Another question for Al

[Rich]

Al,
As a stated a few weeks back my INR is running too low lately.
Because of this I had two checks in December and they were 1.9 and 1.8.
So two weeks ago the doctor made an adjustment (first one in six years).
He increased my weekly dosage by 5 mg, that amounted to a 20% increase.
Today I had my blood checked and my INR was 1.9
Now we are going to increase it by another 2.5 mg and see what happens.
I have tried to slow down my activity level some but it doesn't seem to be working.
Funny thing is I thought I heard that as people get older their blood tends to thin naturally but in my case it seems to be getting thicker.
What do you think about this Al ?

 

[Guest]

11 people read this before me and there were no responses. I'd be the 12th except that you addressed it to me.

This is really a hard question.

1. Are you sure that the pharmacy gave you warfarin? That sounds so simple but I've seen it happen. It even happened to me at the pharmacy where I work. It wasn't warfarin but they gave me the wrong medication and I took it for a day or two before I realized it wasn't the right stuff. So look in the bottle and verify that.

2. Could there be a vitamin or supplement that you were taking that was re-formulated to include vitamin K? There is no law that requires that this change be stated on the label. These thing are like the "wild west", everybody for themselves and "the devil take the hindmost".

3. Did your activity really increase that much. I would think that you had to double your activity level to cause such a drastic change.

4. Might you have changed something that you are eating? Active-culture yogurt will add vitamin K producung bacteria to your intestinal tract.

5. What about medication changes that take a long time to show up?
Stopping or cutting back on:
Amiodarone
Fiorinal - Fioricet
Dilantin
Donnatal
Bellergal

even chewing tobacco or alcohol consumption

Something changed about 2 to 6 months ago that took a long time to show up. It is almost surely something that you put in your mouth. The only other alternative is that somehow your liver started working more efficiently which does not seem too likely.

 

[Perrster]

INR "It's Never Right!"

INR "It's Never Right!"

Rich and Al,

I too, have become a recent victim of a lower INR testing yesterday with a 2.2. That's not all THAT bad, however I haven't changed doses since last May, so now I'm on my own mission to figure out what the heck I've done differently. I was upped by 2.5mg.

1. could a flu shot have an effect? Got one last month after my last Protime.
2. thanks for the heads-up on active culture yogurt, however I have consistently eaten yogurt almost daily for a couple of years. Would the little "active gurts" take that long to build up a Vit. K supply in me?
3. I've upped the winter exercise routine so I expected that to have some effect.
4. I have also slowly re-introduced small amounts of salads to my diet a couple times a week.

Rich, I hope you figure it out soon. I retest in two weeks, although I think I should re-test today as I sit here with a bloody nose (most likely due to this danged Midwest indoor dryness!). I get BN's a lot!

Cheers!

 

[LUVMyBirman]

Your a mess my friend Perry

It's the increased activity! Your flu shot is long out of harms way to have an affect on your INR. Usually you see an increase.

Happy to see you have added some salads. Doing the same and really with the added flaxseed oil caps.....basically on the same dose as usual. Try Iceburg for your salads. Less K and still gives the same pleasure as the dark green stuff

 

[medtronic of borg]

Just one thought

Just one thought

Ask if the lab has changed its protiens used in the test. I had to once and was right they had changed to a new company.

Med

 

[Guest]

A little more exercise and a little more salads are the probable reasons for a small INR change like that. Consistently eating yogurt will not cause a change.

 

[LUVMyBirman]

Well well well

Well well well

If you can't beat them...join em'..is the "old saying".

Got back into my routine full swing this past week. Exercising x3 weekly in a resistant arobic state.

My INR is 2.1 today. Wondering if going to the gym is dangerous until it comes back up? That just opens up another whole can of worms if I don't...how will it ever level out then

Any suggestions AL?

Thanks.

 

[Guest]

I don't think there is any extra danger in going to the gym.

 

[LUVMyBirman]

As always..thank you Al.

I debated with much thought...and decided to go ahead. Was just concerned about throwing a clot with the lower INR.

Guess there are individuals walking around out there that have no idea where there INR is because they do not test. This only comes to mind because I knew someone with a valve that did not bother to have her INR checked but every three months on a regular basis.

"Going to the doctor and waiting is such a hassle" as it was put. Yes, it can be...but were talking about something potentially much more damaging than losing an hour or so from your day!

PS. Rich and Perry. How are you both doing with your levels?

 

[Ross]

I don't think there is any extra danger in going to the gym.

Maybe not for her, but what about all those poor people around her?

 

[LUVMyBirman]

Are you certain you have not met me in person Ross?

 

[Ross]

I'm certain, but I think it would be great, even if it does position me in danger.

 

[Granbonny]

Gina

Gina

Bumped into the Hubby of my friend (from pool in summers)...We were chatting and he told me himself..that he only checks his INR every 3 months.She's the one that told me the first summer ..after my surgery..that I dwell on my INR too much He takes coumadin for some kind of heart problem.. He is also the one who passed out from taking vitamin E. His dr. told him it would be O.K. hit his head from the fall and severe nosebleed...Just didn't bother to start up another conversation with him You cannot talk to people like that..Bonnie

 

[LUVMyBirman]

There's another one out there!

There's another one out there!

Hi Bonnie,

Tried on numerous occasions to speak to this woman. She was a neighbor and friend down south. Once we were standing next to each other at a party as she wiped a drop a blood from under her nose Already knew about lack of testing frequency. Could not say a thing. Though I wanted to grab her and take her to my house for a test. I even offered to test if she could not get to the doctor, etc.

After my surgery I ended up with a major bleed because of the Coumadin. I was following the direction of my cardio. Came so close to death I could taste it. Not ready to go there anytime soon.

Testing weekly is not a bad idea if you have your own machine or otherwise. Just proved here.Went very South in one weeks time. 3.9 last Wednesday to 2.1 today. Not much of a change diet. Increased activity.

I have found the difference between the Northern and Southern winters...my INR was very stable down South in the winter months. The weather swaying in the North must effect the INR. Was even having some Merlot here and there and still low. Wonder where I would have been with that wine!

Bonnie, your are a very educated patient. Keep up the good work and don't let anyone tell you otherwise

 

[Guest]

I had a gut come in the other day who had an INR greater than 8. Had only been once in 2003 - in July. Had ignored all of our letters, calls etc. Well he's coming in now often enought to make up for all the missed appts.

 

[Rich]

Gina,
I'll go back in two weeks and see if I made any progress.
We have raised my dosage by 25%.
My doctor feels that an INR of 2.0 to 2.5 is about right for a mechanical valve.
I went almost seven years without a problem and then BANG!!
Perry,
How are you making out?
Do you think the nosebleeds are from the Coumadin or just the dryness?
My one grandson has nosebleeds all the time.
It is really dry in our house, we have hot water heat so there isn't much humidity in here.
And it is really cold here in Michigan, expecting 5 below tonite.
I don't know how those in the northeast are surviving at 35 below.

 

[Missy]

Al

Al

I did not know that about the yogurt. Thanks. How much vitamin K does it produce? I eat yogurt but not everyday. So maybe I could adjust my diet like a swap.
I really hate to give up yogurt but don't want to eat it everyday. Help.

 

[LUVMyBirman]

Perry, how are you doing today? Kara had a small bleeder last night.

It's so very dry. The say we are going to have a low of 4 this weekend. We might was well boil a huge pot of water and stand over it, lol. Can always stand in front of the dishwasher after a cycle when the door opens.

We have one of those "whole house" humidifiers which, in my opinion do not work.

Hope you are doing much better. Tracy sends his best.

 

[Gisele]

I had the same problem with my INR's. The last few years on Coumadin I found myself with low INR's and my dose needed to be upped to an average of about 8mg daily (more or less) from 4-5 mgs daily. I think it will remain a mystery as to why my need for a higher dose occured. I was beginning to think I had become resistant to the medication but Al assured me that wasn't possible.

I know what you are going through and you can drive yourself crazy trying to analyze it. I am so happy all of this is behind me now. Good luck to all my Coumadin friends out there.

PS: The first few years I was on Coumadin (21 years ago) I hardly showed up to have my blood tested. Of course that was back in the day when hardly anyone was on it and doctors weren't as educated about it as most are now. Guess I was really lucky.

 

[Guest]

Yogurt cannot be managed like vegetables. The bacteria stay in the intestine long after you ingested them. They are usually limited by the amount of nutrition available and their competition with the viruses and yeasts that live in there too.