Can someone help me?

[Blake777]

My INR decided to plummet to 1.8 for some reason. I have been having a horrible time with my leg that decided to just mess up on me the other day, but looked down while showering and it was all bruised up for some reason. Don't know why my husband just don't see this stuff on me. Probably just from straining to walk on it. Looks bad, but looks like it's healing, it does feel better today.

But I went to that coumadin dosing calculator online and it said to take 6.5mg tonight, sounds about right to me, but I usually talk to my warfarin clinic but it's the weekend and I can't talk to anyone. So I guess this is going to be okay, not really comfortable with the calculator, it's the one that is posted on this site. Is the calculator pretty accurate? I just need to get it back up. I know it takes 3 days to show on the monitor, but just need to know is this going to be okay? Anyone, that uses this calculator, if you can help me out please? Hate being this low. Especially since I had the heart attack scare and then my leg went numb last week and messed up on me, and INR was like that then 1.8. Thanks for listening.

 

[pellicle]

Hi

what was your INR before it "plummeted" ... so anyone who offers advice (like me) has some idea. What is your normal dose (so that anyone who reads you question knows what it was and has something to work with other than you going to 6.5)?

personally I'd just take another half milligram (and my regular dose is 7) and measure in two days ...


so flying blind that's what I'd say

 

[Blake777]

Sorry, I went out for a minute. It was 2.5 exactly about 5 days ago. Well when I seen all that bruising on my leg I decided to take it to see where it was.

 

[Blake777]

Well my normal dose if 4mg. But they will have to change me to 5mg because when the weather starts to cool down my INR drops then they have to raise me to 5mg, but the warfarin clinic didn't raise me up, so I keep dropping with the 4mg. I don't see them again until Tuesday. I really don't think a 1/2 dose will raise me, I've been here before. I think If I take my regular dose plus maybe 2-2.5 it will go up to about 3.0. Anything less will probably barely move it up.

 

[Bina]

Hi there,
If you are truly concerned with the low INR of 1.8 and your past leg issues, then you could always go to a local hospital for a Lovenox shot to protect you immediately until
you get your INR up over the next few days.
I do agree that taking 6mg today will get the ball rolling towards a higher INR for Tuesday.
You could also take 5mg on Sunday and 5mg on Monday without worry of it going too high. (that's what i would do). And don't binge on spinach this weekend

 

[pellicle]

Hi

Well my normal dose if 4mg.

well then, 5 is a large relative increase ... my personal experience is that a 10% increase makes a definate swing up.

of course we're all different ;-)

But they will have to change me to 5mg because when the weather starts to cool down my INR drops then they have to raise me to 5mg,

interesting ... so you've had a regular thing happening where as you're metabolic rate changes you need to increase your dose ...

I really don't think a 1/2 dose will raise me, I've been here before. I think If I take my regular dose plus maybe 2-2.5 it will go up to about 3.0. Anything less will probably barely move it up.

well you seem to know yourself better ... personally I'd not have suggested so much ... but as you say "you've been here before"

so do you take the same dose every day?

 

[pellicle]

And don't binge on spinach this weekend

I binged on Broccoli this last few days ... who'd a thought I'd find myself liking it so much more now that I'm "not supposed to have as much"

;-)

 

[Blake777]

Hi there,
If you are truly concerned with the low INR of 1.8 and your past leg issues, then you could always go to a local hospital for a Lovenox shot to protect you immediately until
you get your INR up over the next few days.
I do agree that taking 6mg today will get the ball rolling towards a higher INR for Tuesday.
You could also take 5mg on Sunday and 5mg on Monday without worry of it going too high. (that's what i would do). And don't binge on spinach this weekend

Yes, was trying not to get them darn shots, just got off of them and have a huge bruise trying to heal now. The nurse that gave it did it really fast and I still have a bruise the size of a lemon. Actually that is when my leg issues started after I got the shot and came home next day. Now my leg is completely going numb then bottom half goes numb, then back to my thigh. Mostly when I walk around. My mom and husband just look at me like I know she is not going back to the hospital. I know pitiful that I manage to worry about what they are thinking and I try to explain to them but they don't understand.

 

[Bina]

I binged on Broccoli this last few days ... who'd a thought I'd find myself liking it so much more now that I'm "not supposed to have as much"

;-)

LOL...isn't that always the way ?!
My farmer neighbour has been selling so much of his organic produce the past few weeks and we indulged. (INR was 2.9 yesterday) Yay, still in range.
Got a bag of brussel sprouts in the fridge to enjoy with haddock tonight.

 

[Bina]

Yes, was trying not to get them darn shots, just got off of them and have a huge bruise trying to heal now. The nurse that gave it did it really fast and I still have a bruise the size of a lemon. Actually that is when my leg issues started after I got the shot and came home next day. Now my leg is completely going numb then bottom half goes numb, then back to my thigh. Mostly when I walk around. My mom and husband just look at me like I know she is not going back to the hospital. I know pitiful that I manage to worry about what they are thinking and I try to explain to them but they don't understand.

Ouch, did that nurse stick you in the leg? I've only ever had 1 shot in 2006 and my daughter stuck it in my tummy.

 

[Blake777]

Hi


well then, 5 is a large relative increase ... my personal experience is that a 10% increase makes a definate swing up.

of course we're all different ;-)


interesting ... so you've had a regular thing happening where as you're metabolic rate changes you need to increase your dose ...



well you seem to know yourself better ... personally I'd not have suggested so much ... but as you say "you've been here before"

so do you take the same dose every day?

Yes, I do know myself only because I have been there so many times on this 4mg dose, but sometimes I doubt myself so I thought I would write here just to see if I got the same response then that would probably make me feel more comfortable doing it. And yes, they finally figured out I need to change in summer and winter, because they have been trying to stabilize me for 4 years, and when I told them I think I need to change from summer because it goes up when I overheat they agreed. But I was at 1.8 a couple of weeks ago so that when I started lovenox shots for about a week days, was stable, but when I stopped taking them it went down again.

 

[Blake777]

Ouch, did that nurse stick you in the leg? I've only ever had 1 shot in 2006 and my daughter stuck it in my tummy.

She stuck me in the side of my stomach. I had about 6 shots. Three I did myself and no bruise at all.

 

[Bina]

She stuck me in the side of my stomach. I had about 6 shots. Three I did myself and no bruise at all.

They are small needles, so lord only knows what that nasty nurse did.....

 

[pellicle]

so out of interest, what's your INR target range?

 

[Blake777]

Target range is 2.5 - 3.0

 

[Blake777]

They are small needles, so lord only knows what that nasty nurse did.....

She said there was a small chance she could hit a blood vessel and she think that is what happened.

 

[Blake777]

So to keep from having a stroke and keep from getting lovenox shots again I think I will go with the dosing calculator. Even though it take a while to get in blood stream, going to see what happens. And I think I would rather be a little high than staying so low with the heart attack scare I had last week. Which they said I still could have some blockage but the hospital I went to still has not sent my records over to my primary so he can send me to cardiology to get a angiogram. If things start to get worse I will head to ER.

 

[Bina]

At least you have a plan, Blake...... keep an eye on things and mark down your doses on your calendar or agenda.
(i process Coumadin slowly and would be getting that Lovenox today, if it was me)

 

[Protimenow]

I'm not a big fan of Lovenox -- I had to self-inject for a few days after a stroke, but had minimal bruising. And, at that time, it was possible that my INR was below 1.8 for at least a week or two.

One of the protocols that I've seen - I'm pretty sure that it was from the Duke (University) Clinic called for a 50% increase in dosage one day - (which would mean a jump from 4 to 6 today), and some close monitoring (I forget what they call for on the second and third day). If your INR may have been 1.8 for five or six days, Lovenox should be considered -- but for one or two days, I'm not sure if it's necessary.

Based on your history, it probably wouldn't be a bad idea to take 6 mg today and start your 'winter' dose of 5 mg tomorrow.

Lovenox can seem like pretty nasty stuff, and probably was responsible for the bruising in your leg (especially if it was inadvertently injected into a blood vessel).

I'm sure that we all want to hear about your positive progress from here forward.

 

[Eva]

Great advice, Bina, as always!

Ladies,

strangely for me too, the other day I binged on steamed broccoli leftover from dinner the night before. I never ever liked broccoli before!

Rhonda,

I'm not sure what time you take your warfarin, but if I were you I would take the 6 mg right away!

God luck and keep us informed.

(Side note for us women only: men may notice things but keep it to themselves! Why? Not sure! I come from a hair dresser with a shorter hair and sometimes different color!! With sit. Down for dinner expecting to hear a compliment or a complaint...nothing! Nothing at all, as He doesn't notice me either! So, No comments until I ask. . In any case he is an angel.

we do! Last sunday, a member. Of my church sitting behind me flipped my blouse label inward...my husband helped close my necklace loop for me that