inr level question

[tex4ever54]

Greetings All:

I was just wondering how long it some of you guys to get your INR in range post surgery? I am now 11 days post AVR surgery and am only up to 1.2. The first 7 days I took 5 mg warfarin, tested and was at 1. I was then switched to 10 mg for 2 nights then 6 mg for 1 night, tested and was at 1.2. I am now bumped up to 10 mg for the next 3 nights and will be tested again Monday. I am a little nervous being so low, but the nurse said that the adjustment period varies from person to person and that I am not out the ordinary. Thanks in advance for your input!!!

 

[Ross]

It can take a month or two. Alot depends on your other meds and your diet. Are you watching for hidden sources of Vitamin K? Also the more active you become, the more Warfarin you'll need to take to keep your INR up.

It sounds to me like they are messing up in your testing. It takes 3 days for a dose to show in the test. They need to put you on a weeks worth and then test instead of changing your dose every 3 days and testing again. They aren't giving it enough time to see what is really going on.

 

[Karlynn]

Chances are that your eating habits will change as well. Many have a hard time eating post-surgery for a while. You will most likely be changing INR's and dosages for quite a while. And if you're like me you'll never be all that stable. Hopefully you won't be like me tho.

 

[bvdr]

I would be nervous too if my INR took that long to get into range. Some people require much higher doses of warfarin than others. We have a member who takes more than 20mg a day. I just don't like the fact that you are quite vulnerable so early post op to clot. I would call and talk to my cardiologist and really voice your concerns. I know our member who takes 20mg a day had to have her new valve replaced very soon after her surgery and, if I am recalling correctly, I think she had a problem with clotting. I just think you are in a dangerous position. I'm not one to over-react but I hope that is what I'm doing here but please make that call.

 

[bvdr]

Please read the personal story of Christine Winkleman (the link are on the opening page of VR.com). Her story is located under the heading of AORTIC VALVE. Her newly implanted valve clotted off when her INR did not come into range in a timely manner. She was 1.4 and clotted requiring a second operation and a new valve. Are you on Lovenox?

 

[hayden]

I had OHS in August 2004 and my INR remains messed up......

 

[geebee]

We need to start a campaign to clue doctors in on the importance of the INR being in range. It seems they are either way too lax or way too focused on unimportant things.

Either they don't react when INR is too low or they spend their time trying to make us worry about what to eat.

Tex and Hayden - you both need to light fires under your doctors. You need to get your INRs up and quickly. Clotting is almost a given, it's just a matter of when and it is impossible to predict whether sooner or later.

If it sounds like I am trying to scare you - RIGHT. It is much better to get the INR up and bring back down if it gets too high than to slowly bring it up.

 

[ALCapshaw2]

Tex -

Was your INR under 2 when they released you from the hospital? If so, somebody needs a WAKE UP CALL.

They should have either kept you (on heparin drip) until your INR was >2 or sent you home on Lovenox injections until your INR comes up above 2.

At 1.1 or 1.2, you have virtually NO protection. CALL first thing Saturday Morning. Ask if you should be put on a Heparin drip or Lovenox Injections until your INR is in range.

'AL Capshaw'

 

[brendamarlene]

When I first came home my INR was over 8! I was given a dose of Vitamin K and then it took TWO weeks to get it over 2! I was very frightened during this time.

This has certainly been a struggle. I do not eat any salads or spinach or broccoli---all of which I miss. Finally got to 3.3 last week. Yea!

Then, today, back down to 2.3.

This is so frustrating.

 

[bvdr]

Greetings All:

I was just wondering how long it some of you guys to get your INR in range post surgery? I am now 11 days post AVR surgery and am only up to 1.2. The first 7 days I took 5 mg warfarin, tested and was at 1. I was then switched to 10 mg for 2 nights then 6 mg for 1 night, tested and was at 1.2. I am now bumped up to 10 mg for the next 3 nights and will be tested again Monday. I am a little nervous being so low, but the nurse said that the adjustment period varies from person to person and that I am not out the ordinary. Thanks in advance for your input!!!

I've been thinking about you and wondering how you are doing getting your INR in therapeutic range. If you can will you please update?

 

[Barry]

I find that my INR is more unstable when I take generic Warfarin than when I take brand-name Coumadin.

 

[LisaD0365]

I take the generic Warfarin...but was told if the pharmacy would order it thru the same company...wouldn't have any problems...the hosp nurses right after my OHS asked me if I was going to take brand or generic...I was given 10 mg every day for 5 days post-op then was put on 5 mg every day...was test every 5 days until I got therapeutic then I was on 5 mg for awhile but my INR likes to keep me on my toes....

 

[tex4ever54]

Inr Level

Inr Level

I've been thinking about you and wondering how you are doing getting your INR in therapeutic range. If you can will you please update?

Thanks for your thoughts!! I am going in today to have my inr tested. I have been on 15 mg Coumadin a day since my last test 3 days ago (I was at 1.5). Maybe I am one of those super-rats who has developed a resistance to Coumadin. As soon I get the new results I will post the results.

 

[Karlynn]

Thanks for your thoughts!! I am going in today to have my inr tested. I have been on 15 mg Coumadin a day since my last test 3 days ago (I was at 1.5). Maybe I am one of those super-rats who has developed a resistance to Coumadin. As soon I get the new results I will post the results.

Or your liver is a Ferrari!!! My bro-in-law teaches pharmacology at a medical school here in Chicago. He's confirmed our suspicions here that some of us having to take a lot of Coumadin to stay in range have really healthy livers!!!

 

[bvdr]

I'll be watching for those results. Don't panic if you are too high. It is better to be high than low and being high won't make you bleed but will just make you bleed longer if you injure yourself than you otherwise would. I would much rather be at a 6.0 and slowly adjusting downward than a 1.5 and adjusting upwards.

 

[tex4ever54]

New Inr Level

New Inr Level

I'll be watching for those results. Don't panic if you are too high. It is better to be high than low and being high won't make you bleed but will just make you bleed longer if you injure yourself than you otherwise would. I would much rather be at a 6.0 and slowly adjusting downward than a 1.5 and adjusting upwards.

Just got back from having my inr tested and found I had jumped from 1.5 to 2.5 in 3 days . I am now at least at the low end of the range. The doctor said there was a possibility that I respond better to brand name Coumadin than to generic warfarin (the first 10 days I was on warfarin and the past 3 Coumadin). They went on to say that, in general, they felt that staying regulated was easier on Coumadin than the generic brands. I will now go from 15mg a day to 12mg a day and retest this coming Monday. Thanks All!!!!

 

[Barry]

...They went on to say that, in general, they felt that staying regulated was easier on Coumadin than the generic brands...

My INR tends to be more stable on Coumadin than on generic Warfarin.

 

[bvdr]

Well, I sure am glad you are into range!

Some people say that their INRs are more stable on coumadin and some doctors agree but I think all the studies show there is no difference but the price.

I am wondering why they lowered your warfarin dose when you had just reached the bottom end of your range. I think you are already getting the idea that the medical profession on a whole does not do the best job with warfarin management.

Thanks for getting back to us with your INR results. It is very important to keep your level up.

 

[Guest]

What is it with Midland, Texas??? One person doesn't get warfarin. The other one's doctor doesn't get it.

I think you have someone with a minimal understanding of warfarin who got most of their information from the marketing department of DuPont when they owned Coumadin and then closed their mind many years ago.

DuPont lost a huge multimillion dollar lawsuit for having their sales reps say that Coumadin was made to better standards than Barr's warfarin when the truth was jsut the opposite. People that manage warfarin should know that there is no difference. When they tell you that you react differently to one or another they are showing their own lack of knowledge on the subject.

 

[perkicar]

What is it with Midland, Texas??? One person doesn't get warfarin. The other one's doctor doesn't get it.

I think you have someone with a minimal understanding of warfarin who got most of their information from the marketing department of DuPont when they owned Coumadin and then closed their mind many years ago.

DuPont lost a huge multimillion dollar lawsuit for having their sales reps say that Coumadin was made to better standards than Barr's warfarin when the truth was jsut the opposite. People that manage warfarin should know that there is no difference. When they tell you that you react differently to one or another they are showing their own lack of knowledge on the subject.

Aren't they the same thing chemically? Or am I oversimplifying this?