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[dkapuscik]

Just got back from my pro time test. 1.4 cant get it to come up. Here is my sched of waferin and dosages:

6/30 2.5-5-2.5-5-2.5-5-2.5 Result 4.20 25mg week
7/3 2.5-5-5-5-2.5-5-2.5 Result 1.5 27.5mg
7/10 5-5-5-5-5-5-5 Result 1.5 35mg
7/20 5-5-5-5-5-5-2.5 Result 3.7 32.5mg
8/3 5-5-5-5-5-5-2.5 Result 2.6 32.5mg
8/17 5-2.5-5-2.5-5-2.5-5 Result 6.7 27.5mg
8/21 5-2.5-5-2.5-5-2.5-5 Result 2.5 27.5mg
9/6 5-2.5-5-2.5-5-2.5-5 Result 1.4 27.5mg

As you can see, I'm all over the place they had me take an additional 2.5 today and go back to 5 per day and retest in 7 days. ANY SUGGESTIONS FROM THE EXPERIENCED WAFERIN TAKERS?

 

[Ross]

How are you being tested, Fingerstick or lab?
How soon do you get the results?
Any extreme changes in diet or excercise?
What other medications are you taking?

Right now, I'm thinking you need to go to a new lab!
I don't think it's you, I think the lab is coming up with bogus results. Your 6/30 and 8/17 results appear flawed and it looks like you really need to be on 30 to 32.5 per week. It's hard to tell like this, but something is certainly not right.

 

[catwoman]

David:

Who is managing your warfarin? What activities are you involved in right now? (From your profile, you are an extremely active person.)

You're at risk of a clot, at 1.4. That's not much above what an unanticoagulated person's INR would be (1.0). I can't tell if the INR results are based on the intake the week before or what... Because you had a 6.7 (? -- could be a false reading?) on 8/17 based on 27.5mg and retested on 8/21 and had an INR of 2.5 with same dosage. Stayed on same dosage of 27.5 and had an INR of 1.4 on 9/6.

My guess is you're increasing your activity level as you continue to recover and need to be upping your dosage.

 

[Karlynn]

Just got back from my pro time test. 1.4 cant get it to come up. Here is my sched of waferin and dosages:

6/30 2.5-5-2.5-5-2.5-5-2.5 Result 4.20 25mg week
7/3 2.5-5-5-5-2.5-5-2.5 Result 1.5 27.5mg
7/10 5-5-5-5-5-5-5 Result 1.5 35mg
7/20 5-5-5-5-5-5-2.5 Result 3.7 32.5mg
8/3 5-5-5-5-5-5-2.5 Result 2.6 32.5mg
8/17 5-2.5-5-2.5-5-2.5-5 Result 6.7 27.5mg
8/21 5-2.5-5-2.5-5-2.5-5 Result 2.5 27.5mg
9/6 5-2.5-5-2.5-5-2.5-5 Result 1.4 27.5mg

As you can see, I'm all over the place they had me take an additional 2.5 today and go back to 5 per day and retest in 7 days. ANY SUGGESTIONS FROM THE EXPERIENCED WAFERIN TAKERS?

Are your doses what you were at when the INR was taken. INR 4.2, was from the 25/week? I'm a bit confused. I'm reading that your INR was 4.2 and they increased your dose to 27.5. Or was it 4.2 and they gave you and instruction of 25/week. So your next INR of 1.5 was from the 25.

I'm thinking you need a new lab too. Finger stick or lab draw? If it's a lab draw you need to find a place that does finger sticks.

When do you get your results? The same day? The next day? After that?

Looking at your results, I'm guessing that the 6.7 was a bogus result. If I'm correct they lowered your dose afte that 6.7 from 32.5 to 27.5. So then 4 days later your INR was 2.5 (it probably was really in the 3's when you got the 6.7). They kept you on the same dose since they felt that the 27.5 was dropping you nicely from the 6.7. So then approximately 2 weeks later (was that their instruction - to test in 2 weeks?) you were at 1.4. It looks like your dose is going to be that 32.5 or 35, or around there.

Whenever I get an INR test that is way off, I always retest before changing dose.

So they have you on 37.5 for the week? (assuming 7.5 today). If that pushes you high, don't let them make a huge adjustment. They've got you swinging all over the place with dosage changes.

 

[Mike C]

If it were me, I would be giving myself shots until I got up to 2.0.
I would also pick a dosage and stick with it for a couple of weeks, hard to say from your numbers but i would start with 35mg/week.
you are better off being high than low.
i think it better to be consistent with the dose and be flexible with the inr thatn the other way around. meaning if one week if pops up to 3.5, dont sweat it, leave the dose as it is.

 

[dkapuscik]

The sample is a finger stick with quick results on a strip that gives a digital read out. The pro time lab is the lab at the Oklahoma heart hospital where I had my surgery.

The results are from the previous weeks dosages. I am also taking Cymbalta 60mg daily. I am taking both in the AM when I get up. I did mis a dose last Saturday, but I felt that there was adequate time to recover before the test today. I'm a meat and potato kind of guy so I dint have to watch the vegetable and vitamin K thing to close.

Yes I am much more active now. I am requiring less sleep and am back at work. I have been doing some push ups and stuff like that. I wake boarded at the lake over the holiday for a short run. So yes I am starting to move around more, lift more, and work around the house some.

Do you guys think I should take an extra 2.5 a couple of times a week?

 

[Ross]

From the inconsistent readings, it looks to me that your sweet spot is about 32.5mg per week. 35 may be a touch too much, but better high then where you are now. I would do 5mg Sun, Mon, Tues, Thur,Fri, Sat and 2.5mg on Wed. or simply 5mg for all 7 days.

Realize of course, that I'm no pro, just a self dosing home tester.

 

[Guest]

For the 6.2 I would have probably just held one dose and had you contiunue on the same dose and checked you a week later. At the visit before the 6.2, why was your dose reduced? The fact that you also got an INR in range four days after the 6.2 on the same weekly dose should have tipped the warfarin manager that something was not right about the 6.2. This type of thing is why I rarely make dosage changes for INRs in this range. Just holding one dose and resuming the same weekly dose is usually sufficient.