High iNr

[LeoLillac]

hi , to all my heart buddies DOes anyone havea problem with
erratic INR ( especially on the high side ) . I get tested every 5 week's and found out today my Inr was 5.O have not consumed any alcohol ,vitiman Etc.
It could be a full moon perhaps
Seriously , any input would be apprecaited my favorite n urse
practioner is on vacation she is awesome and i only trust her plus
she has treated me like family not just a patient .
Hope everyone has a good summer ( if summer ever arrives )
Dara ( new york city
Tricuspid valve repalcement
feb 9th 2001
DR . Fuster ( my angel)
Dr Griepp Surgeon

 

[terry40]

Leolillac

Leolillac

I sure there will be others on to help you with the high Pt inr, mine tends to run low, in fact I'm a bit nervous for this week test, I had to take a few tylenol for the migraines I've been I hoping it doesn't lower my result Fingers are XXX

Terry40

 

[Andre']

LeoLillac:

It's been my experience (having been on Coumadin for 9 years) that my levels can become elevated if I'm taking antibiotics or Tylenol.
I have noticed lower levels when I take vitamins or when I restrict my carb intake.
Either way if your INR is 5 your in serious danger of bleeding, you should make sure your monitoring it very closely, (more often than every 5 weeks), that your diet remains the same and that you take the coumandin at the same time each day. Perhaps start a diary.

Good Luck
Hope I helped some

 

[Guest]

I have analyzed thousands of my patients' clinic visits and I have found that there is little risk of bleeding if your INR is monitored every 4 weeks and it does not go above 5.0.

Since you are slightly outside that range you may have some increased risk of bleeding but not enough to sit home and worry about. I assume that they already to you to hold one dose (I hope not more). Then your INR is already back below 5 and your bleeding risk is minimal.

What I would do, if you were my patient, is to have you hold, one dose, then reduce your weekly dose by the equivalent of about one tablet per week. Then I would recheck you in 2 to 4 weeks depending on how your INRs have been running.

If anyone is interested, I have these guidelines available for sale at http://www.warfarinfo.com/publications.htm for $4.95. Look at the 3rd item down on the page "Warfarin Dosing Algortihms" Some of you have already purchased them.

 

[Blanche]

Dara:
My husband, Al, has been on anticoagulants for almost 13 years. His INR can sometimes vary for no apparent reason ( antibiotics, booze, high K foods). His range, due to stroke, is 3.0-4.0. He has often been at 5.0 or near, and has not had any difficulties. But, that is not something to wait on. For an INR that high, a decrease in dosage should be ordered by your doctor everytime. We worry more about a severe drop in INR, as Al did have a stroke when his INR was well below his range.

Blanche

 

[Blanche]

PS

PS

Dara:
I noticed that you said, "If summer ever comes." May I come visit you in NY City and enjoy the cool weather? It's 107 degrees today here in Tempe, Arizona. (Smiles) Blanche

 

[ccrawford]

OTC drugs often the culprit

OTC drugs often the culprit

Dara - Do you have a list of drugs and herbs that can affect Coumadin? If not, i'd reccommend you buy one. Also be really careful to check the labels on food products, food supplements, etc. A lot of the over the counter pain killers can afffect your INR, especially if you are on a regular regimen. Even a lot of doctors will plead ignorance on this topic because there are so many things that interact with Coumadin. Check some of the older posts and you'll find some web sites for extensive lists. Hope this helps. Chris

 

[LeoLillac]

High INr

High INr

HI , i wan't to thank everyone for there replies .
IN response ,to the person who asked if i was aware of
herb/ drug interactions. I took the liberty of getting that info directly from the makers of coumadin
My inr had been very stable for almost 9 months.
It must be the solar eclipse that we just had

I am so glad i found this site .
God bles Hank for such a great job .
Dara ( new York CITY)
Tricuspid valve replacement(Feb9th2001)
DR Fuster ( my angel)
Dr Poon ( karate man )
Dr Griepp ( surgeon )
MA ( awesome nurse NP)

 

[LUVMyBirman]

Hi Leo,

Sorry you are having concerns with higher than normal INR's. My cycle of erratic readings occur during the summer months. Living down south in TN they would bouce all over the place during the summer. Usually lower than higher. Now that I am up north again....have been 3.2 - 4.2 range. Actually, as of late the weeks I eat my salads.......INR still comes out high.

Had a good deal of high K foods, (including cole slaw) over the past week and received a 4.2 today! I love my greens and it bothers me when I have to think about how much to consume or not.
On the bright side..... going to find myself the best salad in town and enjoy myself today. Greek salads are the best!

Take care.

 

[Lorraine]

Gina,

Interesting INR. Mine was 4.3 today. BP was 128/62. So I guess my headaches aren't from hypertension or anything. At least I don't have to worry about that. It may have just been cause my glasses kept falling down my face. Glad I got them fixed and adjusted Saturday!

Now maybe my 4.3 was from some Mimosas yesterday? Cardio nurse told me to hold a day and I refused. I normally take 7.5 mg. I told her I'd take 5.0mg and eat my mexican salad I was telling you about. Sounds like a plan to me. When I told the nurse she just said she would pretend she didn't hear what I said. She did understand that after a while we do get to know our INR fluctuation and how we react to holding doese etc. No matter what the guidelines say. Every person is different. I metabolize the Coumadin a lot faster than some people.

Everytime they tell me to hold from the 4.0 range I go down to 1.8. They don't want to see me until next Monday. I'll let you know what it is then.

 

[alicia]

Ive been on Coumadin since Jan 2003 and my INR has only been really high twice and both times I knew it because I had bloody noses and spitting up blood. Today my INR was 3.9 and I have had bleeding from the rectum so my cardiologist sent me to my GI Dr and he is going to do a colonoscopy next month. My levels usually run around 2.5 or 2.9...It was as high as 6.5 and boy was I bleeding. I even developed cysts on my ovaries and I was bleeding into the cysts due to high INR level. Its a constant battle for me. I dont drink any alcohol and I try to only have 1 salad a week but it still goes up.

I never knew managing Coumadin would be so hard and lead to so many bleeding problems. Thats okay though, at least my heart is working better now so its all worth it!

 

[Granbonny]

Questions

Questions

Leo, Have you had your INR checked since June 2 when you posted? Did it drop back into range? Hope so. Blanche, When Al had his stroke..when (days , weeks, before had he tested?And what was his last INR before stroke. Did it just drop suddenly?....Al, Having my Protime..it's too tempt ing .to check like 10 day or 2 weeks when I feel like I have done something? different. Have been going to pool for last several days and lots of sunshine and a nice tan. Got worried today..after only testing 10 days ago. ..Hit a perfect 3.0 My question? is...if a person only tested at a clinic or doctor's office every 4-5 weeks..How would they know that maybe they should test earlier? I'm sure excessive bleeding would be a sign of too high of an INR.I don't mind testing often ( insurance pays $10.00 and I pay $2.00.....but if I hold off testing for 4 weeks (which my clinical nurse ask me too) what would be the signs that my INR is too low? I guess what I'm trying to ask. is ..can a person have a stroke within 4 weeks if their INR drops low and I would not know it? .....Alicia..what did your GI doctor tell you about holding coumadin before your colonoscopy? Thanks to all for answers. bonnie

 

[Christina]

Bonnie,


I test WHEN "I" think I need to test, and don't ask permission from the doctor. I call him every other week with the results. He NEVER questions me.
When I am low, I take extra Coumadin and test again in three days. That's how long it takes to see a change in the reading. I was too low yesterday (1.9) because I changed my diet and am eating more fruits, vegies and salads in addition to proteins. I gues I can't have too much of this, but I am trying to lose more weight. I am damned if I do, and damned if I don't.
Yes, you can stroke within 4 weeks of testing. Many things can interfere with Coumadin and you can't be too carefull.
I believe everyone should test weekly or for sure every other week, just to be safe. The doctors just want to save the insurance companies money, because they are told to do so. I don't think they really are looking out for our health, and at times put our health in danger by testing every 4-6 weeks. The only thing important to them is the bottom line, and that is the almighty dollar. Isn't it a shame that it has come to that?

 

[Blanche]

Bonnie:
I sense that you're worried. It seems to me that you have the machine and the materials to test whenever you want. If you have a concern, for any reason, rational or not, why not just do a test and be done with it. You can't hurt anything by testing too much. I also don't think that you are going to do yourself harm by having a few salads, drinks, or moderately high vitamin K foods. But, who am I to talk. I'm worried all the time about Al, so I understand. He tests once a week and that is probably too much. But, we pay for the tests ($12. no insurance) and they give him peace of mind. (me too).

Albert had a TIA on Friday, December l5, while having lunch with his buds at the local watering hole. He was unconscious for 1-1/2 hours, and incoherent for another 3 hours. The doctors kept him in hospital for 5 days and released him on Wednesday, December 20. On Friday, December 22, in front of my very eyes, he had the big stroke (CVA). When he had the TIA (first stroke) his INR was measured at 1.7 in the hospital. His last test prior to this was 27 days previous and his INR was 3.6. Actually, he was going to get his protime test the next day when the first stroke hit. When he was hospitalized the second time, his INR was 1.6.
About 4 months later, he had a small TIA that lasted about 2 hours. His INR was measured at the emergency room at 1.7.

You have to put this into context. Al had his valve replaced 10 years before he had the strokes. In that time, he had no trouble at all that we know of. Prior to his strokes, neither he nor I had ever even heard the term INR. We still can't be positive that the strokes were caused by a low INR, although that does seem very probable. I was able to get a copy of his protime test results for three plus years prior to his strokes. His INR was below 2.0 three times in those prior three plus years and nothing untoward happened. In May 2002 Al was hospitalized with internal bleeding. He received transfusions and his INR dropped to 1.8. He did not have a stroke this time.

I guess you can say that when the INR drops below 2.0, the risk of stroke increases. But that does not mean that a stoke will happen everytime. That's why we have a home monitor and that's why Al probably tests more than he has to. I hope this information helps. I don't like to give advice, but in this case I will say, if you are concerned about your INR, do the test. It's your call.

Kind regards,
Blanche

 

[Granbonny]

How often to test?

How often to test?

Christina..Like I said in my above post. I tested today because I had been in the sun for a few days. 10 days ago..I tested 2.8..average for me..No dosage changes for 1 year...Reading how sun affects different people. was tempted to check today. Hit a 3.0.. When I saw my Card. last month for 1 year checkup.. he was very impressed with my ranges from home testing. Kept them and showed him. He said I should always stay in the 2.5-3.5 range. Below 3.0 I have never had any bleeding from DEEP oral cleaning. Have another one the 25th of this month...Also NO brusing. even tho I took a big fall several months ago in parking lot. Posted that one I call in my INR to HIS office (Card's) and HIS clinical nurse, Ashley takes it and calls me back within an hour and tells me..that's good..test again in 4 weeks....and they DO NOT charge my insurance carrier for this service.My Cardiologist is Dr. Jeffery Marshall ..who is in charge of the new Heart center, the Ronnie Green Heart Hospital in Gainesville, Ga. He is not making any money off of my Insurance carrier. Just taking good care of his former patients.....Blanche...Also, on my above post I said, Al..(our coumadin doctor) and followed by asking..how would one know if their INR was low? Signs, ect. if they did not check but every 4 weeks? Nope, not worried. I have 2 friends on coumadin here where I live that only check their INR every 3-4 months.. They tell me that I worry too much about mine. Long post..but trying to figure out...HOW MUCH SHOULD ONE TEST. Bonnie

 

[Blanche]

Bonnie:
I responded to what I thought you asked. You said:

"Blanche, when Al had his stroke...when days, weeks, before he tested? And what was him INR before stroke. Did it drop suddenly?"

THe short version of my answer is: He tested 27 days before the stroke. His INR was 1.7 when he had the stroke and 3.6 when he tested at the lab 27 days before. Did it drop suddenly? Who knows when it dropped in that 27 days. All we know is that in 27 days it went from 3.6 to 1.7.

How much should you test? That's your question. There is no definative answer. The doctors say that every four weeks is fine. Albert tested every four weeks for ten years and had no troubles whatever. Then, up jumped the Devil and he had a stroke and a low INR. Was the stroke caused by a low INR. Who knows. I just know this. The chances of him having another stroke are greatly reduced with frequent testing. If you want to test once a month, go for it. If we had a monitor in October, l990 when Al had his valve replaced, you can believe that our choice would have been frequent testing....once a week.

If you are comfortable with once a month, go for it. As to the folks you know who test every 3-4 months, well......I"ll quote someone else on this board. "You might we able to run across the freeway many times before being hit."

Blanche

 

[LeoLillac]

High INr

High INr

Hi all, thank's so much for such insightfull replies .
I wen't back yesterday and it was 2.9 right on target .
I don't feel the need to get tested every 2 weeks since
My inr has been pretty stable for the mostpart for close to a year . Iv'e never heard of a person getting tested every 3 to 4 months that's really pushing it .
Hope everyone has a nice summer .
Dara ( tricuspid valve replacement feb 9th 2001
Dr Fuster ( my angel)
Dr Griepp ( surgeon )
Mt Sinia HOspital new york city

 

[Nancy]

I certainly agree with what you said, Blanche. So many things can affect INR, no one can adequately predict what it will be, outside of some known interactions with medications. 3-4 months is just asking for trouble, and testing every one or two days will get you into a see-saw situation, or an Al (Lodwick) says "the puppy chasing its tail".

Like your husband, Blanche, Joe has many conditions that change all the time. Fortunately, we have a doctor monitoring him who takes good care of the situation.

We only live about 20 minutes from the hospital so it's easy to go there for testing. Plus he has to have lots of other blood-work anyway.

If we lived far from the hospital, I guarantee you, we would have our own unit.

By the way, in all these years of being on Coumadin, Joe still can't determine, by how he is feeling, if his INR is going to be high. Just last week, he had his protime test and the phlebotomist had a hard time stopping the bleeding from the site. She predicted that it would turn out to be high, but it was right on target. But then he gets tested fairly frequently and doesn't get too far afield.

 

[ccrawford]

The answer is ______

The answer is ______

Granbon - I hate to sound like a doctor, but the answer is "it depends". If you are a really consistant person in regards to what and how much you eat and drink, do not vary your usage of OTC drugs, don't have to take pain pills as needed, etc., then you can probably get by with longer periods between INR tests. I'd only do this, however, after having a series of results that were not very variable. If you have read a lot about coumadin interactions and understand what is going on re your lifestyle and coumadin, then you can also probably intuitively know when you need a test. If you have a lot of changes in your lifestyle and only know a little about coumadin, then I'd test pretty frequently. I've heard that possum stew and Georgia moonshine can keep a gal's INR right on track. Hope this helps. Chris

 

[Guest]

Haven't responded for a few days. We had 11 people including all 5 grandchildren at Pagosa Springs for soaking in the "healing waters" as well as seeing the mountains.

I think somebody said a few posts back that their INR was high in spite of only eating one salad per week. Eating few greens will lead to higher than normal INRs.

Every day spent below the desired INR range increases the risk of stroke. That said, it is rare that this will happen with an INR of the 1.7 for less than a month. It is also rare that an INR 5.0 or below will lead to serious bleeding complications. But there is always someone who beats the odds.

I just had a melanoma removed from the top of my head, so I do not believe in a "nice tan". My next door neighbor has had a pool for 20 years. She is a small, thin woman, but has the most wrinkled, baggy skin of anyone I have ever seen. The dermatologist told me, "If you want to see what damage the sun does to your skin, stand by a mirror where you can see your back. Comapre your bare butt to the back of your hand."