comments, anyone?

[netmiff]

I keep my INR results in Excel, not sure if the formatting will hold, but here goes : (if anyone wants the actual Excel files, let me know)

MEDICATIONS


MORNING

Effexor 225 mg
Ramipril 10 mg
Amlodipine 5 mg - stopped June 25th
Calcium 500mg
Bisoprolol 10 mg
Vitamin D 400 IU

EVENING (6PM)

Calcium 500 mg
Aspirin 81 mg
Warfarin per chart
Multi-Vitamin

Immodium (store brand)
2 - 3 tabs /day
per Dr. Miller, gastro


JUNE
DATE DOSAGE INR NOTES

Mon 16 7.5 mg 4.3
Tues 17 8 mg
Wed 18 8 mg
Thurs 19 8 mg
Fri 20 7.5 mg
Sat 21 8 mg
Sun 22 8 mg 3.1
Mon 23 7.5 mg
Tues 24 8 mg
Wed 25 8 mg Amlodipine stopped
Thurs 26 8 mg
Fri 27 7.5 mg
Sat 28 8 mg
Sun 29 8.5 mg 2.1
Mon 30 8.5 mg

JULY
Tues 1 8.5
Wed 2 8.5
Thurs 3 8.5
Fri 4 8.5
Sat 5 9.5 2.4 8pm, before meds
Sun 6 8.5
Mon 7 9.5
Tues 8 8.5 stopped immodium
Wed 9 8.5
Thurs 10 8.5
Fri 11 8.5 61.5
Sat 12 10 1.8 after lunch; talked with Dr. Dorisami, he recommended 10 tonight and tomorrow, re-test Monday
Sun 13 10
Mon 14 re-check

 

[Ross]

I'm confuzzled, what is it your asking?

 

[netmiff]

INR now in red; Dr. suggested increasing then re-testing in 2 days? It seems to be going down, no matter how much more I take .. I also feel 1.8 is really low;


Sorry about the format, I don't know how else I can cut-and-paste and keep the Excel format

 

[Guest]

If you are asking what dose to try next, I'd say 10 mg daily. Where are all of these 0.5 mg things coming from? How many pills do you take toget these crazy doses?

If you are just over 1 month post-op, your warfarin manager should have been anticipating that your need for waqrfarin was going to significantly increase.

 

[netmiff]

Sorry, I am 10 months post-op, was fairly stable until this all started happening; didn' want to post months and months worth!

I have 2.5 and 1 mg pills, I usually manage to get the odd .5 doses without halving the 1mg ones . .although I must admit the 9 mg is hard, and I do halve for them!

Any ideas why INR is going down ??? despite slight increases in dosing?

 

[netmiff]

just a thought - could Diet Coke increase do it?

 

[Bina]

I agree that you have got to take at least 10 mg tonight.....skip the diet coke crap, drink water and add some lemon if you need more taste.
You may want to buy 5 mg pills which are much easier to combine and split for your level of dosages.

 

[Guest]

Diet Coke has no effect on the INR.

I suspect that you are feeling better, more active, and eating more than you were two months ago. All of these things have to do with recovering and driving the INR down. With warfarin the better you feel, the more drug you need.

 

[netmiff]

Al, sorry to report, surgery on September 6th, home and working (a little at a time) September 13th, opened (and worked at) first retail store on October 1 and apart from 2 weeks off after Christmas (DH and I both needed it), haven't stopped since !

INR was stable until about a month ago, I only posted about a month's results. I also tried to to put in anything else that had changed. My long-term diarrhea problem does seem to be sorting itself out, slowly, but I thought less frequent and firmer BMs would mean higher INR - you know, longer retention in the GI of anything taken by mouth, thus possibly more absorption into the bloodstream.

I would like to find out if there is anything I am eating/drinking that might be doing it, I can't think of anything, hence the Diet Coke - that was a stab in the dark, it has been hot up here and that is my cold drink of choice at the store, as we do not have a fridge but an abundance of places that sell pop - I refuse to pay $2 for a bottle of water, I prefer getting some chemicals in there for my hard-earned cash lol

Sorry, I do seem to go on - the hazards of reading posts by trained typists

 

[Guest]

Diarrhea quite often raises the INR. The reason is that the bacteria in the intestinal tract produce vitamin K. Diarrhea washes them out. This seems to be a bigger factor (for most people) than having the warfarin get absorbed. When diarrhea resolves and the bacteria return to a more normal level, the INR will drop. Another example of the better your health, the more warfarin you will need.

 

[netmiff]

I'll keep this one short - thanks, Al

 

[catwoman]

netmiff:

Have you considered adding another size of warfarin to your arsenal of meds?

Say, 7.5 or 10mg tabs? With the 7.5, you wouldn't need to split and halve tablets. With 10mg ones, you'd have them and take 3 1mg tabs to get 8mg, 2 and a half of the 1s + half a 10 to get 7.5. You'd be stretching your prescription refills further.

I have 1, 2 and 10mg tablets and halve them. Right now I'm alternating between 5mg and 5.5mg daily. I've gotten up to 7mg at times.

I'm spending $60/year for my warfarin at a grocery store (same as at a Wal-Mart). It actually stretches for more than a year because I don't always use all the 2's.

 

[netmiff]

got my ACT doctor today, he was trying to figure it out; says take another 10 tonight and tomorrow, and then re-test. He asked a few questions, but I didn't get a definitive answer as to WHY! We'll see what Wednesday brings.

 

[zipper2]

Netmiff,
Sorry to see your having all this inr delima right now
keeping my fingers crossed for wednesday for you
hoping it gets better for you soon

zipper2

 

[ALCapshaw2]

got my ACT doctor today, he was trying to figure it out; says take another 10 tonight and tomorrow, and then re-test. He asked a few questions, but I didn't get a definitive answer as to WHY! We'll see what Wednesday brings.

I think I've spotted your problem.

IF your ACT Doctor thinks he is going to see a definitive change in 2 Days, HE is the problem, especially if he recommends a Dose Adjustment after only 2 days. That kind of "management" only GUARANTEES that you will be chasing your tail and NEVER get stable.

 

[netmiff]

Al, it wasn't my ACT doctor that said that, it was the on-call doc on Saturday; I have since figured out he is a lung-man, my MIL saw him, he is good with lung problems caused by liver problems . . . not sure about his ACT skills! ACT Dr. wants me o re-test Wednesday, which will be 4 days.

Carla, I have a plan where I pay $2 each prescription, so I am not too worried about having to gobble 4 each night, but if this keeps up, I may get some 5s and 10s, too.

2.5 today; taken 10 mg the last 4 nights, so will continue with that; did not hear from Dr. today, hopefully tomorrow

Thanks for all your support

 

[Bina]

Good, you are heading in the right direction!

 

[Guest]

Netmiff,

You may not have seen my thread on the reuinions site. VR reunions aren't really reunions because much of the time we have never met except over the internet. I travel all around the US giving seminars on warfarin management. I also like to try the local food specialties. Next Tuesday I am doing a seminar in Buffalo. Monday night at 6PM, I plan to be at the Anchor Bar for Buffalo wings. I see that you are from that area. Perhaps you can make it. My wife will be along, so if you have anyone else to come that will be fine, too. I'm not really hosting a dinner - the group may be too big for that. BYOM - bring your own money. Yours probably goes farther now anyhow.!!!