battling with my inr again

[jax]

well i went to get my inr checked on monday again. it had again dropped down to 1.26 so i was put on lovenox shots. fun fun. not only that she doubled my dose of coumadin for the four days to 8 mg a day. i had to recheck yesterday and thankfully my inr was up to 2.47 that is the highest it has been since i have been out of the hospital for two months. still a little below range but it's getting there. the only thing that concerns me is that she wants to keep me on 8 mg/per day and check in a week actually since i am driving up to canada to see my family on tuesday it will be more like 10 days which she said was fine. but my concern is that if i went up that quickly in 4 days that when i do get back from my visit while taking 8 mg/per day that it will be way too high by the time i get back. I was thinking of doing 6 per day until i get it checked again. Any thoughts on this?

 

[Freddie]

Where abouts in Canada are you going?
You may be able to get it check here if you have the proper paper work from you doc.

 

[jax]

going to london, ontario. most of my family live in a little town about 1/2 an hour out called melbourne. that's where i was born and raised. she didn't give me any forms to get tested there. i am assuming she believes i will be fine for a couple extra days but the dosage is what worries me. i was on 8 mon., wed., and friday and 4 the other days. the only reason it dropped was because i had to buy vitamins and there was more vitamin k in the ones i bought because i couldn't find any with the same amount. i discontinued that on sunday. so the only way i get any vitamin k now is through diet which now i'll be able to keep that consistent. i guess that 8 every day just seems pretty excessive considering that i am not on the vitamins anymore. this is the highest i have been since surgery so i am on the right track with my dosing finally but i just don't want it going too far the other way while i am gone either.

 

[Freddie]

You know...........you should be okay on 8mg. Since this is the first time since surgery that your almost in range and your activity level may increase more during your trip.

Can you go for one more test before you leave to see if your levels are raising with this new dosage?

 

[jax]

i leave on tuesday so i could possibly go on monday for another test but i remember the one time i went 3 days after a test it was brought to my attention that my insurance may not cover it because they were so close together. which didn't make any sense to me of course but with the doctor telling me to wait that long i have no idea whether that would have any affect on my insurance whether i did go against her wishes and get it tested early before i went.

 

[Bina]

I would test on Monday....screw the cost, it's your safety at stake.

 

[Freddie]

You were on 4mg and then your doc doubled it to 8mg for 4 days right?
(1.26 to 2.47 in four days) and your range is 2.5 - 3.5?
Now I'm not the sharpest tool in the shed, but try this and book mark it - http://www.pace-med-apps.com/CoumCalc.htm
miss the first line and fill in just below where it says "Continued Dosing" click on weekly dose and put in the amount of 'mg' BUT do not type in the 'mg' after your amount, then click on "Calculate"

 

[jax]

i used the calculator and it says 8 mg per day except for 9mg on 4 of the days. so maybe the doc isn't too far off. considering getting it checked on monday for sure bina. because it would be nice to know what it is before i drive 4 hours and then i won't have to worry about it too much.

 

[Freddie]

Yea, I got the same result - but take note: when adjusting your dosage, the dosage should only be increased by 5 to 10% from what you were taking before.

If you dose beyond that, you go to high then you have to decrease 5 - 10% which can cause you to be on a roller-coaster ride.......and trust me its not fun.

Lets see what Monday brings.

 

[Ross]

It all sounds perfectly reasonable to me. You should be "Good to go".

 

[ALCapshaw2]

well i went to get my inr checked on monday again. it had again dropped down to 1.26 so i was put on lovenox shots. fun fun. not only that she doubled my dose of coumadin for the four days to 8 mg a day. i had to recheck yesterday and thankfully my inr was up to 2.47 that is the highest it has been since i have been out of the hospital for two months. still a little below range but it's getting there. the only thing that concerns me is that she wants to keep me on 8 mg/per day and check in a week actually since i am driving up to canada to see my family on tuesday it will be more like 10 days which she said was fine. but my concern is that if i went up that quickly in 4 days that when i do get back from my visit while taking 8 mg/per day that it will be way too high by the time i get back. I was thinking of doing 6 per day until i get it checked again. Any thoughts on this?

It's not clear to me how many days after you started taking 8 mg that you were tested (INR =2.47).

I am guessing that this test was a bit Early and you will continue to RISE. If I were you, I would go get tested again Monday (before you leave for Canada) to make sure you have not gone TOO HIGH. By that time, you should have a better idea if you are going to remain stable on that dose or continue to rise.

I would also ask for an RX for a couple of INR Tests that you can take with you while on vacation.

I don't remember if you have asked for an Rx for a Home Test Instrument or not. Obviously, that would be a Big Benefit, especially when you travel!

'AL Capshaw'

 

[Bina]

I'm quite sure that some kind of travel insurance (Blue Cross?) would be needed to have a blood test in Ontario.