This is a bit of a cautionary tale.
My ENT specialist went on medical leave, and another doctor in his practice saw me. Her exam of my nose was more aggressive than the doctor for whom she was filling in. She gave me medications for a yeast infection in my throat. I went to the pharmacy - which has been filling my warfarin prescriptions for years, and picked up the medications.
Six days later, I had severe pain in my upper calf. I checked my INR -- 4.7.
I then checked online to see if any of the new medications interacted with warfarin. BOTH apparently did (one much more than the other).
The next morning, the pain was worse, it was hard to bend my leg without pain, and it felt as if I had fluid between the back of my knee and my calf muscles.
I went to the emergency room, because I was concerned about fluid or blood impinging on my knee joint. The INR at the hospital - 5.3. I usually don't worry about an INR in that range - I eat some salad, discontinue my warfarin for a day, then retest. This time, because of my leg pain, I thought that it might be different.
I called the doctor. She eventually called me back. She 'apologized' for giving me the medication. She said that my use of warfarin wasn't in her chart - IT WAS. I filled out the papers when I visited the doctor for whom she was filling in. HE tried to schedule a procedure, but wanted me to discontinue warfarin for a few days before the procedure and to bring my meter to check that my INR was low enough to safely do the procedure.
This 'new' doctor apparently didn't look at the chart before seeing me.
She tried to act as if my taking warfarin was something new, that she wouldn't have known about. She asked me 'how long have you been taking warfarin?' I told her 'twenty-five years.' Again, she apologized. My cover sheet, that says that I take warfarin may not be in the chart NOW - after she failed to look for it and I reported a problem. She offered to have me re-start on one of the medications that she originally gave me, with some reports of possible interactions.
---
What's as distressing about her inability to look at the chart was my pharmacy's inability to check for drug interactions. They should NOT have filled the prescription. Their computers should have detected an interaction. The sheet that they printed out about the medication did NOT mention interaction with warfarin.
I trusted that a) the doctor wouldn't give me a medication that interacted with Wafarin and b) the pharmacy would have detected this and called the doctor.
My point is this -- I may have been a bit naive to trust that the doctor and pharmacy knew WHAT THE HELL THEY WERE DOING. I may not be quite that naive with new medications in the future (and may not even believe the summary of risks and benefits that come with my prescriptions).
My other point -- if I didn't have my own meter, and be able to self-test, I wouldn't have been able to detect that my INR was higher than it should be. Anyone on warfarin who IS able to test SHOULD have a meter available and be able to test if anything unusual (like bruising or swelling) should occur.
End of lecture.
My ENT specialist went on medical leave, and another doctor in his practice saw me. Her exam of my nose was more aggressive than the doctor for whom she was filling in. She gave me medications for a yeast infection in my throat. I went to the pharmacy - which has been filling my warfarin prescriptions for years, and picked up the medications.
Six days later, I had severe pain in my upper calf. I checked my INR -- 4.7.
I then checked online to see if any of the new medications interacted with warfarin. BOTH apparently did (one much more than the other).
The next morning, the pain was worse, it was hard to bend my leg without pain, and it felt as if I had fluid between the back of my knee and my calf muscles.
I went to the emergency room, because I was concerned about fluid or blood impinging on my knee joint. The INR at the hospital - 5.3. I usually don't worry about an INR in that range - I eat some salad, discontinue my warfarin for a day, then retest. This time, because of my leg pain, I thought that it might be different.
I called the doctor. She eventually called me back. She 'apologized' for giving me the medication. She said that my use of warfarin wasn't in her chart - IT WAS. I filled out the papers when I visited the doctor for whom she was filling in. HE tried to schedule a procedure, but wanted me to discontinue warfarin for a few days before the procedure and to bring my meter to check that my INR was low enough to safely do the procedure.
This 'new' doctor apparently didn't look at the chart before seeing me.
She tried to act as if my taking warfarin was something new, that she wouldn't have known about. She asked me 'how long have you been taking warfarin?' I told her 'twenty-five years.' Again, she apologized. My cover sheet, that says that I take warfarin may not be in the chart NOW - after she failed to look for it and I reported a problem. She offered to have me re-start on one of the medications that she originally gave me, with some reports of possible interactions.
---
What's as distressing about her inability to look at the chart was my pharmacy's inability to check for drug interactions. They should NOT have filled the prescription. Their computers should have detected an interaction. The sheet that they printed out about the medication did NOT mention interaction with warfarin.
I trusted that a) the doctor wouldn't give me a medication that interacted with Wafarin and b) the pharmacy would have detected this and called the doctor.
My point is this -- I may have been a bit naive to trust that the doctor and pharmacy knew WHAT THE HELL THEY WERE DOING. I may not be quite that naive with new medications in the future (and may not even believe the summary of risks and benefits that come with my prescriptions).
My other point -- if I didn't have my own meter, and be able to self-test, I wouldn't have been able to detect that my INR was higher than it should be. Anyone on warfarin who IS able to test SHOULD have a meter available and be able to test if anything unusual (like bruising or swelling) should occur.
End of lecture.
