Inr 1.0

[Beverley]

I'm a bit concerned here. Last Tuesday I had to have a colonoscopy to determine why my cbc results were so low. My cardiologist refered me to the GI doc for the colonoscopy. The problem seemed to be that there was and still is not any coordination of my care between the two physicians. Initially, my GI physician told me that I should immediately stop taking my coumadin. And that I should stay off the coumadin for 10 days until I had the colonoscopy. This did not sound right so I contacted my cardiologist who said to continue the coumadin until 3-4 days before the procedure. Well 4 days before the colonoscopy I had to have a blood transfusion because of the severe anemia. Before being discharged, I asked the nurse what my INR was and she said it was 1.7. Again being concerned I contacted my cardiologists office and was told to take the coumadin until 2 days before my procedure. The day prior to the procedure I dscontinued the coumadin and was put on heparin therapy. The colonoscopy was done the next day and I was told to continue taking my coumadin the day after my procedure. I resumed at my regular dosage and then did an INR test three days later. The results came back at 1.0! Is this what normally happens when you discontinue coumadin due to medical procedures. Should my INR level have been stabilized before I left the Hospital?

 

[Nancy]

Hi Beverly-

My husband has had many procedures when he has had to go off Coumadin. It takes 3 days for any change in your dosage to show up in the INR. Also they really cannot give you a heavy dose to get it going, it's not a good idea. So it will be a gradual return to your normal level. I suspect that the INR would have showed some movement on day 4. And you'll probably have to have frequent testing to get to your therapeutic range.

Joe has gone off it using almost every scenario, including the use of Vitamin K to get the level down fast. It's always a slow go of it to get it up, and the use of Vitamin K pre surgery was the absolute worst. I think he was hospitalized for about 10 days afterward while they tried to get the level up far enough so he could go home.

Have patience, it'll get there.

 

[ALCapshaw]

My understanding is that it takes 3 or 4 DAYS for changes in Coumadin to show up in INR readings.

I am amazed that your cardiologist and GI Doc were not in communication on how to best manage this procedure !

Others have reported being hospitalized and put on Heparin before and after surgery while the Coumadin stopped and then restarted, allowing for a 'proper' transition. If I were in your shoes, I would insist on an immediate office visit with your Cardiologist or at least an immediate phone call to sort out what to do next.

'AL'

 

[LUVMyBirman]

Looks like I am the exception to the rule. My INR will drop down to 1.5 - 1.8 if I hold my Coumadin for one day. If it gets a bit low and my dose is bumped up...... I have seen the change within 48 hours. Sometimes 24 hours.

In reverse when I have been taken off my Coumadin for a procedure it takes close to 3 weeks for it to get back up and stabilize. Knowing this testing every 2-3 days after resuming the Coumadin. They would manage me with Lovenox at home in the interim. With the recent controversies.....not sure that is the best way to handle it. Discussing it with my cardiologist at next appointment.

With Coumadin everyone is different and should be handled accordingly.