INR/ not again!!

[NascarfanMary]

I am in tears. My INR is at 6.0 I have no idea what is going on!! Nothing has changed in my eating, medications. They only thing that is going on is Justin has been ill, and we had a death in the family.

I am exhausted. Have a dr. appointment on tues (2/14). I haven't felt good for about 3 weeks. My arms and legs are so weak and I am very tired. I take Lipitor (have been for months), that is one of the side effects. The Dr. syas we will get it under control. I don't really know.

I am so tired of being poked at, today it took 3 tries to get blood out. My poor veins are absolutely worn out. My dosage is 6mg so I have to hold it for 2 days then recheck on Fri.

I am just about to give it all up, but I know I have to take coumadin because of the mechanical valve. But when will I get in range?? I know there are others here that are having the same problem.

Thanks for letting me vent!!!

 

[Ross]

As with everyone else that cannot get stable. We need more information. How often are you tested? What is your current weekly dose? Other meds besides Lipitor? How is your excerise routine? Diet? The more info you can post, the better we'll be able to see what's wrong, though I have an idea already.

This is not meant to sound snotty if that's the way it comes across. Please forgive if so.

 

[NascarfanMary]

Here are my meds:
Lanoxin, Lasix, Dilantin, Lipitor, Imdur, Enalapril, Advair, Spriva, Warfarin, Neurontin(neuropathy), Nitro stat, Duo-neb nebulizer, K-dur, and Albuterol

I can't exercise very much get short of breath, and chest pains. (walking isn't too bad) I watch vitamin K, the green stuff, haven't had a salad in weeks. My dosage now has been 6mg for almost two weeks.

I have had to do some extra nebulizer treaments this past week, due to more shortness of breath. The only thing I have eaten different was some tuna fish salad.

I go weekly to have labs done. This week I was a few days late, due to the weather. I just don't know or understand. I must be doing something wrong.

 

[Karlynn]

With an INR of 6 the last thing you need to do is watch "the green stuff".

If you love spinach salad - treat yourself to one today.

Don't forget Mary that our mantra is "Dose the diet, don't diet the dose." In other words, eat what you normally would and let your medication be adjusted to your diet.

I've found that the more I try to control my coumadin by monitoring everything, the wackier it gets. The simplest advice I can give is to live life as you want (if it's healthy! ) and let your coumadin be adjusted to your life.

You may have other issues, but I just want to "free you up" to live a normal life with Coumadin.

 

[Ross]

So 6mg x 7 = 42mg for the week. How often are they changing doses and how often are they testing in between dose changes? Some of those meds will cause INR to rise, while some lower it, so your going to be difficult to manage anyhow. Why are you not eating your veggies? Your body needs them and you should dose the normal diet you eat, not diet the dose of Coumadin your on.

 

[NascarfanMary]

I eat all my vegetables. Daily, I am a piggy. When they change my dose I then recheck in several days. This week was longer due to the wind chill and not being able to get out.

3 weeks ago I was on Lovenox shots due to colonoscopy. Last night the Dr. said that could be it. Tommorrow I get rechecked. Everytime I hold the dose, it gets too low. That makes it confusing . I eat at least 3 meals a day. Sometimes if I don't feel well, I will at least eat a banana maybe some soup for lunch.

I know alot of my meds are working against me, along with my health problems. So I just have to wait and see what the results will be. This bouncing around it nerve wrecking. I always write the results down and when to recheck. I do abide by Dr. orders.

 

[lance]

How about holding 1/2 dose

How about holding 1/2 dose

Mary you said holding a full dose causes too much of a drop in INR.

I'd try holding 1/2 dose for 1 day.

 

[geebee]

Since Lovenox does not show up in the INR, I am not sure why your doctor would say that might be the issue. If he believes that, I am worried about his ability to manage your coumadin dose. Or did I misunderstand?

You should try to find a coumadin clinic that uses fingerstick testing. It is so much easier and one can always get blood from the finger. Much less painful and saves the veins for other things.

I am sorry you are having so much trouble; it doesn't need to be that way.

 

[NascarfanMary]

Lance, I agree with holding only 1/2 the dose. That is what I did last night. My husband agrees with both of us. I have been told to hold the dose before and took 1/2 and did get some better results.

Gina, I have been researching about home testing and I wrote to our Al to get some advice. I have information coming to take to the office with me on Tues. I think testing at home would benefit me alot. Each time I have my labs done it takes 2-3 times tries to get blood. I have no veins in my arms left. Sometimes the have to use the wrist and it is very painful. But I don't fight with them cause it is important to get the INR done. I feel that my Dr. knows what he is doing and I trust him.

We will see what the results are tommorrow. I can't stop taking all my meds. They are what has kept me alive these past few years. Plus I have to take care of my mechanical valve and my heart even tho it is not in the best of health.

 

[Ross]

I'm sort of reading between the lines, but what I'm thinking here is that it was a bad test result and not true. Lovenox cannot be measured in an INR test, so that is not a factor and I too call into question whether this person knows what they are doing.

 

[ALCapshaw2]

SNIP

Gina, I have been researching about home testing and I wrote to our Al to get some advice. I have information coming to take to the office with me on Tues. I think testing at home would benefit me alot. Each time I have my labs done it takes 2-3 times tries to get blood. I have no veins in my arms left. Sometimes the have to use the wrist and it is very painful. But I don't fight with them cause it is important to get the INR done. I feel that my Dr. knows what he is doing and I trust him.
SNIP

Mary,

There is another alternative that may be less painful and more productive, namely the veins in the back of your HANDS. Contrary to popular opinion, I find that LESS painful than overworked arm / elbow veins, especially if you ask for a SMALL Needle or Butterfly Needle. It may take a little longer to fill the tube, but I find those small needles to be almost pain free.

'AL Capshaw'

 

[NascarfanMary]

The veins in my hands are getting wore out, and also my wrists. They do use the butterfly needles, sometimes you can hear the veins blow right away. That is why I have thought about home testing. I'm sure it will benefit me in some way, ( can't hurt me any more than it already does)

I bled for about 8 hrs yesterday about the lab was drawn. I'm glad that they put that elastic wrap around my arm afterwards. Boy have I been extremely tired for days. Almost went to ER but I always get a hassle about my dosage and they tell me that I don't know anything about coumadin.

Yes, I am not the smartest person, but I understand how this works and how my INR will fuctuate. I know others here, alternate one day, then another day, different doses. Is it working for some of you? My Dr. has never done that to me, even tho the ER had sugested that, route, a while back.

The only place to have my INR checked here is our local Hospital, some of have mentioned Coumadin Clinics. The next nearest hospital, is 25 miles from here. I have thought about going there but I am not in good health to drive.

 

[NascarfanMary]

I took the advice Lance gave me by taking half the dose instead of holding it for 2 days. My Inr came back at 3.7, better than 6.0. I am going to recheck on Monday. I bled a long time yesterday. Just kept seeping thru the bandage slowly.

To the others here, that do home testing, do you adjust your dosage, or do you call your INR in to your doctor, and he adjusts it for you? I hope that I will be able to get home testing for myself. I am going to work hard at asking my Dr. on Tuesday.

 

[Ross]

To the others here, that do home testing, do you adjust your dosage, or do you call your INR in to your doctor, and he adjusts it for you? I hope that I will be able to get home testing for myself. I am going to work hard at asking my Dr. on Tuesday.

We have both, self dosing and people who call it in. It just depends on how your Doctor feels about you managing your own therapy. I self dose and only call in if I'm extremely out of range. I then tell him what I'm going to do about it and will call with the new result when I've completed my mission.

 

[Karlynn]

My cardio is fine with me adjusting my own dose. I've been on the drug a long time and know how my body reacts to changes in it. We've had people here who have educated themselves using the information that Al Lodwick provides www.warfarinfo.com and have just taken it upon themselves to adjust their own dose because they felt their management didn't have correct knowledge.

If people who are diabetic can learn to manage their own insulin dosing (done 2 times a day) then most warfarin users should be able to learn to manage their own warfarin. It's getting the doctors on board that's the hardest part.

Both my cardio and my primary care physician are totally cool with me doing my own.

 

[geebee]

I do my own dosing but I do visit the lab every 6 months just to ease my cardio's mind. I think that will probably stop soon since he seems to be fine with what I am doing.