6.1

[perrypiratesdad]

He ran out of a pain med for a few days which may or may not have affected this last test.

Why is he on pain medication?

 

[catwoman]

No I wasn't told to skip three days. She suggested skipping a second day but I told her that he would just keep dropping. We agreed to 2mg that night. continuing at 3mg the rest of the week until his next test. Sorry for the confusion.

Sorry, Wendy. Didn't mean to confuse you with my questions about skipping 3 days.
My questions were directed at witzkeyman.


If Andrew is having to start/stop meds, that can screw up his INRs.

 

[Jkm7]

Why is he on pain medication?

I am wondering the same thing. Isn't he far enough out of surgery he might not need them? Though I do realize everyone is different.

 

[Blanche]

For your sake

For your sake

Witzkeyman:

You are an educator. Learning is your business!

Please take the time to learn about Coumadin and the threat of strokes. What your medical providers have told you is very dangerous.

I speak as the spouse of a stroke survivor. My guy had three strokes, one right after the other. His INR was 1.6, 1.8, and 1.7. The first stroke happened in a restaurant. He was taken by ambulance to the hospital. He was unconscious for nearly 5 hours. The second stroke was a week later.
He was hospitalized for nearly 4 weeks.

During the first few weeks of his second hospitalization, he could not read, write, speak, walk, control his bladder or bowels, and, for the first few days, he could not eat or drink. And, this is just the tip of the iceberg.

Why did this happen? Well, I'll tell you why!!!!

It happened because neither of us, the engineer and the teacher, took the time to learn about anticoagulation and the dangers of out of control INRs. When my dear one had his stroke, he had been on Coumadin for 10 years and 2 months.

I've talked to you about this before. How many times do you think that one can run across the thruway without being hit? (from a Vr.com poster, name forgotten,) It's your choice

www.warfarinfo.com
http://www.clotcare.com/clotcare/ptinr.aspx
Blanche

 

[dick0236]

yes, I did what he said. it was also explained by my cardio that the blood does not cause a clot because of a low INR for a week or so. it's over the course over a much longer period of time.

I have a hard time with this post. It MIGHT be true that blood does not cause a clot because of a low INR (+/- 1.5?) for a week or so. To go off ACT for 3 days will put you close to 1.0, and you may very well stroke. I know because I did something stupid like that many years ago and the result was life altering. Under NO CIRCUMSTANCES would I permit a medical provider to withold warfarin for that long, unless bridging was involved.

It may have only been a coincidence that I had a stroke after being off Coumadin for 4+/- days but I sure as hell ain't gonna test it. Since that event I have been very careful about dosing and have seldom stopped warfarin for more than a day (for a couple of dental procedures). It has been 34 years since my stroke and I have had NOadditional problems.

 

[warrenr]

Witzkeyman

Witzkeyman

Witzkeyman,

Do you want to end up like my father or what? You need to find a medical professional that is up to date with current anticoagulation guidelines and understands how the coltting cascade works.

 

[witzkeyman]

I'm not sure why my cardio told me this. I'm not sure because I have never had a problem with blood clotting. I am just repeating what I was told to me by my cardio. he makes it seem as if a high INR is much more dangerous than a low INR.

 

[ALCapshaw2]

I'm not sure why my cardio told me this. I'm not sure because I have never had a problem with blood clotting. I am just repeating what I was told to me by my cardio. he makes it seem as if a high INR is much more dangerous than a low INR.

Your Cardio is giving you VERY OUTDATED information
that could be Dangerous to Your Health.

Ask him when his last Continuing Education Class in Anticoagulation Management was.

 

[gijanet]

Wendy!!

Wendy!!

So sorry to hear about the latest coumadin/INR snags. Missed all this completely. I hope that it stabilizes soon. Andrew's dose seems kind of low, but I know it differs from person to person. Katie is seven and takes 3.5 most days with 4 on two days (Tuesdays and Fridays). Just upped it as her INR has been hitting 2.5 on the last two draws and that is too close to being in the risk zone for my liking or her PC's. On a positive note, I can't believe Andrew graduated from high school!!! How did I miss that? ANd with the highest GPA? Congratulations!!!! What's next? College? Kick back for a while and figure out what's next? Many hugs and I hope ANdrew is back in sync soon. Much love. J.

 

[gijanet]

Witzkey! (hugs)

Witzkey! (hugs)

Please don't think we are beating you up. We are just concerned about your health. I seriously would not done much of anything with an INR of 4 on a one time reading. If it was four for a couple of draws, then I might lower Katie's a tiny bit. Never would I have held a dose for one day, much less three. Yikes! I know an aortic valve does not require quite as high an INr as a mitral valve, but still! One of our little valve buddies has a mechanical tricuspid valve that is now clotted shut and he is being listed for a heart transplant. Clots and strokes can be scary stuff. Take care and read up, my dear. Hugs. Janet

 

[cocoalab]

Why is he on pain medication?

Andrew developed neuopathy in his feet last year when he had BE, his kidneys failed and everything else. It was the one lingering problem that is getting much better. It caused him much more pain than the surgeries. He still cannot walk as long as he could pre illness but he is well past the excrusiating pain he had experienced.

He is weaning off of them. Lyrica was tried after a few weeks of nueotin did nothing for him. It was a God send. His pain docs have been thrilled with his progress.

Also as an update his INR was 4.1 yesterday. A little higher than they want so we are lowering his dose a bit again. There has been some confusion- he takes 3mg a day and once a week he took 1.5 or 2 mg. We did 2mg Wed and will give him 1.5 a week on sundays. Then if he is in range next Wed we will do the 3 mg everyday and 1.5 every Sunday. Hope that clears up his dosage for those who were wondering.

He is still having some intermitant diarhea so if that is messing him up it may take a couple more trys to keep him steady again.

 

[cocoalab]

So sorry to hear about the latest coumadin/INR snags. Missed all this completely. I hope that it stabilizes soon. Andrew's dose seems kind of low, but I know it differs from person to person. Katie is seven and takes 3.5 most days with 4 on two days (Tuesdays and Fridays). Just upped it as her INR has been hitting 2.5 on the last two draws and that is too close to being in the risk zone for my liking or her PC's. On a positive note, I can't believe Andrew graduated from high school!!! How did I miss that? ANd with the highest GPA? Congratulations!!!! What's next? College? Kick back for a while and figure out what's next? Many hugs and I hope ANdrew is back in sync soon. Much love. J.

Thanks Janet. Katie is probably better about eating her veggies. Andrew has always taken a rather low dose of coumadin. Except when he was on Amiodarone it was a little higher. 6 mg or so. seems so long ago now. LOL!!

Yep he graduated but I still have to tell him to make his bed. He will be starting college locally in a couple weeks. Where did this summmer go? I've love it and am really not ready to start school up again.

Andrew got a new MP3 player and I recently saw him using that penguin again. He's so funny!

 

[ALCapshaw2]

yes, I did what he said. it was also explained by my cardio that the blood does not cause a clot because of a low INR for a week or so. it's over the course over a much longer period of time.

I asked one of the CRNP's at my Coumadin Clinic about this today.

Roughly translating what she said is that for patients whose ONLY Risk Factor is Atrial Fibrilation, clot formation may take several days.

Clot Formation Risk is Greater and FASTER for patients with Mechanical Valve Replacement(s).

She also said that there is NO WAY their clinic would ever recommend a 3 Day Hold for an INR of 4.0

Their recommendation for an INR of 4.0 is the same as everyone here has stated, "Cut the Dose in Half for ONE Day and test in 4 to 7 days."

'AL Capshaw'

 

[catwoman]

Wendy:

How is Andrew doing now? Has he started classes yet?

Witzkeyman:

Most of us here have found that we must know more about warfarin and managing it than our doctors. We have only ourselves to worry about; a doctor has many patients with many different conditions and needs. He/she can't spend as much time on warfarin management as we have.

My own family doctor -- who does understand warfarin, in my book -- said as much to me several years ago. I have given him copies of articles and threads from this website. He said that good warfarin management is a team approach, that I am an important part of that, particularly since I have my own tester machine.
Before his practice began a Wednesday afternoon-only Coumadin clinic, one of the nurses knocked on the exam room door where he and I were, and she questioned him about a patient's INR. Dr. Murphy turned to me and asked what I thought. (I think the INR was something like 2.1)
I asked the reason for being on warfarin. It was for a-fib. I said I would not do anything and to retest at the normal period.
He agreed with me.