checking in - and INR questions

[Barbara]

Hi everybody -
Hope all is well - I tried to CHAT - but noone was in the room - I must be doing something wrong - so greetings to everyone - I have not posted for a while -
I was wondering about the INR levels - I was told to keep mine at 2.0-2.4 - but it seems that most people have a higher level - anyway - I am still wavering at 1.7 last week - and I was taking 2mg - I went up to 3mg. I get tested tommorrow, so I will see what happens -
Other problem is that my pulse rate is a lot higher than before surgery - anyone else have that? - in the 70's now but was usually in the 50/60's before - I take Toprol
I also have a stress test on Friday, so from there I prob will get on a cardiac rehab exercise program -
I'm doing ok - it will be 4 weeks on Tuesday - so still in the adjustment stages -
Stay cool -
Barbara

 

[Ross]

Hi Barbara

The INR question-What valve did you get?
Mechanical range is from 2.5 to 3.5 unless there is some special reason that your Doctor wants you lower. It's really the Doctors call.

Your pulse rate will be probably be higher for awhile yet, though your not really abnormal. 60 to 70 is normal range. It took mine a good 3 months to calm down. Your body is very early in recovery, so don't be surprised by some of these things.

 

[Nancy]

Hi Barbara-

That's a low level for a mechanical valve. Did the surgeon suggest that, or your cardiologist? Usually the suggested level is between 2.5-3.5 for mechanicals. It could be on the lower end for one valve, and higher end for two. Also sometimes when there are additional complications, it could be in the higher end for one.

Maybe you should ask the question as to why the target level was set so low.

Could be a reason, but if it were someone in my family, I would like that answer.

 

[fyrfytr]

Hey Barbara,
I am with Nancy, ask about your levels. I was also told to keep between 2.5 and 3.5. Just got to 3.5 last week. You will be amazed at how you will improve when you start cardic rehab. It is a big help to me. My heart rate was fast after surgery and they put me on a lopressor. Take Care
Dave

Keep your fires small!
_______________________________________
Surgery: 4/21/03
Aortic Aneurysm Repair
AVR, with a St. Jude Mechanical
Heart Center of the Rockies

 

[Georgia]

Glad you're doing well

Glad you're doing well

Ditto on the inr levels.

Glad to hear you're feeling good. One thing about this crowd: ask and you'll get LOTS of answers!

Haven't satifactorially brought my heartrate down - it took 3 months to get it below 100 at all; now it's @80 in the morning, but back up to @100 late afternoons. Go figure. Cardio's still watching; she thinks it'll come down further and more uniformly on the amount of Toprol I'm on now. Hope so. Although I don't feel it; and when it feels slow it's @75. Odd.

 

[Creed3]

Hi Barbara,
I also have a mechanical valve in the aortic position. My docs told me to keep my INR levels between 2.0 and 3.0. They also told me that if I had a doctor back home that wanted me any different (higher or lower) that I should find myself a new doctor. They kept stressing that to me over and over. One thing the docs told me was that when you have a mechanical in the aortic position, your chances are more slight of a clot developing because of the velocity of blood that flows through that valve as well as the direction it is flowing in. I have heard that mechanical mitrals have to have a little higher of an INR. But like everyone else here has said, everyone is different and the docs make the decisions on where they want your INR. If it is something that concerns you, you should definately ask them about it. Knowledge is power.
Regarding the pulse rate. I think it is pretty normal to have your pulse be a little quicker right after surgery. As your heart begins to heal, it should slow down some. But like Ross said, 70s is really pretty normal. I am also on Toprol XL (50mg) once a day. My pulse rate is usually in the 70's.

Take Care!
Gail

 

[Barbara]

thanks for your input - - I went for INR today - It was 2.0, which is ok - and the dr said the levels should be 2.0 - 3.0 - (my aortic valve was replaced with a mechanical)-- I had written down a lower level - so you people are right on target - and hopefully, the heart rate will settle eventually -
I know I am being told info that I just can't seem to absorb - or retain - Basically, I think I am having a hard time actually accepting this whole thing - I don't like having to take coumadin - I don't like hearing the ticking - I don't like the blood tests -
Don't I sound like a spoiled brat? - I know I should be grateful - and I am but -honestly - I also feel very sad -
I prob should not post this - but I think I will - just how long before this sad feeling goes away???? I'm not really depressed - just kind of like I wonder if I really will be able to do some of the things I want to do -
I go for the stress test on friday - that should be interesting - I'll let you know what happens -
Barbara

 

[nadi]

Feeling Sad

Feeling Sad

Hi Barbara,

I understand the Sad part. I am 2 months post op(10 wks) and the last 2 weeks have been rough! I have been depressed and angry all at the same time!! I have argued and yelled at my wonderful husband more in the last 2 wks then I have in the last 10 years but to cut a long story short I went to my PCP today for a virus but she also addressed the depression and put me on an anti depressant. She said it was common and that by going on them doesn't mean you will be on the forever. So here's to hoping they work (quickly!! ). So my suggestion is talk to your doctor.

Take care.

 

[Ross]

I assure you, it doesn't last forever. Everyone is different but for me, it lasted about 3 months then things started looking bright again.

 

[jacksonmn]

for some reason, the first time i had surgery i never noticed any depression...but then, i wasnt on some of these meds as i am now and i was a teen.
now bouts of depression come and ago because i still dont like coumadin, the blood tests and the invalid feeling.
as for heart rate, it was usually 90-120 before surgery then immediately after surgery it went to 60-75 and then went kept going up to the 80-100 stage now. i am taking toprol xl for it. i keep wondering why it was normal immediately after surgery and went up later.
the surgeon suggested an INR of 2.0-2.5 when i left hospital but the anticoagulation clinic suggested 2.5-3.5. i wonder if this is something i should be concerned abt.

 

[MarkU]

The post surgery depression caught me offguard also. The first couple of months were the worst for me, but even now I still get occasional short bouts of the blues 2-1/2 years later.


Mark

 

[Nancy]

Hi Jacksonmn-

I would go with the Coumadin clinic's take in the INR level. You have a mechanical, right?

 

[Creed3]

Hi Barbara,
The sad feeling you are having is very normal. Give it a little time, things will get better. As you start to feel yourself getting stronger and things start to go back to a normal routine, the sadness will slowly slip away. You have been through a traumatic experience. You probably feel like you will never be the way you used to be. Believe me when I say, yes you will. I felt exactly the same way. I felt like an invalid in the beginning and all I wanted to do was get back to doing even the small things that were a part of my normal life. You will get there, it just takes time. Try to look at your recovery on a week to week basis, rather than day to day. You will see much more improvement that way. I remember thinking that in two to three months I should be back and completely healed. Boy, was I wrong. You will feel much much better as the weeks progress, but it takes a very long time for you to completely heal. I was able to go back to work at 8 weeks post op. Even now, I am 9 months post op, things like pinches, twinges, migraines etc...pop up every now and again, but it is nothing that interferes with my daily routine. Just little reminders every now again that yeah, I did have surgery 9 months ago. Sometimes you almost forget, believe it or not. My friends and family have said to me numerous times that life has gotten back to normal, so much that they don't even think about it much anymore. Kind of got off the track here, but back to the sadness. If the sadness continues for months or seems to get worse, please mention it to your doctor. Like others have said, there are things you can do to help you get through this tough time. It's all part of recovery.

Take Care & God Bless!
Gail

 

[jacksonmn]

nancy -

i have two mechanicals (aortic and mitral).
i have had a hard time getting the INR to 2.4.
my last test on thursday came up 2.4...it was 1.6
last monday. i was on 7 1/2 mg for a while. now i am
on 5mg for a couple days. going back on monday for
another check.

 

[Nancy]

With 2 mechanicals, you really need to be at around 3, at least between 2.5 and 3.5. That's my husband's range and has been for many years, because he has aortic and mitral mechanicals, he also has afib, which makes it even more important to keep it up there. All of the doctors he sees on a regular basis know this fact.

The only ones that aren't aware of his proper range are doctors who don't deal much with valve patients, especially double valve patients.

It is quite common to run into doctors who think his level is too high, often specialists out of the cardiology field. Even though I explain it to these folks, they don't believe me.

 

[Barbara]

thank you all again for your sound advice/thoughts - - Nadine - I am angry you are so right - i jut don't want to admit it - But I feel better now - not 100%, - this really is a bummer - I guess I have to have more patience - i am really so lucky - i don't seem to have any real problems etc. and I feel pretty good - I am walking, and waiting for the dr to set up the rehab for me - I had a mini stress test last friday, and it went well - just my legs got so tired -
but I have been out and about -

I am trying to get back up to par for a trip I am going on in the middle of August -
My son is getting married in Japan - and we plan to go - the drs said it should be ok - We will just have to go at a more leisurely pace than we had planned before the surgery - I was advised not to go if I didn't have the surgery first -

so any travel tips are welcome - I know I can't lift anything - so I am not taking a suitcase - just will pack my stuff in my husbands and daughters bag - and walk every hour on the plane (per the cardiologist)- it will be a long trip - - I plan to take a sleeping pill so hopefully will sleep some - I'll have to walk in my sleep...........
Arrangements will be made to have my INR levels checked there - and I will take plenty of meds -

So - any tips are welcome - I have typed enough here - let me check other posts-
Keep cool -
Barbara

 

[RobThatsMe]

Hi Barbara,

I also have a St Judes mechanical heart valve in the aortic position.

My heart surgeon and cadioligist both argreed that the range they want my INR in is 2.0 to 2.5 I also take a 325 mg coated aspirin daily with my Coumadin.

After being a member of this site for some time, and reading info from so many others, I felt that I would feel more safe if my range was 2.5. to 3.0 That way, I am in the middle. Even if I do go alittle high over that, or a little low, I am still OK.

I did not want to dip below 2.0 That puts you into potential stroke range. I just felt that using 2.0 as a bottom level for my INR was dangerous, or even more so,,, very uncomfortable for me mentally. I eliminated the worry, and raised my range to the 2.5 to 3.0 mark. I also discussed this with my doctors and that agreed that it was ok to do.

Anyway, just a note to let you know that there are doctors out there that prefer the low range. My surgeon even provided me with backup do***entation as a reference to support the 2.0 to 2.5 range. I still like the 2.5 to 3.0 <smile>

Good luck,
Rob

 

[bvdr]

Barbara,

In a few weeks you may feel a whole lot better. I'm glad its behind you and you can plan stuff like this wedding that you couldn't before. Have you ever been to Japan? I hope you have a wonderful trip but do be cautious. Keep checking in....I'm monitoring your progress very carefully .

Betty(bvdr)

 

[Granbonny]

Hi Barbara

Hi Barbara

I figure you will be at the around 2 month post- op ..when you go to Japan. I would make sure the airlines will have you a wheelchair for your plane changes, ect. Sometimes, the plane connections are very close.....I would watch swelling in the feet, ankles..and wear very comfortable shoes...sitting that long..Also, check to make sure Japan will take your script for INR testing. How long will you be gone? Good luck..Hope your INR stays good. Bonnie

 

[ccrawford]

Hi Barbara - Welcome to VR.com ! You have already gotten a lot of good advice. Depression is a common byproduct of heart surgery, and please consider getting help if it gets very bad. It typically does not last long, maybe a couple of months, but a good professional can help bridge the gap. My daughter is a psychologist and works with a heart clinic regarding post surgery patients. Re your exciting trip to Japan, Its good to plan to keep busy walking on the plane as it is a long trip to Asia. Please consider contacting the airline to insure you might have three seats side by side so you can catch some naps on the way. I was lucky my last trip and arrived quite refreshed and ready to go. Let the airlines know of your medical condition, and I would be surprised if they are not very helpful. Chris