Fretting over low INR

[MandyMV]

Hi All,
I am not sure the best place for this thread but I just need to vent so this seems like a good place. My BF has been using the INRratio home testing machine for the last month. His first reading was low 1.8, week two 2.5, week three 3.7 and now this week it was 1.7! He tests on Monday and the clinic put him on three lovenox shots and then to test again today. I was at the doctor this morning when he tested again and it was 1.7 again even with an increase in coumadin. I know the lovenox wouldn't show up in the INR but we did increase his coumadin on Tuesday from 5mg to 7.5mg. He is on his way up to the hospital where the coumadin clinic is located (we live about an hour and a half away).

Of course I didn't find all this out until I got home two hours later and noticed the INR machine gone and the lovenox shots out again so I called him and was informed of what was going on...He is much more laid back than I am...so I am here with the pets stressing and waiting to hear what they find out. They are going to run a lab test at the hospital to back up any decisions on dosing.
However, I know that there are slight differences in lab testing and the monitor so not sure if that is a good idea.

Oh and on top of this we are out of testing strips! I ordered more three weeks ago and the automated voice said 3-5 days but lo and behold even after a second call I find out today that they are on backorder. Don't you think they should have called us to tell us that!!! Now the soonest we can get them is Tuesday.

Ok vent over, my BF will shoot me for sharing this but I am sure the SO's out there will sympathize that sometimes we worry more than the patient
Have a good Friday,
Theresa

 

[Bina]

Don't be shy to post in the Anti Coagulation Forum; you are understandibly very concerned.
Hopefully you are writing down his daily doses and test results.

 

[ALCapshaw2]

Having a Lab Draw today and deciding on a course of action based on that is a Good Idea. The next logical step would be to test again sometime next week and *hopefully* he will receive his shipment of Test Strips by then so it sounds like he is covered.

FRUSTRATING no doubt, but with the Lovenox and Lab Test, he should be safe.

 

[Ross]

Mandy if you know and if not, could you find out what his dosing schedule is? How much does he take each day of the week? Any other medications he's on? How about activity, is he really active? Give us as much information as possible so we can see if we might be able to help.

 

[MandyMV]

Update

Update

Hi guys, thank you for letting me know things will be ok. I love this site as it helps me learn and deal with all the changes and challenges we have been through this past year.

So the lab test came back 1.9. He is to take lovenox 1 today then 2 a day through Monday. He is to take 10mg until Monday as well when he tests again at the lab since we won't have strips until Tuesday. He was on 7.5mg all week since the first 1.7. Prior to that he was on 5mg three days and 7.5mg 4 days.

The only thing I can think is affecting the INR is his increased activity level as the weather is getting nicer and we got a new puppy who needs a lot of walking. Otherwise his diet hasn't changed much. The only other medication he is on is Atenol (sp?) for HR rates we still don't know why are out of whack because according to the doctor he is fine.

I know he is covered with the Lovenox but I hate to see him have to take those shots! I am grateful we are home testing each week though as it highlights any changes earlier.

Thank you again for your support.
Theresa
PS Mandy is the kitty in the picture!

 

[Philip B]

Dosage

Dosage

INR is really affected by metabolic rate. Activity plays an important part in how fast one's metabolism runs.

I'm fifty-two and while laid up this winter with a broken foot, 5mg a day kept me within my zone. When I finally got out of my cast and started exercising again it required increasing to 7.5mg per day. Since spring has arrived my exercise schedule has increased and I find that I have to alternate 7.5 & 10mg dosages every other day to keep in my zone. I suspect as my activity level continues to increase with good weather, I'll be doing 10mg every day.

One of my eighteen year old seniors started taking coumadin during Xmas break this year. She's fit, healthy, and engaged in high school sports. Even though she only weighs about 90 pounds she has to take 20mg a day to stay in the low end of her zone.

Diet is also a factor. Concistency is a key with diet.

I don't know who you test strip supplier is, but I've never had problems with mine. Even though I live in a rural mountain area, I get my strips within 48 hours of ordering.

-Philip

 

[denobobeno]

it is scary when things are out of our control and all we can see is caos. Especially when it comes to a loved one. He is blessed to have someone whowill take the time to post and try to look into anything that you think might help.
I pray that he gets it all straightened out very soon.
Pray,Pray,
Deana

 

[briansmom]

Theresa,
I think the SO's have it very hard. Especially if the patient is young and male!
Hang in there and feel free to vent here any time.