Coumadin Puzzle-What would you do?

[Nancy]

It's interesting to know about diarrhea and INR. I would bet though that Joe's CHF with congestive liver had more to do with the higher INR than the diarrhea did. Both combined was definitely not a good thing and I'm sure caused an exponential situation. Who would ever think he'd have both things at once? The CHF came on fast and furious. It even got much worse from the time I brought him to the doctor's office at 2:30 to the time he was admitted to the hospital at 6. His normally flat stomach blew up like a basketball.

Don't mean to scare anyone. This condition is sometimes associated with pulmonary hypertension which Joe has. Not everyone with CHF gets it.

 

[Granbonny]

Still playing the Game

Still playing the Game

With Joe's INR tomorrow. I think it will be low..like 2.0..The 10 mg tonight will not show up until Thursday...10mg tomorrow, Wed. ect..He should be back in range by next weekend..In training to be Al's Nurse. Bonnie

 

[Guest]

I do not think that warfarin management is taught in most medical schools. Even if it were, I'm not sure that it would be right.

In last year's lawsuit against the NYPD for trying to fire an officer for taking warfarin some of the heads of departments at some very influential medical schools were giving testimony like:
He is not fit to even stand guard duty at a parade.
He could die of an internal hemorrhage if someone punched him in the stomach.

 

[Nancy]

Maybe you should devise a curriculum for a course and market it. This is such an important topic. And poor Coumadin management can be life-threatening for so many people.

Just think of this group right here, and how many folks have had really terrible advice regarding Coumadin, some of them in the "ridiculous" category.

 

[Ross]

Nancy you got that right!

It is a disgrace what is going on out here. We have to be consistent in the things that we do to affect our therapy, but there isn't one thing consistent about the places we go to have therapy.

 

[Guest]

I do have a book Role Playing for Anticoagulation Training: 32 case studies at http://warfarinfo.com/publications.htm

 

[Nancy]

I checked the link out, Al and the prices are very reasonable.

Maybe any medical students who monitor this site should hop on over there also. Wouldn't hurt some of the other medical people either and the self-testers.

Improving your Coumadin skills will help countless people.



By the way, Joe's INR came back at 2.3. His Internist is taking care of things now, and Joe's back in good hands. He'll be tested again on Thursday, and is taking 10 mg until then. So he should be in range soon, I suspect he'll continue to drop tomorrow and then start climbing again.