Bruising on Coumadin

[almost_hectic]

So yeah, since I've been on Coumadin I notice I definitely bruise easier. Not a big deal I suppose. However I have had a couple incidents from hurting myself where I've bruised pretty nasty. In the dark I ran into the footboard on my bed and had a huge bruise on my leg the size of a softball for like three weeks or more til it healed. Never went to the doctor but I have since read you should see your doctor for major bruises. Is that just to double check your INR or for reason like the injury needs to be treated somehow, or even perhaps that the bruising has some other adverse effects they need to address?

Now this past weekend I was bit by a dog on my arm. Dog has all its shots. I went to the ER to have the wound cleaned, get a tetanus shot, and antibiotics. But the bruising really wasn't too bad at the time. Now it's had a few days to settle in and start looking pretty gnarly. How big of a deal is this? Should I notify my cardiologist? I can't imagine why, but I'm not sure why the precaution to see a doctor for major bruising when on ACT...

 

[pellicle]

Hi

...In the dark I ran into the footboard on my bed and had a huge bruise on my leg the size of a softball for like three weeks or more til it healed.

ouch

...I went to the ER to have the wound cleaned, get a tetanus shot, and antibiotics. But the bruising really wasn't too bad at the time. Now it's had a few days to settle in and start looking pretty gnarly. How big of a deal is this? Should I notify my cardiologist? I can't imagine why, but I'm not sure why the precaution to see a doctor for major bruising when on ACT...

if it was me I'd not be worried. I don't think there is much more they can do except look it and say "wow" ... that you're seeing the colours means the clots are broken up and moving around being dispersed.

Nothing like this I guess:
http://www.valvereplacement.org/foru...y-graphic-pics

 

[almost_hectic]

Well they told me at the ER that a might want to check my INR more often while on the antibiotic as it may go higher. Well I just checked it and it's 1.5. Which according to OnX is therapeutic. My cardiologist doesn't want me going that low so they set my range at 1.7 to 2.5. First I've ever been too low and wondering if I should take a booster dose now or wait til I can speak with their office tomorrow. Not sure why I'm going lower when they feared I might go higher. My only thought was maybe taking the antibiotic dose too close in time to my Coumadin dose and the coumpounds bind rather than getting absorbed or whatever. Sitting here thinking it can't hurt to take a bump dose like half of my usual 4mg?...

 

[pellicle]

Well they told me at the ER that a might want to check my INR more often while on the antibiotic as it may go higher.

or lower or whatever comes to their mind ... I'm always a firm believer in checking frequently (as you've done).

Well I just checked it and it's 1.5. Which according to OnX is therapeutic. My cardiologist doesn't want me going that low so they set my range at 1.7 to 2.5

well I'm on the same page as your cardiologist ... I'd move it towards 2 if it was me ... On-X or no On-X

. First I've ever been too low and wondering if I should take a booster dose now

assuming your dose is 4mg as you mentioned then I'd be inclined to take a one off of 1mg now and then just keep up your normal dose and test again in 4 or so days. I would not take more.

... My only thought was maybe taking the antibiotic dose too close in time to my Coumadin dose and the coumpounds bind rather than getting absorbed or whatever.

one theory is the change of gut flora altering things another theory is that the p450 disposal of warfarin is ramped up (resulting in lower INR) ... my view is just monitor and see ... hopefully you have a home testing outfit (I don't make it my business to memorise everyone heres dose / equipment levels).

 

[almost_hectic]

yup, i home test thats how i checked it tonight, thanks for the xpert advice. ill take an extra mg tonight. iim usually right at 2.0 but dip to 1.8 or 1.7 occasionally