Argh!!!

[Creed3]

Just need to vent some. My INR is usually pretty stable, but within the last month it has been steadily going down. One month ago I was 2.4. Two weeks ago I was 2.1 and they increased my dosage. I just was tested Monday and it was 1.7. They have just increased my dosage again. I just seem to be steadily decreasing even with an increase in my dosage. I get tested again in two weeks. I really thought I would be back within theraputic range this time, but boy was I wrong. I haven't dropped to under 2.0 in a long long time. The only thing that I can think of is that when my inlaws came to visit they brought a vegetable lasagna for us to eat. Maybe that little extra worth of green veggies did it to me. I ate that for a couple days before I had my INR tested. I haven't had any alcohol to drink since before my surgery, but I'll tell you that I am very close to taking a drink or two right now.....LOL Sorry to go on so, but I just needed to vent. my new dosage is now 4 days a week 7.5 mg and 3 days a week 7mg. A month ago my dosage was 7.5 mg two times a week and 7 mg 5 days a week. I hope this gets straightened out pretty soon. Maybe it's also the change in the weather. Who knows!

Take Care Everyone!
Gail

 

[tommy]

Gail,

Sorry to hear that you are struggling with the INR.

Seems like after a 1.7 reading, you would test again sooner than 2 weeks.

 

[Georgia]

Blame it on Rain

Blame it on Rain

Her dog must be in the garden again. It's too early in the season for the mysterious inr issues again! Stop it, Creed!

Seriously, hope it just as mysteriously resolves itself.

 

[LUVMyBirman]

It the 'fast matabolizer syndrome'! I am convinced those of us who take higher doses have more issues with the Coumadin! Either that or look to the younger woman hormonal thing. In another thread I mentioned tracking this.

 

[Creed3]

I called my insurance company to see if they would pay for a home testing machine. It sounds like they will pay at least 80% if I have met my deductable. She couldn't say for sure if I fell into the high risk group, but in her opinion, she thought there should be no problem in them paying for it. She gave me some tips to follow. She said they would most likely pay for it without a doctor recommending it but said it would more likely be approved if my doctor sent something indicating he felt I would benefit from having a home machine. This just sounds way too easy. I was definately expecting a fight with my insurance company. We'll see what happens when I talk with my doctor and get the ball rolling.

Take Care Everyone!
Gail

 

[Ross]

Gail all the paper work is downloadable from QAS in a single package or you can call them and they'll mail it out to you. You will need a Doctors Prescription for the machine, but they have letters of medical necessity too if needed in the bundle. Check into it when your ready.

Better yet, here are the links to the downloads

ITC Protime Starter Packet

HemoSense INRation Starter Pack

Coaguchek Starter Pack

 

[Guest]

Look for something that you changed about the time this started going down. I'm 99.99% sure that it is not eating veggie lasagna for a day or two.
Change vitamins - including more Slim Fast, Carnation Instant Breakfast?
Stop amiodarone?
Increasing doses of something like Fiorinal/Fioricet or any other medication that may have a barbiturate in it?
Change any herbal or supplement?
Any change in seizure medications - even a dose change?
Change thyroid dose?

 

[Creed3]

Hi Al!

Hi Al!

I really haven't changed anything at all. The only thing was eating a little more green veggies for a couple days. The only other thing is that I have been a little more anxious lately so they increased my Prozac from 20mg to 30 mg a day, but from my understanding, Prozac increases the effects of coumadin. I am so shocked about this whole thing. I actually have been eating less vitamin K than usual since my INR first started to go down. Nothing is different. My kids have been really sick the past week or so. They have rotovirus (GI virus), but I don't have it. All my meds are exactly the same except the Prozac and increasing the coumadin. I changed the brand of multivitamin a few weeks ago, but I checked the label and it doesn't have any vitamin K in it. It is just another brand of a Woman's Vitamin. I am always extremely careful about my routine. That is why I am so puzzled. I don't take any of the other types of meds you have indicated and I don't use Slim Fast or Carnation Instant Breakfast. I hope it gets straightened out pretty soon.

Ross,
Thanks for the information. So, I can't just go into the medical supply store and buy this machine? My insurance company made it sound like I didn't need anything. But maybe that was just that they didn't need anything. I am going to talk to my doctor about getting one of these machines. I see him all the time at work. Hopefully I run into him tonight. Thanks for all of the links. They are really helpful.

Take Care!
Gail

 

[LUVMyBirman]

Gail,

Have noticed many times when I am under alot of stress.....my INR goes down. Also look to increased activity and or exercise

 

[Ross]

Gail everything you need is in those patient starter packs.

Yes you do need a prescription because it's a medical device. Not so sure that it's for the machine, but for the testing supplies.

 

[Creed3]

Hi Gina!
You know I keep going back to what you said about hormones. A couple times a year my cycle goes out of whack from the coumadin and this is the month that that is happening. I wonder if that has anything to do with it. It would also explain why I have been a little more anxious the last few weeks. I won't get into specifics, but ever since my cycle last month and this month, that is when a lot of this has started. The extra 10 mg of Prozac has helped the anxiety some, but the nurse that regulates that doesn't think that I will need to stay on 30 mg a day. She thinks that this is just a stressful time of year for me. All of my yearly doctor appts all come around the same time, and guess when that is NOW! LOL!!! Switching pcp's has also added quite a few extra doctor visits in there. I have my cardio appt, gyn appt, dentist appt, new pcp appts and my appt to regulate my prozac. I'm also making plans with my mom for her to go on vacation with us later in April. She will be staying with us for about a month. I also worry about her because of her getting older and some health issues. Nothing major, just worrying about my mother aging. She will turn 70 in July. My two girls have both been sick. Kristen was sick for a week with rotovirus and now Faith just came down with it. So, what do you think? Am I stressed ? I'm not even counting my in-laws came to visit and a lot of changes are occuring at work. As well as organizing a clothing ministry at church. I guess now when I write it all down, maybe I am a little stressed. Sorry for going on and on here. Thanks for all of your input.

Take Care!
Gail

 

[Birky]

stress

stress

I would be stressed if I followed you around. Some days I am glad that my kids are grown but you still worry about them and the Grandkids. I am finally learning to relax a little. I am still keeping an eye on my 85 yr. old Mom. She had a small stroke a couple of weeks ago so I was doing a lot of running with her. We are going on a trip to the gambling boat this Sunday which she loves. I really don't have the time, but I don't like her to go herself. Hope you get to slow down a little and do something for yourself, all Moms need this once in a while.

 

[Birky]

INR

INR

What I forgot to tell you is that my INR was 1.9 two weeks ago when I was doing all the running and really stressed out. I really do have pumphead syndrome at times. Going to retest next week. I take 30mg. a week. Wants me between 2 and 3. Seems that it should be higher but I'm not the Dr.

 

[Creed3]

I just talked to my pcp while I was at work tonight and he said that I shouldn't wait two weeks to be retested. He wants me back in a week to see if the increased dosage has brought up my inr. Any of you who have read my thread about changing pcp's will probably think that I made I wise choice switching my pcp to this internist. He is really good and on the ball. My cardio is also thinking it may be easier for him to take care of my inr. My new pcp also said that he thinks it would be a good idea for me to have a home unit to test my inr. He is the very first doctor I have talked to that has pretty much agreed with everything you guys have all said. He is definately a keeper.

Take Care!
Gail

 

[Blanche]

Gail:
We have great confidence in our pcp. Actually, after seeing how thorough he was with Al, I changed to him too.

After Al's stroke, his cardiologist and his 12 partners just couldn't get Al's INR stable and we continued to get different directions from different partners. I also had difficulty reaching the partner who handled Al's INR management on a given day. Al's range was 3.0-4.0. One doctor said to stay on the same dose when the INR was 1.9, another doctor said hold all Coumadin for three days when the INR was 3.6.

In April of 2001, we changed Al's anticoagulation management to the pcp. Didn't even mention it to the cardiologist. After three months the cardio's office called and we advised them of the change. When Al next saw his cardio, the guy didn't know he had changed and it took him nearly a year to figure it out!!! Al's cardio actually told me that the practice started its own Coumadin Testing Center because it was so hard to get his 12 partners to agree on anything.

It was the very best change we ever made. From what you have said about your pcp, I would certainly encourage you to make the change too.

Kind regards,
Blanche

 

[tommy]

Gail,

Glad to here that you will be tested again sooner.

 

[Creed3]

I think I may have figured out why my inr has been going down. I know I had said that I had had vegetable lasanga and then went out to dinner and had a little broccoli. I was doing some searching on the threads here and saw where soy also can cause your inr to drop. I have been eating soy chips within the last week along with the other veggies. Maybe the combination of all of those things made it go down. I get tested next Wednesday so I'll know more then.

Thanks to all!
Gail

 

[Rain]

Take a good look at the pills...

Take a good look at the pills...

Gail,

This same thing happened to me a few weeks ago... I tested at 5.9. I had been going about my consistently inconsistent life --where my INR bounces between 2.5 and 4.0 most of the time... when out of the blue I got this reading! I racked my brain and couldn?t think of anything that should have caused this. Until I looked closely at the pills in my hand a couple days later..... I take 3 ½ mgs a day. I currently have 5 mg and 1 mg tablets on hand, so I take a half of a 5 mg tablet and a full 1 mg. Well......... I let my darling, ever so helpful, ten year old daughter, for the first time ever..help me cut and ?do? my pills. (I do three weeks at a time) She had cut the 1 mg tablet in half instead of the five... so I was taking 5 ½ mgs instead of 3 1/2 mgs. Thank goodness I tested only a couple days after we did the pills. Confirmed my instincts to take care of my own pills!!

It's spring........ my dogs favorite time of year to play in the garden! I don't know how or why... but I swear sunshine and stress DO have an impact on INR.... but not quite at much as almost doubling your dose!! lol

 

[McCln]

Gail

Gail

I found that even green beans, much less eating a little salad will mess up my inr. So, it makes sense when we have to figure it out for ourselves. My cardio's nurse use to sound peeved if the numbers was out of sinc. Now, she lets me think it out while we are on the phone. You keep hanging in there, just the the green veggies and stop three days before inr draw, helps me. Take care.

Caroline
09-13-01
Aortic valve replacement
St. Jude's valve

 

[ccrawford]

Gail - I was gonna ask a bunch of questions about what changed but Al beat me to it. Note that the difference between your old weekly dosage and new weekly dosage is only 1 mg. That's not a lot of increase to get you back on track. Hope you get it fixed soon. Do try to get a home tester - it's really the way to go. Chris