INR~How in the WORLD??

[ticktock]

Hi all... Realized I just kinda jumped back in here, and started posting, sometimes in the wrong place. Sorry Granbonny, for interrupting your dental question with a Coumadin question.

My question of the day is THIS ~ I mentioned yesterday that I had a 7.2 INR (home test).. and that it didn't bother me as much as a low INR. No bleeding, and had no problems. I tested yesterday at noon (that would be Wednesday).

I ate broccoli, carrots for lunch and for dinner had avocado with my pasta. LOTS of Vit K, I admit.... but I would not think sufficient enough to drop my INR from 7.2 yesterday noon, to 2.2 today at 9pm. I KNOW< I broke rules by testing at odd hours, but how much effect does this have?? What in the WORLD is going on with my INR?????????????????

Has anyone ever seen this big of a jump, by holding ONE dose of 4mg..... and a drop in the INR of 5. within 33 hours???? My INR is getting so totally out of control, after so many years of predictable results. Anyone have an opinion?? An idea?? HELP!!!

 

[ALCapshaw2]

Makes me wonder if your first (high) reading was correct.

'AL'

 

[Nancy]

Any new medications?

 

[ticktock]

Nancy and Al,
Thanks for thoughts..... no new meds... And I too was suspicious of the first reading. Now I'm wondering if I should be suspicious of the second!! ACK!! Guess I will go back to usual dosing now... and hope I don't crater from all that Vit. K. I just don't understand the instability of it... suppose no one does. A bit frustrated.

Nancy, I don't know if you remember me or not.... I was a joiner back in about 99... or 00?? I remember watching Joe's progress through various trials, and I recall well your positive attitude and supportive nature. Good to see you here!

 

[Gisele]

Mindy

Mindy

Please watch your INR closely. What you describe was the world I used to live in. I was on Coumadin for over 21 years, most of which wasn't too bad. A few years back my INR got more and more erratic. By the time I was taken off my dosing had increased to 7/8 from 5mg daily. If I forgot one dose I could drop in 24 hours by 2 points.

I was careful of what I ate, I exercised, I thought I was doing everything right. My first bleed in my head was from in INR that was in the 7's. Please be very careful. I used to say a high INR was better than a low one, but after 3 subdurals and one stroke, I think an INR in range is better than anything!

Please be careful...............good luck.

 

[Nancy]

Sure I remember you Mindy--You have a very "unique" heart--sort of half man-made and half natural Aren't too many folks walking around with 5 valves!

You're a remarkable gal and overall you are doing great. I'm sure your INR will get in good control again. Maybe testing more frequently and keep a journal of what is going on each day and what you are eating, what kind of activities, etc. you'll find a trend which will help you solve the mystery.

With Joe, who has so many serious problems, he's got to stay in very, very tight control in every way, with his INR, with his fluid retention, with his labs. He's so tightly controlled that we are pretty much able to pinpoint where the problem is before it gets away from him, I hope. It is exhausting to constantly monitor everything, but it beats having him spend weeks and months in the hospital.

Wishing you the best.

 

[tommy]

Mindy,

When I get a big INR bounce, I take a second reading right away to check the first. One time I went so far as to go to my cardio's coumadin clinic to verify. It cost me a few bucks, but I was relieved to know for sure.

If you "self medicate" temporarily with a dose of veggies, then take another INR reading so you don't over-react, and so you can be reasonbly sure why the INR changed. Guess work can get us into trouble.

Good luck.

 

[JimChicago]

I was just wondering which home testing unit you are using?There was some talk of a recall of some testing strips for one of the units.

 

[ticktock]

INR worries

INR worries

Jim and all.....
Thanks for the comments... am sorting them all out. Giesele's comments are kinda scary, because thats what I am anticipating. The machine I have is a CoaguCheck, bought in 1999. There was a huge recall of test strips, and mine were in there. Got a free box to replace.
I sometimes think I test "too" much, if that is possible. At least once every week to 10 days when I'm stable.... Now, I don't know whether to test again today or not. Anyone have advice in that regard?? Guess you could chase that bouncing ball to the point of insanity

 

[JimChicago]

Here was an excerpt on Al Lodwick's website:

>>>
How much vitamin K do you give when it is needed? I have seen an INR of 9 reduced to less than 2 within 24 hours of giving 2 mg of vitamin K IV.
>>>>
If the salads you ate had that much vitamin k - but how could someone eat 2,000 mcg of vitamin k in a salad?
Had you run the high and low controls recently on your Coaguchek?

 

[Georgia]

Hey, Mindy - hope by now you're inr has stabilized.

Rain's dog's probably digging in the garden again. Blame it all on Rain - she has broad shoulders

I have better luck with cutting dosage in half for two days than holding a whole dose. Then rechecking (after rechecking after the first anomolous reading). I'd rather do what you do - eat some greens - than start getting the coumadin levels flying around.

Good luck - this stuff can be a pain in the neck, huh?

 

[Zipper]

Hi Tick...

Hi Tick...

Haven't seen you in a long time Mindy, so I just wanted to say Hi. Did you see the post about Legend from our old stomping grounds (WebMD) ? So sad!!!

Tick..I home test once a week and have been fortunate to stay mostly in range. If I ge a little high, I do eat more greens and if low forego the veggies abit.

My insurance would not pay for my ProTime and/or supplies...so I take that reason to go up to my lab about once a month and am reassured my unit is still giving proper readings. My insurace pays the lab costs.

I hope you've gotten stable by now!!!

Take care...Zipper

 

[EVELYN]

Hi All


DAMN THAT RAIN'S DOG!!! Tyce tested today and was 4.5....last week 2.5. Oh well, we went out and had Caesar Salads for lunch, lowered the coumadin by 10% and will retest again next week......he's been just about 2.3 to 2.5, and we both like him to be about 3.2.....so we upped his coumadin from 37.5 to 40 and look what the heck happened!!! oh well, back to lower doses.

GET THAT DOG OUT OF THE GARDEN, PLEASE MISS RAIN!!!

EV

 

[Guest]

The INR can drop very fast if you take a large amount of warfarin (more than 7.5 mg) per day. The reason that someone would take so much would be because they metabolize it very fast.

If you swab your finger iwth alcohol (Or even water) you can cause a falsely elevated INR if you did not dry it completely.

As I understand it, the recalled strips could give falsely elevated readings. But you probably did not have any of those.

I think your best bet is to test again soon.

 

[Lisa in Katy]

I never hold! I will cut my dose in half, but never never never do I skip the dose. That is because whenever I skip a dose, my INR bottoms out - 6.9 to 1.8 overnight one time! So, I personally think the combination of skipped dose and high Vitamin K could easily make your INR drop like that.

 

[ticktock]

News!!!

News!!!

Hi all!
I had some exciting/disturbing news today concerning a home testing device. I noticed particularly Zippers note, about her insurance not paying for a home testing device or supplies. WELL, I just found out today by chance, that BCBS (as of 2 weeks ago) WILL cover and pay for supplies (mine at 80%)... and that QAS will "supply" the machine.... without an outright purchase.

The insurance companies are getting on the band wagon now that Medicare is covering these costs.... !!! Zipper, please check again, if you haven't recently talked with them. Coagucheck requires that you do all your own insurance paperwork and pay for it yourself... then hope for reimbursement. QAS on the other hand took care of it for me..... THEN I found out that I could "avoid" paying the nearly $500. that my insurance didn't cover, by going on an alternative plan. They said this was because my paperwork was "processed" under policies in effect more than 2 weeks ago. In other words... (blah blah blah), call again!! Call QAS they seem to know exactly who will and who will not pay.

 

[Guest]

No only means no for that person on that phone call. The rules are so complex that they can be distorted however the person on the phone wants (in many cases).

 

[LDS4EVER]

INR LEVELS

INR LEVELS

Hi,this is chris today my Drs. office called said my INR level was at 1.3 last mth it was 1.6 he said to increase dosages to 6-6-3 and repeat then in 10 days check INR protime, well I have found a dr I cant get into my new dr any sooner than the 19th ......this dr of mine said low is better than high but I know this low is dangerously low cause for concern for bleeds and or strokes ....would it be ok to drink some v-8 juice,how much should i drink .I am a time bomb .... oh i was taking 3skip two days then 3rd day another 3

 

[azpam]

V8 juice will DECREASE an Inr!! That is what you want to drink if the Inr is high not low! so stay away from v8,greens,etc until the Inr is higher.

 

[Rain]

My apologies for my out of control dog.

My apologies for my out of control dog.

Hi Mindy,

I?m a little late reading this thread... sure hope you?re INR is back on track. Even with my only taking 3 ½ mgs a day, I would have to have a really, really high reading to totally skip a dose. And it?s not just meds that drastically effect my INR readings. I?ve only been swallowing that rotten rat killer for four years... but that?s long enough for me to have figured out that a LOT of things (including my dog sleeping in the flower bed!) has a huge impact on my readings.

I'm fighting with my insurance company about paying for supplies right now. I cannot convince them it is not durable medical equipment!! Grrrrrr!!!!! I wish QAS could bill it as lab work instead of durable medical equipment.

Hope you are getting good readings. I feel your pain!!