Dad's INR is low again

[Jiddo]

Thanks for sharing, catwoman. This is encouraging. I think because I am new at this, I'm still trying to build my confidence in how to properly dose my dad. I just wish I could go with the pharmacist's recommendations but I've learned enough from you all that we can't always trust the "experts."

My biggest fear though is that my actions could potentially harm my dad one day. I would never be able to forgive myself if anything bad happened. On the other hand, I also know that my understanding/education on coumadin could also save his life.

On a positive note, my dad has never looked better in many, many years. He is down to 240 (from 290+ pounds) and my mom has been buying him some really stylish clothes so he can look and feel his best. His color is great and he is getting better sleep these days. He is still having problems with his right hand but it's gotten a little better over the last few weeks, though he still can't bend a few fingers.

My parents are planning to join a group of church friends for a cruise to Greece/Turkey next year, so that gives them something to look forward to. I will be posting another thread in a different forum on practicalities to consider when traveling out of the country on coumadin.

Thanks again.

Jennie

 

[Ross]

Hon the only way your going to harm dad is to do something foolish like increase his dose 50% or so when he's nearly in range or withholding doses for INR of 5 or less. Beleive me, Coumadin dosing isn't that big of a deal and once your comfortable with it, you'll laugh at how amazingly simple it is and wonder why the heck the pros can't get it right.

When your ready for the trip, if it's Coumadin related, post it here.

 

[Jiddo]

Hi All.

Just a quick update to let you know my dad tested today and his INR is 2.0. I am so surprised because we increased his dose from 80 mg to 87.5 mg (8.6% increase) 10 days ago because his previous INR was 1.8. The good news is that he is in range but I was expecting it to go up higher than 2.0. Do you guys think this still has to do with his metabolism?

I'll talk to the pharmacist tomorrow a.m. about upcoming doses. I'm thinking we should try 12.5 mg/4 days and and 15 mg/3 days for a total of 95 mg for the week or a 7.9% increase. Thanks in advance for your thoughts.

Thanks.
Jennie

 

[Karlynn]

I think you're finding out why the dosing charts recommend a an increase of 10-20%. For most people it does take at least the 10% adjustment to affect a targeted range.

I think it is metabolism. Your Dad must have a very good liver that was just a little sluggish do to the trauma that surgery puts on a body's system. He's now recovering, and his good liver is working hard on that warfarin.

I think your plan sounds reasonable. Just don't let them freak out if he's a bit above range on the next test (which I doubt he will be) and let them start chopping away at his dosage.

I'm glad he's finally in range and I think your desire to do another little increase is a good idea.

 

[catwoman]

Jennie:

I agree with Karlynn. Your thinking is on the right track.
(This is what I've been doing with my husband's warfarin dosages.)

Will be interested in his next INR test results

 

[Jiddo]

Hi guys.

I just spoke with the clinic and the pharmacist originally recommended keeping my dad on 12.5 mg/day or 87.5 for the week. I asked her if we could increase it more and she said she would be ok with doing 15 mg 1 day, which would make it 90 mg for the week. I recommended doing 2 days at 15 mg, which would make it 92.5 mg for the week. She didn't endorce this because she said my dad is technically in range but said it was up to me. So, I just wanted to get your thoughts on whether we should do 90 mg or 92.5 mg for the week. This is probably not a big difference but just wanted some thoughts.

Thanks.
Jennie

 

[Karlynn]

Wow, she is VERY conservative. I think you will be fine going with your plan.

As I've mentioned before, just don't let her freak out if he gets to the higher side of his range.

 

[Jiddo]

OK, 92.5 mg it is! I just spoke with my dad and he is going to follow this dose, 15 mg Tue & Sat, 12.5 mg all other days.

Also, the pharmacist wants him to re-test in 2 weeks, on 9/20. Do you think I should push for a re-test in 7 or 10 days or do you think 2 weeks is appropriate?

Thanks again.

Jennie

 

[Jiddo]

Hi Rachel.

It's a drop-in appt so the logistics are not really a big deal.

Thanks for yout thoughts.
Jennie

 

[Jiddo]

Dad's INR is in range...thanks for your help!

Dad's INR is in range...thanks for your help!

Hi All.

My dad took his blood test yesterday and I just got the results this morning. He is at 2.4 (range is 2-3). I just wanted to say thank you all for your advice and support....he would not be in range without your help! He is going to continue on the same dosage (92.5 mg for the week) and re-test on 10/2.

Thanks again!

Jennie

 

[Ross]

Hi All.

My dad took his blood test yesterday and I just got the results this morning. He is at 2.4 (range is 2-3). I just wanted to say thank you all for your advice and support....he would not be in range without your help! He is going to continue on the same dosage (92.5 mg for the week) and re-test on 10/2.

Thanks again!

Jennie

I be doin the happy dance!!!!!

 

[Karlynn]

Yippee! Congrats to you for being such a great advocate for your Dad and taking things in hand.

 

[catwoman]

Jennie:

I knew y'all could do it!!!!!!!!! I'll bet your dad & mom (not to mention YOU!) were ecstatic.

It is very empowering to realize that you can learn to manage warfarin.

It doesn't take a rocket scientist -- or M.D., D.O., R.N., R.Ph., LPN, LVN, etc., etc. -- to figure it out. Unfortunately, many of them can't and that in turn hurts warfarin patients. I truly believe that many problems some warfarin patients encounter are directly related to anticoagulation therapy (mis)managers who just don't get it.

Give your dad an attaboy! (And an attagirl to you & your mom!)

 

[Ross]

Just make sure MOM DOESNT FIDDLE WITH HIS FOOD!

 

[Jiddo]

Yes, we were estatic.....especially my mom and I! She let out a big "whoo hoo" over the phone. I am just hoping my dad stays in range on his next test as my parents are planning a trip to Vegas a couple of days after the test. My parents usually go to Vegas 3-4 times a year for vacation so it's nice to see that they can resume this less than 4 mo. after my dad's surgery. He is very much looking forward to relaxing. I am planning to find out where the nearest coumadin clinic is to where they are staying.....just in case. Should I be helping them do anything else in preparation for their trip, in terms of the coumadin mgmt?

Thanks again!
Jennie

 

[Jiddo]

Oh, and Ross, I don't think my mom will ever stop fiddling with his food. However, she did "let him" have lunch by himself the other day and she wasn't with him to monitor what he ate. I know it still sounds very controlling but I agree things will get better when his INR stabalizes. It's all about baby steps.......

Jennie

 

[Ross]

Oh, and Ross, I don't think my mom will ever stop fiddling with his food. However, she did "let him" have lunch by himself the other day and she wasn't with him to monitor what he ate. I know it still sounds very controlling but I agree things will get better when his INR stabalizes. It's all about baby steps.......

Jennie

Hon you've got to convince her to stop it. She is going to sabotage his INR by playing with his food intake. It's pretty imperative that she leave his food alone.

As for the trip. Not much really. You can find a clinic usually at any hospital. If his INR is in range with 3 tests, then he probably won't have to worry about it until they are home again.