Help!! please!!!

[njean]

i finally got an appointment with the cardio but it's not until 11/26 but thank god i have a nurse from my in home services coming out wed to draw for another pt/inr maybe they can get through to her that this dangerous!!! I think I am going to have to switch hospital affiliates to find a new pcp. and yes i may have to get a lawyer if god forbid i have another stroke. i would try to get a lovenox injection but insurance won't pay and i can't afford it out of pocket

Nadine,
There are programs that will assist patients who can't pay for Lovonox injections. I dug up this post from another VR member so perhaps you too can benefit from this:

http://www.valvereplacement.com/forums/showthread.php?t=27065

 

[nadi]

thanks i will check into it after next draw going to call in am and see if can get it sooner then next week if not going to hosp for another draw.

 

[ALCapshaw2]

Nadine -

Did you convey to your Cardiologist that your INR was 1.5?

If not, you may want to call and ask to speak with his Nurse, then tell her about your Low INR (from last week) and ask for his recommendation.

Do you take a daily (low dose - 81mg) Aspirin?
If not, you may also want to ask about doing so.
(Or maybe even a regular Aspirin (325 mg).

For an INR <2 and a Target INR of 2.5 to 3.5, AL Lodwick's Dosing Chart recommends increasing your Weekly Dose by 15 to 20% and testing again in 1 week.

If I were in a similar situation (INR, insurance, Doctor),
I would ask any Doctor I could get to about the aspirin regimin and I would increase my Weekly Dosage per AL Lodwick's Guidelines which seems to correlate well with the Guidelines used by my Coumadin Clinic.

You may also want to suggest that your Primary Care Physician obtain the latest CHEST Guidelines which is what most Doctors / Coumadin Clinics use as their "Anti-Coagulation Bible".

 

[nadi]

AL, I upped my dosage myself hopefully I am more in line with my next draw if not going to go up again another 10% cardio office won't discuss anything with me since i have not been in for 4 years ( I know SHAME ON ME!!!!) BUT like I said the business office lied to me and I could not get an appointment when I moved back here.and the insurance company I had at the time would only let me see Dr's at the clinic that "fired" me so I figured that if I had trouble I would go to ER but I didn't have any warning on the stroke just a headache that i figured was stress from work. do you know if I can I find the CHEST GUIDELINES on line?



'

 

[ALCapshaw2]

I found the following reference after a Google Search for "anticoagulation guidelines"

Anticoagulation: American College of Chest Physicians Guidelines ...
Anticoagulation*. American College of Chest Physicians Guidelines for the Prevention and Management of Postoperative Atrial Fibrillation After Cardiac ...
www.chestjournal.org/cgi/content/full/128/2_suppl/24S - Similar pages
by AE Epstein - 2005 - Cited by 9 - Related articles - All 3 versions

=========

There are MANY references you can check out
The Keywords I tried were:
CHEST
CHEST Guidelines
AntiCoagulation Guidelines

When I asked my PCP about anticoagulation,
he went and pulled out a 1 inch thick 8.5 by 11 Paper Bound Book that I believe was one volume from the CHEST Guidelines, saying that it was his "AntiCoagulation Bible".

Hope this helps.

 

[nadi]

Al, thanks.I will print it out for her since she seems to lazy to check out things on her own.

 

[Cris N]

Nadine,
The other thing I would do is go to the website of your valve's manufacturer... it should have the guidelines as well... certainly your doc can't refute what the manufacturer recommends...?

 

[khamis73]

1.55 it's low as i know the INR shouldn't be less than 2.5

 

[nadi]

i finally found a new PCP DR. yeah!!!!!!!!!! at least I know he will listen he was my Dr in the nursing home I have known him for 17 years I should never have gone back to my other Dr. I was an IDIOT!!!!!!!!!! I had another PT/INR draw today but wont get results untill Monday am Dr office closed on Fridays good thing about new Dr his office open m-f and he is available after hours she is not. Monday I have to get office to send him my records so i can be an official patient

 

[AgilityDog]

I'm glad you've got a new pcp, but you need to be getiing your results faster. I hope you can get a home monitor, 'cause 3 days is too slow.

 

[nadi]

got my INR results today 2.0 but that is without eating any green veggies which I normally do even after telling them this I was told to stay on same dosage.ARGGGGG!!!!I told them to fax records to new PCP tired of fighting with them over proper range. Said they would we shall see, I bet I have to fight them on this also. I am going to adjust my warfarin by 1 mg a day see if I can get it up for next test in 2 weeks. starting to get really worried down too long now.

 

[Lisa in Katy]

Nadine - I noticed that you mentioned having to have a referral to see your cardiologist. Just interested - what insurance are you on? Many plans allow direct access to specialists if you have a chronic condition.

 

[nadi]

sorry well i saw new Dr on 10/30 INR (finally up) to 2.98 thank god!!!!! but developed a new problem now I have shingles and can't sit at computer for any length of time. boohoo hoooo. Well I am going to go lay Dow until dinner.

 

[Freddie]

Nadine, hope your feeling better real soon.

 

[zipper2]

Sorry to read about this painful post,

Look after yourself and hope your feeling better with each day.

zipper2 (DEB)