6 pack of beer

[pellicle]

My doctor has me on 10mg daily, my inr kept climbing from 1.8, 2.3, 3.0, 3.8. my nurse told me to eat salad daily, which I really enjoy.

its good that you enjoy a salad, and that you will continue to be able to enjoy a salad.

I think you need to lower your dose to perhaps 8mg daily and see where that leads. Then test again in a week. A graph of your data will help reveal trends.

However the information that your nurse told you is false and very misguided. Please read this post I made here:
http://www.valvereplacement.org/foru...561#post861561

I write:

this link (US Food and Drug) shows that 100g (that's 3.5Oz which of course means nothing to me) of fresh unprepared Spinach has about 373 micro grams of Vitamin K

now, remember that you need A THOUSAND micrograms to make one milligram (its the very definition of the word). Go get some Spinach and put it on the scale till you see 3.5 Oz ... ask yourself if you'll eat that much?

then:

This link (American Heart Association) suggests that guidelines for reducing INR are something like this:
For most warfarin-treated patients who are not bleeding and whose INR is >4.0, oral vitamin K (in doses between 1 and 2.5 mg) will lower the INR to between 1.8 and 4.0 within 24 hours
and for patients about to have a surgery (to get their INR down low) they write this:
"For patients whose INR was 1.4 to 1.9 the day before surgery, 1 mg of oral vitamin K was given. Thirty-nine (90.7%) of the 43 individuals in this cohort had an INR <1.5 the next day, and there was no difficulty reestablishing anticoagulation with warfarin after the procedurel"


So to see a clinically significant drop in INR you need at least 1mg of Vitamin K

So you bed at least 1mg of Vit K. The problem is that most people don't know how to read numbers ... milligram is mg and microgram is µg ...getting it wrong means being wrong by a factor of a thousand

today my INR was 3.6, I guess I can keep my high Coumadin doze and my green leafs.

as you can see eating a few greens will not change your INR down. The problem is that very few of the people managing your INR have the faintest levels of training or even (it would seem) the faintest understanding of numbers or how drugs work. Nurses are not doctors, and doctors are seldom good at understanding drugs ... nurses less so.

Warfarin is a text book example of the managemnt of target by dose ... if you are above range then the only way to bring that down is to reduce the dose ... its simple.

BTW, I am new to this, just started my blood thinner journey last week after being DC from the hospital.

Yes, and I'm so glad that you are here and getting exposure to folks who like Dick and Superman have been managing their INR for years and who are able to understand it because (unlike the nurse) they are personally motivated to sort fact from fiction and who pay attention to the evidence as if their life depend on it ...

Sadly what I read here (in your question) is just more evidence of how people come to harm on warfarin: NB by the mismanagement and ineptitude of their managers.