Help 1.4!

[hpuehler]

I just spoke with the PT nurse and my PT is 1.4. I have been taking 5mg daily M-TH and 2.5 on Friday. Tuesday I missed my dose and I went off of the Aspirin 81mg as the Cardio had said at three months last week. My last Pt was 3/31 and it was 2.56.
I don't think my diet has changed much, if anything I thought I was eating less greens etc.
The PT nurse said if I had a mitral vs my aortic, I would be in the hospital. Just what I wanted to hear since I'm leaving town tonight. I asked her if I should get a Lovenox injection, she said no. She told me to take 7.5 mg tonight, 5mg tommorrow and 7.5 mg on Sunday with a retest on Monday. Does this sound ok? I'm a little apprehensive about going to the lake out in tim-buck-two with my PT so low!


Heather

 

[Ross]

What were you taking on Saturday and Sundays?

Monday thru Thursday=20mg plus Friday 2.5mg=22.5 for the week and two days of nothing is guaranteed to drop it to below normal.

 

[RandyL]

I think I would just go to 5mg every day, go to the lake and have fun and retest in a week. However you prolly shouldn't listen to me because I am still in the learning stages, but that's what I would do.

 

[Georgia]

Seems to make sense that your inr would be at 1.4 - my understanding is that missing a dose will drop your inr 50% - so starting at 2.5, there you go.

Honestly, I wouldn't be so worried about this since you know what caused it. If it just showed up out of the blue, it's a huge concern. Take the dose you missed and spread it over the week in addition to your regular dose and go enjoy yourself.

And don't skip a dose again. (yes, mother).

 

[ALCapshaw2]

You did not indicate what dose you take / took on Saturday and Sunday.

You DO take something EVERY DAY I hope. Skipping two days is GUARANTEED to put your INR in the Tank and even skipping one day will show a significant drop.

I use a 7 day pill box AND a 31 day data sheet to record ALL of my medications as a double check.

'AL Capshaw'

 

[Kathleen]

Me to

Me to

Heather
I will be interested to see the replies you get since I tested at the same level today. I have both the mitral and aortic replacements. I self dosed for the last month raising the amount they considered to be the protocol dose. Still it has tanked and the dose they calculated today from my experience will still not raise me to a therapeutic level.
Kathy

 

[Guest]

This makes no sense. If you missed a dose on Tuesday you should expect the INR to be low on Friday. It takes about 3 days for the missed dose to show up.

Then they give you some oddball dose and tell you to test again on Monday before the oddball dose has a chance to show up on the INR. If it is in range on Monday it will be meaningless because of the lag time.

I have my patients take a double dose on the day they are tested and then retest in another week to 10 days. If you don't give enough time for the INR to adjust to the dose, you have about as much chance of being in range as if a monkey was throwing darts at a bunch of numbers. Then the next time you have about that same chance again.

The fact that you were told that you would be in the hospital if you had a mitral valve also shows a lack of common sense too. Why scare you by bringing up an irrelevant issue? It makes about as much sense as saying, "If you didn't eat a donut last Tuesday then you had better be very careful that you don't get hit by a bus going home tonight."

 

[hpuehler]

Thanks for your responses!

Ross- I take 5 mg on Sat and Sunday also. (Can I still blame that on pumphead?)

Al - I thought her remark was unprofessional. Medicine is based on fact, I don't want to here the if you were someone else speech. I was also thinking that testing my INR on Monday was too soon. I will be seeing the cardiologist soon and plan to insist on home testing! It is so stupid for me to have to call a PT nurse to get the information that I could have told her myself! I'm a nurse, but that doesn't make me an expert either.
I appreciate everyone's input, It is great to have this wonderful bunch to toss things around with!

Heather

 

[Ross]

That would make 32.5 so if it were me, I'd increase it 20%=39 round it to 40mg over the week 5mg 5 days a week and 7.5 two a week. Spread it as evenly as possible.