Blood Question

[cjune1961]

Hello, I have questions concerning the warfarin. June 17 was 2.8,July 15 was 1.8, July 22 was 1.9,nurse up dosage somewhat. Have a streak of blood in my left eye today,have had traces of blood in my spit for several days now and a little bit of streaks in nasal area. My range is 2.5-3.5,and 3 1/2 years out avr, don't know if the low inr readings have anything to do with this new traces of blood situation,any advice or suggestions?Thanks.

Dosage was S=7.5,M-5,T=7.5,W-5,T=7.5,F-5,S=7.5
now S-7.5,M=5,T-7.5,W=7.5,T=12.5{for this week},F-5,S=7.5. I only see a 5 mg. difference is that enough to get the inr reading up more in range? How can have traces of blood coming up if inr so low?Confusing and wanting more greens,even though vitamin k is a small factor,don't want to make it any worse. Carla.

 

[carolinemc]

Are you going back in a week to check your inr again? When you are out of range. things will happen. like bleeding gums and nose bleeds. Please call the nurse to find out what you need to do to get the numbers up, might be to get more green in like salad. Good luck.

 

[KristyW]

Carla,

1st question...why are you testing so often? 15th then 2 days later the 17th, then 4 days later the 22nd? My guess is that because you're INR was low on the 15th, they tested again quickly. With that said. Did they raise your dosage after the low reading on the 15th? Did they make any permanent changes in your weekly dosage or just a one time increase? Have you been fairly easy to regulate in the past? If so, there's something else going on. Have you started any new medications or vitamins or new foods?

As for the bleeding...are you taking aspirin or plavix? If so, they would most likely be the cause of the bleeding...not the warfarin.

Right now there are more questions than answers.

 

[Jkm7]

I'm no expert but if I read your numbers correctly, you may have increased your dosage too much.
I agree, you have been testing too often. The changes to your dosing takes days to be reflected in the test so to increase again before the prior increase starts to show can lead to a high INR.

I am sure the more knowledgeable will be along soon to help.

 

[Bina]

Carla, the timing of your tests is good.

June 17-------2.8

July 15-------1.8
July 22-------1.9

Providing that there is nothing else affecting your INR (meds, etc.) you will need to increase your warfarin, and the 5mg per week was a good start, but don't be afraid to bump it up a bit more.
Testing weekly is best right now.

Your blood streaks are not from a low INR.

 

[dick0236]

Dosage was S=7.5,M-5,T=7.5,W-5,T=7.5,F-5,S=7.5
now S-7.5,M=5,T-7.5,W=7.5,T=12.5{for this week},F-5,S=7.5. I only see a 5 mg. difference is that enough to get the inr reading up more in range? .

I counted a 7.5 increase (but I am old and maybe my math is off). That is about a 17% increass and the protocol I use suggests a 15-20% increase when slightly under 2.0, so I would agree with her approach....baby steps:smile2:.

Like you say, the small evidences of blood are contrary to "low" INR, so I would not think that the blood traces have anything to do with the "under 2.0" INR.

 

[Bina]

Carla,

1st question...why are you testing so often? 15th then 2 days later the 17th, then 4 days later the 22nd? My guess is that because you're INR was low on the 15th, they tested again quickly. With that said. Did they raise your dosage after the low reading on the 15th? Did they make any permanent changes in your weekly dosage or just a one time increase? Have you been fairly easy to regulate in the past? If so, there's something else going on. Have you started any new medications or vitamins or new foods?

As for the bleeding...are you taking aspirin or plavix? If so, they would most likely be the cause of the bleeding...not the warfarin.

Right now there are more questions than answers.

Kristy, you have the months and dates mixed up.

 

[Maryka]

When I am "within range" I always have "streaks" from flossing. When I have no streaks, the INR is too low. I used to be on Aspirin also, but, after a year and a half, big mystery bruises appeared on my extremities. I quit taking the Aspirin and no more mystery buises have shown up.

 

[Maryka]

Oh, and that streak of blood in your eye is somewhat common among all people at least once in their lives. It seems, in me at least, to be related to stress in my life.

 

[catwoman]

Carla:

Have you been coughing or rubbed your eye a lot lately? That could account for a streak of blood. I have had broken blood vessels in my eyes due to severe coughing (bronchitis) or vomiting, and this was pre-MVR, not post-op.
Have you been drinking a lot of water lately? It's been very hot here in the Dallas-Fort Worth area, and if you've overcompensated, that could account for a lower INR, since the concentration of warfarin in your blood would be reduced due to an increase in the water component. Conversely, when you're dehydrated, your INR is apt to be high.
Dehydration could also account for streaks of blood in the nasal area, since the passages would be drier than normal. Of course, you can have nosebleeds with a high INR, too, but that's another matter.

What were your INRs between June 17 and July 15? Are you on a monthly test schedule, and the July 22 was a recheck due to the low reading on July 15?

 

[KristyW]

Oops...sorry about that! I read July for all three. Disregard

 

[cjune1961]

Blood Question

Carla:

Have you been coughing or rubbed your eye a lot lately? That could account for a streak of blood. I have had broken blood vessels in my eyes due to severe coughing (bronchitis) or vomiting, and this was pre-MVR, not post-op.
Have you been drinking a lot of water lately? It's been very hot here in the Dallas-Fort Worth area, and if you've overcompensated, that could account for a lower INR, since the concentration of warfarin in your blood would be reduced due to an increase in the water component. Conversely, when you're dehydrated, your INR is apt to be high.
Dehydration could also account for streaks of blood in the nasal area, since the passages would be drier than normal. Of course, you can have nosebleeds with a high INR, too, but that's another matter.

What were your INRs between June 17 and July 15? Are you on a monthly test schedule, and the July 22 was a recheck due to the low reading on July 15?

Catwoman, my inr readings are exactly those dates,and you are correct,was a recheck on July 22,and have one July 29. Have been doing great for over a year until this. Have been drinking massive amounts of water daily,and it is very hot here. Did not know about too much water decreasing inr reading. Have been rubbing my eye to think of it,and blood streak is gone almost now.Not sure why spitting up traces of blood though. Very little from my nose too. No new medicines,only take warfarin.Thank you everybody for your help and hope on Thursday will have inr back in range. I am eating some salad this week to determine also what dosage is needed to keep that my diet where I need it to be and also be in range without that interfering. I tend to eat lLARGE salads at least 3x and guacomole and broccoli in smaller portions weekly prior to this episode and thought that may have been a deterrent. Appreciate it!Carla.

 

[Ross]

Just keep your diet semi consistent and don't stop eating like you normally do. Everything will fall into place. I'm thinking you have a small sinus infection myself and may or may not know it yet.

 

[cjune1961]

Went back to coumadin clinic today and inr reading was 2.1. Slowly coming back into range hopefully,will go back next Thursday for another round. My nurse set me up for 7.5 seven days a week now with a little bump for today only of 10 mgs. Does that sound about right to anyone? Thanks for all of the advice and suggestions. Carla.

 

[dick0236]

Carla, your nurse seems to be conservative, but you are coming up....and you are above 2.0. I would prefer her changes rather than larger changes that might cause the yo-yo. I'm curious, since your range is 2.5-3.5, have you been in your range until this recent drop? If you have been staying in range, has something else changed....meds, diet, illness, lifestyle, etc. that might cause the sudden drop? I'm not sure I've ever had a sudden drop that was not due to an external reason.