How low can you go??

[Karlynn]

Today's 1st INR 1.4, today's 2nd INR 1.7 INR 9 days ago 2.9

What the heck is going on here? No change in diet.

Then I thought back and realized that when I did my weekly pill sort on Monday night, that I still had 6mg remaining in my Sunday slot. Must not have dumped all the pills in my hand Sunday night, in the dark. So I took 1/3 a dose on Sunday by accident. 3 days later my INR is 1.7 - I'm assuming it's the 1/3 dose on Sunday. Since I take 66 a week my INR would drop fast when holding, but that's fast.

I'm assuming I'm already on my way back up, have a call into the doc (but it will be hard to speak to her because I'm working today and not near my cell phone.

Just wondering if I should take any additional or assume it's the 1/3rd dose from Sunday and see what happens.)

Hmmmm. I'm thinking I'd feel better taking some additional and then deal with a higher INR if I have to.

Thoughts?

 

[geebee]

Karlynn,
Much better to take the extra dose and be too high than where you are now. That being said, I am really concerned about 1.7 for you. If it were me, I would consider getting into the doctor for a Lovenox shot or two. But, then, I am a worrier by genetics.

 

[Guest]

Take enough extra today to make up for what you think that you missed.

 

[Mary]

Yep,
You know I'm not on coumadin, but I think you're needing to get that INR up. Quit taking your medicine in the dark Karlynn!
Do you need me to come up there and supervise you?

 

[Ross]

Yep,
Do you need me to come up there and supervise you?

Actually, I was supervising her and that's why she messed up.

 

[Nancy]

At 1.8 Joe threw splenic infarctions. He has an aortic and mitral mechanical and the additional risk of afib/flutter.

So better a little higher than lower.

Those clots could have gone to his brain.

 

[Natanni]

Low INR

Low INR

I wanted Nathan on Lovenox when he went down to 1.6 at 8 days post op, as did the PA-C. When the PA-C called the surgeon, he said that since it was an aortic valve vs the mitrial Nathan didn't need bridging. Apparently there is enough force of flow in the aortic area that he wasn't too worried about it. Not sure if this is true only in fresh post-ops or long history of AVR. I worried myself silly here at home until he went up.

 

[Mary]

I wanted Nathan on Lovenox when he went down to 1.6 at 8 days post op, as did the PA-C. When the PA-C called the surgeon, he said that since it was an aortic valve vs the mitrial Nathan didn't need bridging. Apparently there is enough force of flow in the aortic area that he wasn't too worried about it. Not sure if this is true only in fresh post-ops or long history of AVR. I worried myself silly here at home until he went up.

Our, take my medicine in the dark girl , owns a mechanical mitral valve.

The White Sox's winning the American League pennant race must have temporarily discombobolated her!

 

[Sherry]

Yikes, Karlynn, with a mitral, I would definitely take another dose. Good luck, and I'll check on the forum when I'm at the reunion to see how you do.

 

[Karlynn]

Just got home from work. Talked to my card. She wants me to take an additional 3 tonight. But I think I'm going to do as Al suggested and take the amount I missed, which would be 6 additional. I have been that low before, for an extended length of time. That's how I found VR! Turned out it was hidden K in a protein bar. I know it's not that this time. If it was the Sunday screw-up, then I shouldn't have been low for too long.

We're heading down to see our son for the weekend. So if you don't hear from me, don't panic! Although I may get a chance to check in on his PC.

 

[Karlynn]

PS - Ross? That was you???

PPS - Mary, come on up. We'll have a great time!

 

[Karlynn]

Nobody yell at me, but I just tested my INR again - just to see if I was correct and that it was on it's way up. It's 1.9 now. I know the whole error margin thing - but I'll take a 1.9 over a 1.7, much less a 1.4. If I'd waited another few days to test, or tested on Monday like I usually do I probably would have never know it was that low.

I just love having wild and crazy fun like this.

But I did come up with a question. We know that mech mitrals are high risk for clots because the blood isn't forced over the valve as strongly as the aortic. But does someone who does cardio work outs have any increased advantage over someone who is sedentary or gets little cardio exercise? I do a cardio workout 3 - 4 days a week and I was wondering if that would give any extra "cushion" to the INR range. (I know it's a shot in the dark, I'm just lookin' for a bone here! You can chuckle and shake your heads if you like. But you can't blame a girl for trying. ) I'll be really happy when I'm up over 3 again.

 

[Mary]

Tuesday, I was where I think you're headed.
Is that cryptic enough for you?
Have you ever eaten at the Sub Shop?

 

[Ross]

PS - Ross? That was you???

I really enjoyed watching the hair on your neck stand up.

 

[Guest]

Nobody knows the answer to the cardio workout question.

 

[Cris N]

Really bizarre, isn't it. Here's my last batch of tests:

• 4.6 dosage 35 mg/week - keep dosage the same (have a V-8).

• skipped a week - still on 35 mg/week

• 1.7 - upped dosage to 40 mg/week - Thoughts of bogus test.

• 3.0 stay at 40 mg/week

• 2.5 - upped dosage to 42 mg/week

• 3.7 (today) nurse wanted me to drop to 41 mg. I said no, stay at 42 mg - I'll have a V-8 if it'll make you happy.

I haven't changed any other meds, exercise level is the same, was on amiodarone for 1 month but quit that end of June. My diet has remained fairly consistent. Anticoag clinic uses Coaguchek S.

Cris

 

[Karlynn]

I'm 3 days shy of my 14th anniversary. I have never had a very stable INR. It used to really confuddle my doctors until they just started going with the flow. Now that I test and dose myself, I find I'm able to keep it pretty well in check, but am always tweaking my dose. (unless I forget to take 2/3's of my dose!! ) About 4 years ago I had to tell my cardio You may as well give up trying to find my concrete dose because it's never going to happen.

Now that we use the INR standards, it's much better. But when it was ProTime it was crazy.