G
Guest
The answer is based on a medical journal article that I found.
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G
Gisele
Hi Al!
Hi Al!
OK, so what is the answer? I once remember a few patients being between 70 - 90........mostly elderly who took too many pills..........who knows, could have been lab error too. One patient was taking his pills with shots of Vodka..............yeah, he ended up with a pretty high INR.
You'll have to let us know what the answer is
Gisele
Hi Al!
OK, so what is the answer? I once remember a few patients being between 70 - 90........mostly elderly who took too many pills..........who knows, could have been lab error too. One patient was taking his pills with shots of Vodka..............yeah, he ended up with a pretty high INR.
You'll have to let us know what the answer is
Gisele
I'm curious too, Giselle. I guessed (and it is a guess!) that it wouldn't really matter as long as you weren't bleeding but over 500 does seem a little on the high side.
I was just thinking about you today and wondering how you were doing.
I was just thinking about you today and wondering how you were doing.
G
Guest
I put it up for two days. I'll tell you the answer on Thursday.
R
Raverlaw
My personal high is 6.1. I think Tom Hosack has the record for the VR board.
I don't have my highest INR written down, but it was around 17-19. I thought that I posted it, but can't find it. Oh well.
I screwed up taking my Coumadin in the first few weeks after surgery. I wasn't thinking straight. I never was able to reconstruct my thoughts or thought processes that caused me to make such a bad mistake. It's the kind of acheivement that is not to be proud of. It's more like "when all else fails, at least I can serve as a bad example".
I screwed up taking my Coumadin in the first few weeks after surgery. I wasn't thinking straight. I never was able to reconstruct my thoughts or thought processes that caused me to make such a bad mistake. It's the kind of acheivement that is not to be proud of. It's more like "when all else fails, at least I can serve as a bad example".
G
Guest
The bottom line is that you survived with no ill effects.
Yes, that is the point, isn't it. Amen.allodwick said:
G
Gisele
My guess......
My guess......
was 50 to 100......I am curious to see though how high it could get.
My guess......
was 50 to 100......I am curious to see though how high it could get.
Sherry
Well-known member
I got up in the high sevens one time and didn't have any evidence of bleeding. My nurse and I just sat and looked at each other quizzically when the number popped up. I will be curious to hear the answer.
BTW, how have ya been, Gisele? Long time no hear...
BTW, how have ya been, Gisele? Long time no hear...
G
Guest
The answer is probably greater than 500. Annals of Internal medicine reports on the case of a man who went to the ER because he had been attempting suicide. He told them that he had been taking warfarin. His INR was higher than the tester could calculate. He got a transfusion, vitamin K, fresh frozen plasma and was discharged. One week later he can back to the ER with a bloody nose. He swore that he had not taken any more warfarin, but BTW it wasn't really warfarin that he took, it was D-Con.
When warfarin was used for rat poison, it killed the rats who were most sensitive to it. Just like people some rats could tolerate higher doses without ill effects. But rats produce babies faster than humans do so pretty soon the only rats living to reproduce were those who could tolerate warfarin. So they had to switch to a super-warfarin. This is called brodifacoum. It is fat soluble. This means that it is deposited in body fat and slowly leached back into the body fluids. Therefore, it is much longer acting and keep levels high for a long time.
When the guy came back with the bloody nose, they tested his INR and it was 398.5. That is correct three hundred ninety eight point five. This was after a week without any more poison. He needed another transfusion, and got more fresh frozen plasma. It then took 100 mg of vitamin K by mouth every day to keep his INR down to the therapeutic range. Over 2 months the vitamin K was tapered as the level of brodifacoum in his body gradually was depleted.
The guy had nothing more serious than needing a few transfusions.
So, no more using the statement, "My INR shot up to ..." unless you can come close to 398.5!!!
When warfarin was used for rat poison, it killed the rats who were most sensitive to it. Just like people some rats could tolerate higher doses without ill effects. But rats produce babies faster than humans do so pretty soon the only rats living to reproduce were those who could tolerate warfarin. So they had to switch to a super-warfarin. This is called brodifacoum. It is fat soluble. This means that it is deposited in body fat and slowly leached back into the body fluids. Therefore, it is much longer acting and keep levels high for a long time.
When the guy came back with the bloody nose, they tested his INR and it was 398.5. That is correct three hundred ninety eight point five. This was after a week without any more poison. He needed another transfusion, and got more fresh frozen plasma. It then took 100 mg of vitamin K by mouth every day to keep his INR down to the therapeutic range. Over 2 months the vitamin K was tapered as the level of brodifacoum in his body gradually was depleted.
The guy had nothing more serious than needing a few transfusions.
So, no more using the statement, "My INR shot up to ..." unless you can come close to 398.5!!!
G
geebee
Holy Cow! (or should I say rat?), I cannot believe those numbers.
However, it is very encouraging to know that panicking (sp?) over a 5.3 is probably a little overreaction (although something still needing attention).
Thanks for the info.
Smiles,
Gina
However, it is very encouraging to know that panicking (sp?) over a 5.3 is probably a little overreaction (although something still needing attention).
Thanks for the info.
Smiles,
Gina
J
JimChicago
Would you say that man's arteries, capillaries must have been in tip top shape so that they didn't leak or bruise with that high inr? On the otherhand some people have bleeding at much lower inr's ( I was up to 7 once after surgery) - is it then becuase they have an injury or their veins are fragile and easily bruised?
G
Gisele
Hi Sherry,
Hi Sherry,
I have been doing OK. I never regained a normal sensation to my foot and get frustrated that I cannot walk or stand for any period of time. I still have some neuro problems, such as memory, balance, comprehension, but I do OK enough to get by so that no one who didn't know my history would know that I have had a problem. Most importantly..........my hair has grown back....lol
I hope that all my friends on the board are doing well and I drop in once in a while to check up on them...............................
How are you doing?
Hi Sherry,
I have been doing OK. I never regained a normal sensation to my foot and get frustrated that I cannot walk or stand for any period of time. I still have some neuro problems, such as memory, balance, comprehension, but I do OK enough to get by so that no one who didn't know my history would know that I have had a problem. Most importantly..........my hair has grown back....lol
I hope that all my friends on the board are doing well and I drop in once in a while to check up on them...............................
How are you doing?
G
Guest
He must have been in pretty good shape.
I see INRs in the 5 range every day. They do not seem to be the cause of much worry. It is not just how high the INR is but how long you stay at that level that causes trouble. A 10% dosage change usually suffices at this range.
The CoaguChek only reads up to 8. I see an 8 or greater than 8 reading every month. Rarely do I recommend vitamin K. You are at much more risk if your INR gets more than about 0.2 units below your range. I feel much more urgency to get a low INR up than I do to get a high INR down.
I see INRs in the 5 range every day. They do not seem to be the cause of much worry. It is not just how high the INR is but how long you stay at that level that causes trouble. A 10% dosage change usually suffices at this range.
The CoaguChek only reads up to 8. I see an 8 or greater than 8 reading every month. Rarely do I recommend vitamin K. You are at much more risk if your INR gets more than about 0.2 units below your range. I feel much more urgency to get a low INR up than I do to get a high INR down.
LUVMyBirman
Well-known member
During my cardiac tamponade (3 week post op event). My INR was charted at 14. I was taken to surgery for the tamponade and fully transfused. Frozen plasma first. Not sure if they gave me vit. K? I can say one thing for sure. I felt myself slipping before they took me in. They prepared my family for a poor outcome. It makes every day a blessing
I don't think I would survive with that high an INR. Jim's comment about the strength of the veins has to have something to do with it. After all, one time when I had an INR of 5.something and a sinus infection... I ended up having bleeding behind my ear drum! Who'da thunk? I guess I'm just not lucky in the bleeding department...
I guess I'm just not lucky in the bleeding department...
G
Guest
Gina, Sherry and Niki's comments, along with this guy's example illustrate the point that warfarin probably does not cause bleeding on its own -- it makes something bleed when there is an predisposition to bleeding.
Gina had just had surgery when she had bleeding around her heart.
Niki had a sinus infection and bled from what was probably an irritated vein in her nose.
Sherry did not have a problem when her INR was 7
If you do not have a predisposing factor, you are unlikely to bleed at INRs that are not grossly elevated. The problem is that you don't always know about predisposing factors.
Gina had just had surgery when she had bleeding around her heart.
Niki had a sinus infection and bled from what was probably an irritated vein in her nose.
Sherry did not have a problem when her INR was 7
If you do not have a predisposing factor, you are unlikely to bleed at INRs that are not grossly elevated. The problem is that you don't always know about predisposing factors.
N
Nan
Wow!!! I am going to print this out....I may take it to the ER where they told me I was toxic with an INR of 4!!! It seems that some medical personnel really panic with any INR over 3.5 or so.
Al, what you are saying about there having to be a pre-disposition to bleed for a high INR to cause a problem really makes sense.
Al, what you are saying about there having to be a pre-disposition to bleed for a high INR to cause a problem really makes sense.
