Help - vomiting after taking warfarin dose???

[gijanet]

Okay, I know no one is up and I am in a panic. Katie threw up two and 1/2 hours after taking her warfarin dose. What do I do???? I gave it to her at 10 PM, and she threw up about 12:45. Dunno if it makes any difference, but she also threw up most of the now curdled chocolate milk she drank around 9:30. Dunno if it makes any difference, but we crush up Katie's tabs and mix them in a syringe with water.Did any of the warfarin get absorbed? Do I repeat her dose? Give her half? I dunno what to do...........wah! Probably is irrelevant, but she is also running 102 temp. Thought we were over this crud -we were for a few days anyway, but now it is back with a vengeance.

Katie is on a 2.5, 2.5, 2.0 regimine, and this was our 2nd 2.5 night. I guess if no one responds soon - which I would be highly surprised if anyone did, I will give her at least a 1 mg. tablet crushed up tonight. Her INR was checked two weeks ago, and it was 3.1 - perfect! But we have not had it tested since and are supposed to go have it checked this next week. STill waiting on insurance to come through with a home tester..........sigh!

I've spent the last 45 minutes researching Al's site and doing a search on here and can't find anything..................

Thanks. Janet

 

[Yaps]

I think what you have done is good, there is no way to tell, without testing if any was absorbed. I hope she will be ok, sounds like the flu. Sending prayers,love Yaps

 

[Curtsmum]

I can't help out but a hope you have managed to sort everything out. Wishing Katie a speedy recovery, best of luck Paula x

 

[ALCapshaw2]

Given that she had the dose in her system for over 2 hours, I *suspect* that most was absorbed.

Your idea of supplementing with 1 mg is reasonable.
If none was absorbed (unlikely), then you avoid a complete skip.
If it was all absorbed, then you only have <50% increase.
Either way, you don't 'shock' her system too severely.

'AL Capshaw'

 

[Emma]

You did exactly what I always do if Chloe throws it up too Janet.
I give half the dose she already had that evening if she throws up within a couple of hours of taking it. Some, but not all of the warfarin would have been absorbed but a little higher INR is better than too low I always think so i give some more and test within a couple of days.

Hope Katie gets over this bug soon - dont' forget her INR may well be affected by her being sick anyway, not just by throwing up some of her dose.

Love to you all
Emma
xxx

 

[Guest]

Ordinarily, you would expect that warfarin would be absorbed within two hours. But the two hours just before vomiting are probably not two ordinary hours. It is impossible to predict. Vomiting can remove vitamin K producung bactreria from the intestinal tract which will cause the INR to go up. There is no way to predict what is right. You just have to be confident that God will guide the hand of the mother to make a correct decision. You have been doing this for years, so just go with what you are being led to do. Of course, God, also made ERs (although sometimes they seem like you went down instead of up) so use it if you think it is necessary.

 

[cocoalab]

Janet I am so sorry to hear that Katie is sick. I am sure you have done what you have done with the dose. It is always a hard call. I think I was always told to skip it. It didn't happen very often thankfully.

I hope Katie will be feeling better real soon.


hugs,
Wendy

Okay, I know no one is up and I am in a panic. Katie threw up two and 1/2 hours after taking her warfarin dose. What do I do???? I gave it to her at 10 PM, and she threw up about 12:45. Dunno if it makes any difference, but she also threw up most of the now curdled chocolate milk she drank around 9:30. Dunno if it makes any difference, but we crush up Katie's tabs and mix them in a syringe with water.Did any of the warfarin get absorbed? Do I repeat her dose? Give her half? I dunno what to do...........wah! Probably is irrelevant, but she is also running 102 temp. Thought we were over this crud -we were for a few days anyway, but now it is back with a vengeance.

Katie is on a 2.5, 2.5, 2.0 regimine, and this was our 2nd 2.5 night. I guess if no one responds soon - which I would be highly surprised if anyone did, I will give her at least a 1 mg. tablet crushed up tonight. Her INR was checked two weeks ago, and it was 3.1 - perfect! But we have not had it tested since and are supposed to go have it checked this next week. STill waiting on insurance to come through with a home tester..........sigh!

I've spent the last 45 minutes researching Al's site and doing a search on here and can't find anything..................

Thanks. Janet

 

[geebee]

Janet,

Sorry no one was around at 2AM to help you out. Those nights can be really long.

As others have said, I think you did the right thing by adding 1mg to Katie's dose. It will keep things from dropping and will not increase by that much if she absorbed all of the original dose.

Hope she (and you) are feeling better.

 

[gijanet]

Thanks, y'all...........

Thanks, y'all...........

I appreciate the vote of confidence as I did give her the 1 mg. I guess we will find out next week how wrong or right I was. If it hadn't been for all of that curdled milk (sorry!), I probably would have just let it ride, but I figured if all of that was still in there, then at least some of that coumadin had to be sitting in there, too...........dunno. Guess it's a crapshoot at best, but hopefully God did steer me in the right direction......God knows He's given me enough crap to deal with in my life......... , He at least ought to steer the way. At least He got me here, so maybe this was a good call, too.

Anyway, I can't believe y'all aren't up at 2:30 AM sitting at the keyboard just waiting for my crises to occur. And, yes, Gina, these types of nights can be very long and lonely. 'Course that is when most of our crises do occur. I started just to pick up the phone and call a local hospital and pose the question, but figured I would waste a lot of time and still not get an answer.

I did manage to get Katie in to the ped's this morning. Our ped wasn't doing Saturday clinic this weekend, so it's always fun trying to explain Katie's anatomy to a new doc.

While listening to her heart on the left side, the doc says," Well, you certainly don't hear that all the time."

I said, "Well, actually, we do, and it's even louder on the right."

"Oh, she has dextrocardia, huh?"

"Yep, heterotaxy, too."

"Okay, Katie, I'm just gonna check for any stomach tenderness" as he feels on the left.

So, I say, "Oh, her stomach is on the right, too."

"So she has situs inversus."

"No, actually she has situs ambiguous."

"Liver?"

"Yeah, she has one........haha! It's midline. Oh, and she's polysplenic."

"So, I guess it wouldn't do any good for me to check for spleen enlargement?"

Sigh...............

When all of that was over, Katie explained to him that the only time her stomach hurts is when she has gasoline in it (guess she was thinking back to the hospital and those horrible gas pains she had). STill, I had to laugh! I think mine would hurt, too, if it had gasoline in it.

Anyway, to make a long story short, she has one really red pussy tonsil, so he did a quick strep culture, which came back negative. They're gonna call me on the 24 hour culture tomorrow and let me know how that one turns out. He said, though, that the quick culture is usually right and that this is probably viral strep. So I asked about the aspirin and whether to stop that due to Reye syndrome risk. He said that Reye syndrome is usually associated with chicken pox (and she's been vaccinated for that already) or flu, which we were just vaccinated for last Monday, and it's a dead virus, so "shouldn't" cause the flu...........well, I do hope and pray that he's right on that front. He said the risk to her heart with stopping the aspirin would probably be greater than the risk of Reye. I said, "Well, I'm not as nervous about stopping her aspirin for a few days like I used to be because of the coumadin." That went right over his head. Didn't even bother to ask about the coumadin issue as I knew it would be pointless.

Anyway, thanks for letting me vent and for the prayers and hugs. I have to wonder like Niki, though, why can't simple illnesses ever be simple?

P.S. Of course, I have been feeling like crud all afternoon. Dunno if it is from very little sleep last night, or if Katie is generously sharing her crud.

Many hugs. J.

 

[Guest]

At least he recognized that something was different when he listened to the left side of her chest. You'd have to really wonder if he had said, "She seems OK."

 

[Mary]

Janet,
You need a nap.
Oh, and I have just the picture to cheer you up, but I can't post it. Let me see if I can send it via email. It's a hoot!

Just checked for your email; I don't think VR will let this one get through. Send it to me via PM if you get a chance.

 

[gijanet]

Okay, now you've got me curious..........

Okay, now you've got me curious..........

Janet,
You need a nap.
Oh, and I have just the picture to cheer you up, but I can't post it. Let me see if I can send it via email. It's a hoot!

Just checked for your email; I don't think VR will let this one get through. Send it to me via PM if you get a chance.

ON two counts...........my e-mail addy won't show up when you click on my hang down thingie.........okay, well, that sounds perverse...........you know what I mean, I hope? Anyway, will PM it. J.

 

[WendyD]

Hi Janet,
Sorry to hear that Katie is not well at the moment.
We are thinking of her and send her our love and best wishes.
We loved the "gasoline" story'
Hope that everything settles down for you all really soon
Best Wishes
Ernie Wendy & Fam.

 

[Mary]

ON two counts...........my e-mail addy won't show up when you click on my hang down thingie.........okay, well, that sounds perverse...........you know what I mean, I hope? Anyway, will PM it. J.

It's an attachment, and the VR email reply doesn't take attachments!

 

[LUVMyBirman]

Hi Janet,

If it is any comfort.......
The few times I have vomited from a stomach virus while on Coumadin. My INR's were perfect! Better than normal.

Go figure. It's one thing I always worried about. If I do happen to catch a bug.....resting easy. I did force myself to eat even though I did not feel well.