6 year INR history

[dick0236]

This is FYI for any new anti-coagulant patient who is having trouble understanding the "ups and downs" of INR results.
The sample is small: ME
Number of tests: 93 (probably does not include a few I forgot to record)
Time period: 2002 thru Nov. 2007
Type of test: 95% finger stik, 5% vein draws
Place of test:
PCP office who had me on a yo-yo,
Cardiologist Pro-Time Clinic,
Self-Testing*,
Current PCP office

*I was satisfied with self-testing but my new PCP is very convenient, my co-pay is -0- and the hassle between me, Raytel and Medicare wasn't worth continuing. Someday I may try again, if need be.

*************MY SAMPLE RESULTS************

TARGET RANGE 2.5-3.5: 56 tests or 60% of total (93)

MY ACCEPTABLE RANGE 2.0-4.0: 79 tests or 85% of total (93)

I think these results are indicative of my results over many years. Some may find these results scarey. There were only two that scared me; one 1.5 and one 5.4. The above results seem to mirrow a study I saw on the Inernet that was compiled by Medicare which concluded that INR is normally difficult to maintain to very close tolerances.
After 40 years of results like those above, I have had only one serious TIA event. I was 38 years old and the event was due to my own dumb behavior and not to Coumadin. Hope this little study helps put some minds at ease.

 

[Computec]

I appreciate you posting your results, Dick. Thank you.

I'm new to self testing and have what would be a free ride as far as how often I test. I admit I've experimented a bit. Comes with being a Nerd.

Since starting on my InRatio machine I've had some strange readings that seemed so abnormal that I suspected my "newbieness" as the culprit. I'm still not sure.

I'm a 2.5 to 3.5 person myself. My readings in the past two months have been 1.6 to 4.3. I swear that I've tried like hell to maintain the same decadent life style during this period to the point of forcing that third beer in the evening. What a chore.

I can't explain the swings but I feel OK with the range so far. I'm not a purist that insists that I be between the numbers. Being a rationalist I wish I could see the easy answer for the swings. (No cravings for spinach salad here!) But, again, I'm content that my INR hasn't taken some of the major excursions that some other members of this forum have experienced.

I suspect that your numbers are valid for the majority and a lot of the swing can be attributed to the daily difference in the concentration based on dosing time and test time. My wife is a nurse and she assures me that the concentration is a saw tooth wave with peaks and valleys. The spot in between is the "normal". If you can't trust your wife...

It sounds like your doing fine.

Jerry

 

[Ross]

I'll have to compile mine, but I have similiar results. It's not always perfect, but it's far better then I was getting at the clinic.

 

[Cooker]

I have only been on warfarin twenty one months so I don?t have much of track record to share. I test at my cardiologist office once a month. My target INR range is also 2-4. My comfort zone between 2.5-3.0. The lowest that I have been is 1.9 and that was one month after surgery.

The main reason that I do not home test is that my insurance covers the cost with no co-pay. The cardiologist?s is also only ten minutes from home. Now I do feel lucky/blessed that I seem to stay in range without worrying too much about what I eat and drink; I know some folks have a very hard time managing ACT. If my INR becomes hard to manage then I would consider home testing and the expense that goes along with it. A question????if one has a history of being stable is that likely to change with age or length of time on ACT if diet etc remains constant?

 

[Karlynn]

Like Al Capshaw has said many times the 2 - 5 range is comfortable to me. That's not to say that I don't make adjustments for anything too far outside my 2.5 - 3.5 prescribed range. But I consider anything 2-5 as successful ACT management. I think the % of in-range tests would be higher if we considered a 3.7 for a 2.5 - 3.5 range to be "in range".

So many ACT manager start getting excited for any out of range test regardless of the number of points. (And as we've seen here - some get fidgety when it gets to the high end of the range and not even out of range.)

I haven't taken the time to go back through my history - but my guess is that my numbers are probably similar to Dick's.

 

[Ross]

A question????if one has a history of being stable is that likely to change with age or length of time on ACT if diet etc remains constant?

Sure certainly. Your body is not always going to metabolize the same. As you age, things will slow down and depending on how active you are then, well I think you get the picture.

 

[dick0236]

To Cooker
I'm not positive, but I think my need for Warfarin has declined over time. I think I took 50-70 mg/wk when I was in my prime but that was also under the old system of measuring PT against a control number. In my 50's/60's a reasonably stable INR took 40-60 mg/wk. Now in my 70's it takes 30-40 mg/wk and normally 35 mg with few adjustments keeps me at 3.0+ INR.
My diet has changed very little. My physical exercise is different but I am still pretty active . One big change is I am OUT of the rat race

Dick

ps: This is all from memory and that is the second thing that goes!!

 

[aussigal]

This is a good lesson for those who are new to ACT...
I had to go have a look at my little book also. It shows that in 18mths I too have been fine for 45 tests (INR between 2-4) except 4 times. Does a 90% strike-rate earn me an "A"! Curiously, the times when I was a little bit off-target was when "they" prescribed/ordered an adjustment to my usual dose and before I had the confidence gained here . Thanks to those here I have learnt to ignore tiny variances in my INR and no longer stress-out over ratsak.

I bet this holds true for most of us here...I reckon we do a marvellous job