Foods on warfarin

[Superman]

Yes it would be better if the dates were in there, but that still wouldn't tell what's happening between tests. I'm supposed to get my blood tested monthly as per doctor's orders, or sooner if it is out of range. 35 years of doing this!

The newbies who came up with home testing don’t remember the guidance we were given back in the day. It’s funny saying that because I’m younger than most of them.

Pre-home testing once a month was the norm. And I sure didn’t get there that often. It is amazing how much we can fluctuate week to week though. I went from 3.0 to 2.2 this week. Reason for the dip is a lower dose. I’ve been messing with trying to get right again after a necessary steroid treatment that threw me out of whack. I topped out at 5.2. Had I just kept at my normal 6 mg daily and never testing, I may have gone even higher.

But for me, even as much as the frequency and awareness is helpful, the convenience is the best. I love not having to leave the house for that. Just a quick test and done. So easy. Took a break from work today (I work from a home office) and did my workout, shower, and INR test all under an hour and didn’t have to drive anywhere.

 

[Chuck C]

I was torn between the response I gave and the mandatory confounding

Although I have never given the to anyone, I hear that it is best done completely arbitrarily, leaving the OP, and everyone else, completely baffled as to why.

 

[pellicle]

The newbies who came up with home testing don’t remember

I am glad to be a newbie ;-)

I do remember my surgeon saying to me in 1992 "we don't want to see you on warfarin just yet". I had no idea what he meant by that and it wasn't until well after I'd started with the new valve in 2011 that I began to realise that the problem was clinics. I guess that this is a good time to share this video segment from Dr Schaff at the Mayo again:

 

[Protimenow]

Yes it would be better if the dates were in there, but that still wouldn't tell what's happening between tests. I'm supposed to get my blood tested monthly as per doctor's orders, or sooner if it is out of range. 35 years of doing this!

I wasn't under the impression that you test monthly or more often if results are out of range. If your INR is consistent, it's still risky testing monthly (I had an INR clinic that I HAD to go to a few years ago, and because I self tested, my INR was always in range when I went to the clinic for a test. After a dozen or so tests in range, they pushed the frequency to 2 weeks, and eventually to a month. I didn't agree, but didn't argue, either, keeping to my own weekly self testing regimen.

If your INR was out of range, changing your dose, then retesting after 3 or 4 days will give you a good idea of what your new INR is.

I suggest that you get a meter - this way, you can test at home without traveling to a clinic.

There are many CoaguChek XS meters for sale on eBay - for as low as $29.95. I bought two - one had a few tests on it, and the other was new, with the plastic still on the screen. These meters are missing a back and a strip guide (this little thing trips a switch inside the machine, so a test can be run). Roche might possibly send these items. If not, putting an extra, used strip where the strip guide goes will make the meter usable.

I don't think there's much (if any) risk of buying from one of these sellers and, if I recall correctly, they offer free returns.

I both self test and self manage (dose management), and have been doing this since 2009. Pellicle is a great resource for information about INR management.

There's a lot of information about self testing and self managing your INR on this site.

 

[Protimenow]

Yes it would be better if the dates were in there, but that still wouldn't tell what's happening between tests. I'm supposed to get my blood tested monthly as per doctor's orders, or sooner if it is out of range. 35 years of doing this!

It depends on how you define an island. Australia is so large that it's considered a sub-continent.



And, for what it's worth, Pellicle might be in Finland now.

 

[pellicle]

And, for what it's worth, Pellicle might be in Finland now.

nah, been here since the pandemic, things look a bit sketchy in Europe ATM, but I'd like to go back soon.

 

[ThomasM]

Doctors suggest once/mo for me, more frequent only if the levels warrant it. If I got involved in home testing, however it works, I would probably do it more often and definitely with more regularity.

 

[carolinemc]

No, assumptions often get people the wrong message, as I get my annual check up every year. This Sept I have a
Complete cardiac ultrasound exam (2D with spectral and color flow Doppler) sched'd.

Then be more clear in your comments here. For it sounded like you were visiting Cardo doctor every few years or not at all. Not the wrong message for we are very serious about Cardio/Vascular care.

 

[tom in MO]

Good morning

well based on your later assertion that you are willing to listen (which your post didn't seem to suggest, nor your later replies which contained claims of saying "you felt I had good things to say" but when asked where they were you as yet have not answered) I thought I'd have another attempt at discussion, communication and perhaps guidance.

first and foremost, this is not a US only forum, cultural communications vary across the globe and the english speaking world is bigger than I think you imagine (many in Europe, India and then the other Colonies like Canada and Australia for starters). Australians are not like Canadians we are more direct (Superman called it blunt, but I can demonstrate blunt if asked. Its worth noting Australians are rank amateurs at Blunt when compared to the Finns and I lived there for over 10 years all up), if you had identified as Japanese I would have spoken to you as my sensei (先生 which means you're experience predates mine).

So, firstly I'd like to address this:

This is called survivor bias,

Another kind of survivorship bias would involve thinking that an incident was not all that dangerous because everyone communicated with afterwards survived. Even if one knew that some people are dead, they would not have their voice to add to the conversation, leading to bias in the conversation.​

its well documented where people think "I did something right" when indeed it was just the stats. The stats show that some people doing everything wrong can be somehow (probably metabolically) an outlier and never even take their warfarin. I recommend you read this post and the associated links

https://www.valvereplacement.org/threads/how-long-can-you-go-without-it.887951/
However despite you (and them) getting off so far in your game of "INR Russian roulette" not everyone does:

View attachment 888710

the key points in there are: irregular warfarin therapy and low INR. I'm not saying you're irregular but we just don't know (and you know the old saying about ASSUME

I prefer to be explicit rather than make and Ass out of anyone.



this of course brings me to the fact that PT is no longer used because it is meaningless. We now use INR which is constructed differently (I can go into that if you wish, but you could start your own reading here)


I did and I guessed that was some sort of "standing on laurels" rather than addressing the argument or the statements or supplying anything like reasons.

You yourself commented that you didn't think it was the ideal method. Now if you like I can discuss more things which you may or may not know about the possibility of an INR deviance, the reasons for the target in INR being what it is (Eg target INR = 2.5 for aortic valve and no other predisposing factors).

Lastly I'm sorry if I have not provided the required deference to age / reverence to wisdom or other cultural (mysterious to me) requirements to be deemed politeでございます but unless you tell me what's needed I can only guess. Please accept the flowers and rainbows below as an indication of my respectfulness and courtesy in intention.

View attachment 888711

Best wishes

I know Australians and I watch Australian TV and movies. I don't find Australians or their culture more rude than any other English speaking nation. Please don't use your birth country as an excuse to be rude. You do your homeland a disservice.

 

[Eva]

Although, I don't get my blood checked as I should, it was about a month ago I had my PT checked. Before that it was about 6 months since the last check. …..

Be careful. Glad you’re well (until now), but please don’t depend on your luck!
After six years of taking warfarin and doing great, I thought I mastered food and dosing! Wrong!
I skipped checking my INR one week. What happened: I was at a nail salon and I started seeing a grey shade dropping and covering my left eye sight. Luckily, my ophthalmologist took me right away then…it was TIA!! Once I returned home, I checked my INR, it was LOW. I increased my dose right away!
Stay well.

 

[brachikaa]

TBH the Gods will reward you with better health.

:-D

 

[pellicle]

@brachikaa
because it seems you didn't write anything (and because my citation to which you reply does not follow into a reply to a reply) did you have something you wanted to add to this:

or just to agree ;-)

 

[newarrior]

HJ

I eat whatever I want, including foods with a lot of vitamin k and just adjust my warfarin dose to make sure that that I am in my INR range.
That being said, due to its anti-coagulation, I avoid tumeric.

"Concurrent use of turmeric/curcumin containing natural health products with these medicines may result in prolonged bleeding times and should be avoided (5).

The antiplatelet effects of curcumin do not explain the increase in the patient’s INR, but show that it may have additive effects when used with warfarin."

https://www.medsafe.govt.nz/safety/...eric/curcumin,effects when used with warfarin.

" Data showed that curcumin and BDMC prolonged aPTT and PT significantly and inhibited thrombin and FXa activities. "

https://pubmed.ncbi.nlm.nih.gov/22531131/
Personally, I had an unexpected INR spike about 8 months ago. The only thing that I ate the previous 24 hours that was unusual for me was a Thai soup, which had significant tumeric. I can't say for certain that it was the tumeric that my raised my INR, but many guidelines do recommend avoiding tumeric when on warfarin, and so I do so.

How do you adjust your warfarin ? With a clinc ? Doctor ? On your own ? How do you know how much to adjust or subtract to your daily dose ?

 

[Superman]

HJ

How do you adjust your warfarin ? With a clinc ? Doctor ? On your own ? How do you know how much to adjust or subtract to your daily dose ?

Good grief. I’ve been ignoring your obnoxious thread necromancy for a while now, but holy smokes. You know @Chuck C. You’ve had tons of dialogue with him. You’re posting this like you haven’t asked these questions 1,000 times already and received answers. Not only from Chuck but from everyone else on here.

Like how do you not know that Chuck home tests and self manages his warfarin at this point?

 

[pellicle]

but many guidelines do recommend avoiding tumeric when on warfarin, and so I do so.

They do?

(PS: Tumeric is antiplatelet, like aspirin, so it won't show in your INR)

 

[pellicle]

Hi

How do you adjust your warfarin ? With a clinc ? Doctor ? On your own ? How do you know how much to adjust or subtract to your daily dose ?

I've discussed this many times here. But then you don't read posts do you?

So please take this advice

1. go to a convience shop and buy a typical school use exersize book
2. at the top of the first page write your question, use as many pages as needed
3. underneath that write the answers you get
4. leave a couple of pages
5. write the next question you have
6. repeat

then when you want to ask a question here, read through that book and then ask the question.

next, there's this:

Good grief. I’ve been ignoring your obnoxious thread necromancy for a while now, but holy smokes.

Superman is a really nice and patient guy, so when you get to the end of his tether you know you've really achieved something.

I know you think of us as nothing people not up to your standards of achievement in life (its evident in how you interact with us) but if we are so lowly why even ask us?

You have received a lot of patient support here but to be frank you're burning that up. Ignoring everything we tell you is the most honest mark of disrespect you can give. So if you value this place please don't **** everyone off. You just don't know what that will lead to ... and trust me, you don't want to know the answer to that.

Yes, I know you're a US citizen living in Thailand and that your single.

 

[Chuck C]

They do?

(PS: Tumeric is antiplatelet, like aspirin, so it won't show in your INR)

Many at least warn about it. I used to take turmeric (curcumin) supplements, due to its anti-inflammatory properties. After surgery, I went through the few supplements that I take to make sure that they would not interfere with warfarin. Several clinics and pharmaceutical organizations have cautions about turmeric. So, I stopped supplementing with it.

From the New Zealand government: Beware turmeric/curcumin containing products can interact with warfarin

Turmeric does have antiplatelet properties. But, I do also wonder if it interferes with warfarin clearance, affecting INR. There are some anecdotal reports of high INR being reported after starting turmeric supplementation. Personally, on two occasions, I found my INR was about one point higher after eating curry soup at my favorite Vietnamese restaurant. The next time we visited I inquired about the ingredients and found that the soup had significant turmeric added. I chose another curry soup which did not have turmeric this time, after which there appeared to be no spike in my INR. That is just my own little n=1 anecdote. My wife makes a couple dishes with a small amount of turmeric, and I do eat that, just not too much and she does not go heavy on the turmeric.

 

[pellicle]

Turmeric does have antiplatelet properties. But, I do also wonder if it interferes with warfarin clearance, affecting INR.

I dunno, I've personally tried to provoke such with some of my curries , but to no avail.

Your mileage may vary

 

[pellicle]

My wife makes a couple dishes with a small amount of turmeric, and I do eat that, just not too much and she does not go heavy on the turmeric.

May be worth more experiments that n=1 and a single attempt

 

[ThomasM]

I eat mainly an indian diet right now

Just curious once starting long term anticoagulation therapy should something change on this diet ?

Initially, I was very selective on what I ate based on my heart surgery, but as time went on I pretty much eat what I want to eat. Although, I watch what I eat based on what any person should eat and should not eat. Specifically, keeping the fatty foods down and not much in the way of sugary foods. I am probably in Better Health than most people, as I am not overweight and take pride in my physical makeup accordingly. What I eat is one of the things I don't worry about too much, as I have had my SJ mechanical valve now for over 36 years.