I'm about to pull my hair out

[ALCapshaw2]

Well I went in this past Tuesday and I was at 1.1 but prior two weeks I was at 7.2. Now that I am at 1.1 I had taken 2 mg that day. They added two more that day, and then told me 4 the following day and then back on the 2,4,2,4 schedule until next Monday.

I am eating basically the same thing and doing everything normally except working out 5 times a week.

This is driving me batty!

Whoever is managing your Coumadin Dosing is CLUELESS about how Coumadin works in the body. My recommendation is to find a Real Coumadin Clinic to manage your dosing (and consider getting a Home Test Unit and Self Dosing).

The reason that your INR is not stabilizing is that your manager DOES NOT KNOW what they are doing!

 

[catwoman]

Trina:

Where are you going for INR tests? (BTW, congrats on having had your surgery at St. Luke's -- the 5th best in the United States, according to U.S. News & World Reports.)

My sister is on warfarin for 3-6 months, thanks to a clot following varicose vein surgery.
They put her on 7.5mg X 7, which I thought might be a little high. First INR, on my INRatio 2 days after initiating therapy, was 1.7. Three days later it was 2.9, which was good. (Nancy said the nurse thought it a "little" high. I told her 2.0-3.0 was usual range for clots.)
Then she developed a bladder infection and had to go on antibiotics. First antibiotic was deep-sized after culture showed bacteria wasn't responsive to that Rx. So she was put on Bactrim. I told her that her INR would really increase.
You bet it did. Her INR on Monday, Aug. 3, was 7.0. So her doctor (guess family doctor) said to skip 2 doses, and restart on Wednesday at 5.0mg, and come back on Monday, Aug. 10, for another INR. I think her doctor is bringing in her cardiovascular surgeon on these instructions.
I agreed that skipping only 2 days was probably appropriate and restarting at a lower dose was OK.
Her doctor doesn't have a finger-stick monitor, so she has to have lab draws. She now understands why I cherish my INRatio!

So -- in light that she only held for 2 days, then went back to a lower dose (mind you, she doesn't have a mechanical), it appears that your doctors may not understand anticoagulation therapy as well as her doctors seem to so far.

Have you checked around Houston for a Coumadin clinic?

Check out these clinics in Houston at the Anticoagulation Forum's website:

http://www.acforum.org/clinics_southwest.htm#TX

Depending on where you live in the Houston area, you may want to look at one in a suburb.

 

[Lisa in Katy]

Trina, I assume you're going to a physician near your house for management, rather than someone in the Medical Center. At least I hope those in the Medical Center know better.

As far as I know, there are no dedicated Coumadin clinics in the Houston area. I haven't looked lately, but periodically I check around and can't find anythings. However, there are definitely doctors and nurses that are better than others. I went to a doctor for about a year after my surgery because his office was near mine. They were very aggressive on Coumadin management, had me on a 2.5-3.0 range, and I was never in range, bouncing around quite a bit. I finally figured out that tight ranges and aggression don't work with Coumadin management. They have to be patient, give your body time to adjust to a dose (at least a week), and then check before making a change. When they make adjustments, they have to work with small numbers - no more than 10-20%. Skipping 3 days and then starting out on a very small dose is a huge adjustment and shows stupidity on their part.

Do what Ross says, tell your doctor what you're doing and why, if he has a problem, find a new doctor.

 

[Ross]

Know how you feel. My INR has been up and down since January. Was back in Hospital a couple of weeks ago to have Sternum wires removed. They went to a lot of time and effort to prepare me for the Op and to get me right afterwards in regtard to INR.
But it seems that my problem was related to my diet. I was using Soya milk seems their is a link to it causing problems with us on Warfarin.

Best of luck with it and try to be patient it will come right.

J

Yes Soy will decrease your INR if you drink lots of it everyday, but as with everything that you put into your mouth, it can be adjusted for. Don't let them get you on the kick of dieting the dose. Dose the diet!