Dietary consistency?

[Marge]

I guess I'm pretty confused about coumadin. I think what really worries me is this business of "consistency." Am I understanding this correctly -- you have to basically be eating the same things all the time?

We've always eaten fresh, seasonal foods as much as possible. I was raised mostly in Europe, and that's the way I grew up. So, for example, I'll eat a particular vegetable when it's in season and available locally grown at the farmers' market, and I might not have it for months when it's not. I'm a little concerned that I may not be able to continue to do that sort of thing if I'm on Coumadin?

And there's also the matter of travel. As soon as I can, after my valve surgery next month, I want to resume travelling, and of course that makes dietary consistency more difficult to attain. How do people who travel deal with these issues. Hopefully I will not need coumadin for too long (if my surgeon's confidence that he can do a repair is not misplaced) but I'd like to know what I'm in for if I do end up having to stay on it.

 

[Nancy]

Marge, just eat what you like, and don't go overboard with items that have vitamin K. Your Coumadin manager will make the necessary adjustments. Everyone needs to have a healthy diet.

Coumadin will fluctuate a little no matter what you do anyway. That's why it has to be tested frequently.

 

[Ross]

I'm a poster boy for inconsistent eating habits and I'm not having a very hard time with my management. Just do the best you can with your limiting on Vitamin K items, but do not cut them out, and you'll be alright. Really, it isn't that big of a deal.

 

[Guest]

Please read my web page http://warfarinfo.com/foods.htm

 

[Marge]

Thank you all for your replies, which were helpful and reassuring.

I know that we tend to eat large amounts of seasonal items over relatively short periods of time -- whenever they are fresh and available, whether it's veggies or seafood -- and then not eat any of them until they are next in season. Sort of like the lady in Al's story who ate all the coleslaw. But of course Al knew how to deal with that. I do not know if I'll have anybody running my coumadin monitoring who's as competent as Al. One of the things I've gathered from this board is that a lot of the people who monitor coumadin are not that terribly good at it!

Oh well. I guess it's the least of things to worry about at this point, I will figure out how to deal with it if & when I need to.

 

[Georgia]

The one thing you need to watch is overdoing on certain things - like broccoli, cabbage, spinach, lettuce - where I might have had a nice big salad, I now make that salad with a small amount of letture and lots of celery, green peppers, tomatoes, (peeled) cucumbers . . . you get the picture.

And you want to eat your vitamin K foods year 'round - so that your coumadin dosage reflects that input. So in the winter be sure you have your veggies that are high in K so in the summer you don't get in trouble.

And if you like a glass of wine or beer, drink one every day - alcohol use affects your inr.

Further, you don't have to think of eating the same every day - coumdain is a very slow acting drug - I figure on about 3 servings of high vit. K veggies per week. I'm not a big veggie/salad fan. But that could be 10 per week, and the coumdin dose would reflect it.

 

[Guest]

Georgia,

You're putting me out to pasture.

 

[Georgia]

Nah - you can just be proud that we're all learning. I don't think you know how much you've helped us. And once we can internalize this stuff about coumadin, it makes living with it pretty easy (unless Rain's dog's in the garden, of course).

I have no doubt that if I hadn't found this forum (and yours) that I'd still be getting my blood checked every couple of weeks and having my inr flying around and still going to that same awful doctor. As it is, it's stabilized quite nicely (knock wood).

 

[tommy]

Add to the list list of vitamin K "biggies" - avocados.

Live as you prefer.
Be reasonbly consistent on a weekly basis.
Adjust the dose to fit your life.

 

[Marge]

<< Add to the list list of vitamin K "biggies" - avocados. >>

DARN. One of my FAVORITES. And something I eat only SEASONALLY, when they are in. I don't, for instance, buy that frozen avocado stuff. Ugh.

 

[Raverlaw]

Yes!

Now I can *justify* that daily glass of excellent Central Coast red wine!

 

[Georgia]

I eat guacamole; just not in the quantity I used to. It's now a very special treat and I kindof add it to the week-long equation of what I eat; like if we have avocados then I skip a serving of broccoli.

I really think that once the inr stabilizes for most folks, you don't have to be a vit. K nazi to keep it stabilized.

 

[Blanche]

What is the problem with avacados? We have been using a list of foods and vitamin K content from the makers of Coumadin for quite a while now. That list shows a small avacado at 14mg. The canned pumpkin (1/2 cup) in a Thanksgiving piece of pie has 16mg, and 2 pieces of homemade corn bread have 14.8mg. Carrots, califlower, mixed nuts, kiwi, celery, green peas, okra, and even french fries all have around the same vitamin K as the avacado.

I think it might be helpful to have a food chart with vitamin K values available here somewhere so that people might easily check the vitamin K content of their foods. We all need Vitamin K in our diets, including those on anticoagulants. The trick, as I see it, is consistency and not going overboard (becoming food nazis..gracias, Georgia), or comsuming foods that are extremely high in Vitamin K. I would worry about things like collard greens, 1/2 cup (440mg) 1/2 boiled spinach (360), 5 brussels sprouts (289).

All of this is caused by the hard fact that there is absolutely no way to quantify the optimum amount of vitamin K a person can ingest. If someone said, "valvers on anticoagulants can have xxxmgs of K a day," there would be no problem. That will only happen in my dreams. In the meantime (Why is there always a meantime?) the best that can be done is consistency and relying on the prothrombin test and resulting INR to guide anticoagulation doses.

Kind regards,
Blanche

P.S. My next question might be, what's the problem with olive oil at 4mg per tablespoon?

 

[tommy]

Blanche..............I stand corrected about the avacados. I don't knwo where I got the impression they they were full of vitamin K. I've been staying clear of guacamole dip.......no more. Thanks for setting me straight.

 

[Ross]

Like I said, eat, drink and be merry then check your INR and go from there. I tried that "Count the numbers" gig and it doesn't do anything but drive one insane. Forget it, use some common sense and enjoy your food.

 

[Guest]

Tom will report back on how the guacamole diet squares with his goal of losing 24 pounds.

 

[tommy]

Al, thanks for reminding me.
PS... 2 lbs so far (sans guacamole)

 

[Guest]

It's not like I have any room to talk!!!

 

[Karlynn]

use some common sense and enjoy your food.

Amen Brother Ross

 

[Harpoon]

I would just add that if you're checking your INR/PT on a regular basis you should be fine.

Expect certain chainges, like when your fresh veggies are no longer in season and you stop eating them, or when they come back into season.

Those kinds of changes in your basis diet will affect your INR, but it should be managable.


The key is not to load up on something high in vitamin K or suddenly stop eating things that have vitamin K in them that you've been eating all along. It's the abrupt changes you should be worried about, not your regular diet...

Oh, and what about canning those fresh veggies???? =)

I've been plotting since last fall to try my hand at canning this spring. I want to try a no salt pickle recipe I have first, with veggies from the store, but I'll plant a garden this year with my kid (he's turning 4 in a month) and my wife and hopefully we can try canning some of that stuff next fall. We planted sunflowers last summer for the kid and he just got the biggest kick out of that.

Plus they tend to grow fast so he saw quick results for his labor, other plants don't always do that for little kids.