently you're on 8mg/day 8x7=56.
10% of 56 = 5.6.
56-5.6=50.4. Let's say 49 for ease of 7 day arithmetic.
49/7 =7mg/day to reduce your total weekly dosage by just over 10%.

If you take 1/2 (4.0) today and 1/2 (4.0) tomorrow to get your INR down, then the next 7 days, starting with the first day you halved your dose, would look like this.

4.0, 4.0, 7.0, 7.0, 7.0, 7.0, 7.0 = 43

That's a 20+% reduction to get your INR back in line. Then next week you continue with the 7mg/day to maintain the new INR while you're still on antibiotics.

Do not test more than once a week. That will make things more difficult.

What size pills (mg) do you have? 4's, 5's, 6's, 7.5's? Knowing what dosage of pills you have will make it easier for us to suggest a WEEKLY regimen for you. I capitalized weekly because my own Dr. still looks at is as a daily regimen. While trying to get my INR to rise after my surgery, he told me to alternate 5's with 7.5's. Well doing that gives me 2 different doses over 2 weeks. I told him, I'll take 5's on Su, Tu, Th, & Sa and 7.5's on M,W,F. That's a weekly dose.

The difficult part of this is whether or not the Drs. keep messing with your other meds while you heal. If they do, you'll just have to keep making small adjustments until all your meds are stabilized. Once you are off the antibiotics and starting to move around more, you'll have to adjust upwards. We'll cross that bridge when we get there though.


You know you can PM me anytime.

 

[aussiemember]

Sorry to hear you are still having problems - no wonder you are feeling down about things especially as you have been feeling unwell for quite a while now. I agree with the others above, if it was me I would take a couple of half doses, reduce your intake slightly and then retest in a week and see what happens. Hope things start to improve for you.

 

[stilldreamin]

thank you so much for the replies... i had another fun filled day in the emerg for my continuing issues post-hysterectomy, i managed to convince them not to keep me, but the need for the CT sooner than later was decided... hopefully next week. i'm having more issues after the hysterectomy than after my OHS!
as for my INR, i did half the dose last nite, and decided to drop down to 6mg/day since my diet has been suffering because i haven't been feeling well, and i'll be on the antibiotics for another 2 weeks. i'll test again on monday... i agree that testing more than once a week is not a good idea.
i'm not doing anything heavy or pushing myself either, thanks for asking norma. i'm being well taken care of..
i have 1mg, 3mg, and 5mg pills, i figured i could get the greatest combinations from those. my doc will prescribe me whatever i ask for tho, she's been great at letting me take control of this, and knows i have all of you to help me too.
thanks again... i know i don't post often, but your support and knowing you're all there has helped me more times than i can count.

jen

 

[catwoman]

Jen:

I'll be interested in the results of the CT. Something definitely is going on.

Have a safe, comfortable New Year's -- no visits to the ER!!!!!!