INR Crashing Now!!! Yes!!!

[jgibson]

---


Thanks everybody for your recommendations and ideas on what to do when my INR went though the roof.

I didn't take my dosage last night. Decided to go in today for an extra visit and check to see just what my level was again.

Just got the call back from the Cardiac floor. It's 4.6 now!!!

So in one day, it goes from 7.3 to 4.6. UNBELIEVABLE!!!

Well, maybe not unbelievable, but I had a feeling it would drop like that after one day.

The funny thing was, I kind of argued with the nurse on the phone this morning, that I felt my INR would crash back down to 1.0 if I stayed off it for 3 days. She said she didn't think it would drop that fast. She felt it might only drop 1 point from yesterday to today. She also felt that it might be a waste of time for me to get another reading, however, I pressed her on it and even told her I was concerned there may have been a mistake at the lab. Anything so I could go in again.

So now I'm back on the juice (as everybody seems to call it here).

I'm supposed to take 2.5 mg tonight, 2.5 mg Saturday night, and 5.0 (normal dose), on Sunday. This is per my surgeon.

Thanks again everyone for their feedback. I'm just a little happy that my INR isn't quite so high now. Maybe I can shave tomorrow!

Take Care Everyone.

 

[ALCapshaw2]

It sounds like that Nurse has NOT dealt with many Coumadin patients !

I *think* I remember someone (AL Lodwick?) saying that a 1 day hold should drop the INR in HALF (so that Nurse's idea that it would only come down 1 point is WAY OFF BASE - I hope you will "Clue Her In"!)

I would 'almost' GUARANTEE a 3 Day Hold would take you back to "Ground ZERO". Anyone who suggests a 3 day hold is an IDIOT (IMHO) (i.e. doesn't know much about how Coumadin behaves).

'AL Capshaw'

 

[Bina]

Jeff, congratulations on making some great decisions and progress.
(along with our expert coag team of Ross, Karlynn, Gina, Al, etc.etc.)

 

[Karlynn]

And it will still drop since the full effect of your skipped dose hasn't been realized yet. I'm with Al, the nurse's comments just demonstrated her lack of knowledge.

Don't worry - you aren't crashing. You would have been had you followed their instructions.

Just an FYI - the more Coumadin you take, the more quickly your INR drops with a hold. I take 10/day and my INR would drop very fast compared to someone who takes 5/day. This is why warfarin managers can't use the exact same protocol for every patient.

 

[Ross]

Which is why I said if it were me, I'd hold 2 doses, then start back in again 20% less of a dose over the week. A two day hold for 7.5 should put you in range if not, slightly under.