Dosage question

[Randy & Robyn]

My range is 2.0 - 3.0 but not because of the On-X. I believe that is the standard range for aortic valves. I am getting tested weekly and mine climbed from 1.7 to 2.8 in the last week. Even if it climbed that much in the next week again it wouldn't be a disaster but would certainly be time to take corrective measures.

I'll see what my PCP says this time.

Randy

Hey Randy

Congrats on finally getting your INR up there!! Is your target range lower with the On-X? Nathan's is 2.5 to 3.5 and he hovers around 2.8 quite consistantly. We would actually like it a smidge higher, as alot of valvers prefer it on the higher side of normal than lower end, to give more room for fluctuations. But he likes to keep his doses as easy as possible, so he keeps his at 5mg a day and stays at the 2.8. How often were you getting tested and how fast did it climb? Hard call on that one...Nathan tested twice a week until he was in range for awhile. He is now again with the added Zetia.

I have seen a few posts lately talking about lab values in the hundreths...not sure if that makes them more reliable.

 

[Guest]

The INR is a lot like the speedometer on your car. Just because you went from 17 to 28 doesn't mean that you will be at 45 next week. Try taking the same number of mg over the next 7 days that you did over the last 7 days. You shouldn't be too far out of range next week, if at all.

 

[Ross]

Ross is the man! Following his advice I went from 1.70 last week to 2.81 today. I feel much better with that number. I haven't spoken with my PCP yet. It will be interesting when I inform him that I did not follow his order. If I had listened to him I am sure I would still be dropping.

My question now is will I keep shooting up? I would love to level off at a nice comfortable 2.5 or so. Should I drop back the dosage just a bit?

Also, what is the deal with including hundredths in the results? Are these tests really that accurate now?

Randy

Forgive me, but how many days did you get to take the 5mg before testing? If you went a full 7, then I doubt that it's going to climb much further right now. It may actually start to level out or fall some in the next month or so, depending on your recovery. Even though your range is 2 to 3, don't worry if it's over 3. Anymore as long as I'm between 2.0 and 4.0, life is good. I don't know why they have the hundredths on the test, it's pretty worthless.

You Doc most likely won't be happy with you not listening, but present him with the new education you've gotten and convince the guy you can handle it. If you were senile or sloppy then I'd worry, but your head is still in the right place, so he should congratulate you and not shame you.

 

[Randy & Robyn]

Thanks Al and Ross. I will stay on the same dose of 5 mg that I have been taking for the past six days and retest in a week or so. It's great to have people I trust to ask advice from. There is no question that blind faith in my physician would have left me in the danger zone. Very scary because he manages many other patients on coumadin.

Randy

 

[Randy & Robyn]

Quick update...two weeks ago after following Ross' suggestion to increase my dose to 5 mg/day I was at 2.8. Last week I was 2.6. This week I am 2.9. I am still on the same 5 mg/day dose. I hesitate to conclude that I am stabilized but it sure is nice to see the numbers hanging right there where I want them. My doctor told me to wait two weeks for the next test.

Randy

 

[Guest]

Randy,
You are stabilized. Getting the same INR three times in a row happens about as often as getting three alike on a slot machine. You may need tweaks but you have found a dose that will serve you well + or - a little.