INR at 4.7 - help

[Bridgette]

It's a power thing with SOME of these medical people - they don't like patients being proactive and taking control of their own health. It makes them redundant in the big picture.
Plus, they think that we're stupid and incapable of working things out for ourselves....SHOCK, HORROR....mere mortals (lay people) can actually educate themselves!

 

[Ross]

I love my power trip!

 

[Bridgette]

LOL

Sorry for the rant in the previous message. Actually I am doing an essay on Health for an assignment and this subject has come up - power issues in the doctor/patient relationship.

 

[Cooker]

I was at 4.8 yesterday so held a dose today .... If I'm between 2 and 5 I'm a happy camper

 

[Ross]

I was at 4.8 yesterday so held a dose today .... If I'm between 2 and 5 I'm a happy camper

Yeah I know you are, but in all honesty, please don't go higher then 4 if you can help it. Not that something tragic is going to happen at 5, but there isn't any purpose served by being higher then 4.

 

[ALCapshaw2]

It's a power thing with SOME of these medical people - they don't like patients being proactive and taking control of their own health. It makes them redundant in the big picture.
Plus, they think that we're stupid and incapable of working things out for ourselves....SHOCK, HORROR....mere mortals (lay people) can actually educate themselves!

I enjoy 'talking shop' with the well educated and well trained Nurse Practicioneers at my Coumadin Clinic. They have NO problem 'negotiating' what dose to try if /when I am slightly out of range. (Typically that is a debate between changing by 1 or 2 mg/wk and they offer me my choice).

It was the Nurses who had NO CLUE how Coumadin works and seemed incapable of thinking for themselves who were ADAMANT that I follow THEIR Directions. I changed clinics in short order, going to one with a sharp CRNP.

Eventually the hospital combined those two clinics and put CRNP's in charge of patient dosing. They have a patient load of over 1500 patients, seeing around 150 per day.

Their standard policy for High INR Readings from their 'Fingerstick' machines is to require a Veinous Draw for verification if the fingerstick machine registered an INR above 4.5 (and they get the Lab result in less than 1 hour).

The CRNP's also typically do NOT recommend a Hold for an INR below 5.0 - same as AL Lodwick.

I wonder WHY the rest of the (out of date) Medical Community can't come around to the 'New and Improved' Standards of Care for Anti-Coagulation Management ???

'AL Capshaw'

 

[Bridgette]

Many medical people are really good about patients educating themselves and being partners in their health care - sounds like the nurses at your clinic fit that description, Al.

I've been pretty lucky - a local doctor told me about the Coaguchek and actively helped me to get one, another doctor at the local hospital talked about INR with me, showed me a site on the net similiar to Al Lodwick's, and was positive about self testing and self dosing....
BUT one nurse at my GP's clinic really annoyed me when she said, "It's all very well having your own testing machine but you will have to call in all your results so we can adjust your dosing because you won't know what to do"
I informed her that actually I did know what to do, thank you - she walked away in a huff......

 

[Ross]

I informed her that actually I did know what to do, thank you - she walked away in a huff......

You should be around for some of the arguements I get into with some of these people. They simply refuse to believe that a patient can manage their own therapy. For every stupid thing they say, I correct them and it really makes them mad.

 

[Taysgrama]

I just tested again after having problems last night getting enough blood for the darn thing and I am still high (4.5). I think because we were out of town last week and not eating like normal, that has something to do with it. Typically, restuarants don't serve alot of green veggies (unless its salad) and I never ordered a salad (I know.....bad girl), so I will have spinach with dinner tonight and either brussel sprouts or brocolli for dinner tomorrow and then I am also going to split a 2.5mg tablet in half for tonight and tomorrow and then go back to a full 2.5mg on Sunday. Does that sound about right? I do not want to skip two days...I think that is tooo risky for me. My luck, I would drop like a bomb! LOL Thanks all

 

[Bina]

For me.......one day of a half pill would be fine......and broccoli.....yes, yes.

 

[Ross]

I just tested again after having problems last night getting enough blood for the darn thing and I am still high (4.5). I think because we were out of town last week and not eating like normal, that has something to do with it. Typically, restuarants don't serve alot of green veggies (unless its salad) and I never ordered a salad (I know.....bad girl), so I will have spinach with dinner tonight and either brussel sprouts or brocolli for dinner tomorrow and then I am also going to split a 2.5mg tablet in half for tonight and tomorrow and then go back to a full 2.5mg on Sunday. Does that sound about right? I do not want to skip two days...I think that is tooo risky for me. My luck, I would drop like a bomb! LOL Thanks all

What is your total weekly dose now? I'm with Bina, half dose one night only. If your continually this high, cut back by 5% for the week and see if that isn't your sweet spot. Don't try to control INR with diet.

 

[Taysgrama]

My weekly dose is 17.5mg (2.5mg per day). So, what you are saying is that I should only do 1/2 a dose tonight and then back to my regular dose tomorrow, right? I have called my doc for a prescription of 2mg tablets so I can cut those easier to 1/2 a dose. Thanks again all........

 

[Ross]

Yes. I'm thinking you might drop to 16.5mg for a week and see what you get.

 

[Bina]

I'm usually taking 19 mg per week and was having too many readings lately of around 4.0
So, now I'm taking 18 mg this week. I'm good with small changes too.