Haha, I'm new here to posting but I already felt like I knew everyone that replied in this thread, I've read many posts where you helped others. When I posted I was hoping I would see some familiar faces (and smiling finger) come to my rescue
I learned about Amiodarone from Chuck C.'s story in another thread and now I know even more about it. My husband will probably be sick of me spouting off all my new found knowledge but I don't give a rat's behind Your husband is lucky to have you. Doing all this research during a traumatic time is a lot to take in, and I think you are doing great. Sadly it doesn't seem unusual for people with mechanical valves to become more knowledgeable than some staff at anticoagulation clinics. I have a therapeutic range of 2.5 to 3.5 for my St Jude valve, and my surgeon felt so strongly about a low INR that he wrote in my anticoagulation booklet "If INR <2 give Heparin injections". When my INR did indeed drop below 2 a couple of months after surgery, my clinic refused to do this. So I went to the hospital and was able to see my surgeon when he came out of theatre, and he wrote a prescription for Heparin injections on the spot.Haha, I'm new here to posting but I already felt like I knew everyone that replied in this thread, I've read many posts where you helped others. When I posted I was hoping I would see some familiar faces (and smiling finger) come to my rescue
I'm actually running low on them myself, should put in another order.
So many stories about the clinics and their dosing practices. I'm glad your Dr was on top of things! I have to wonder why clinic staff make some of the decisions they do.
Very true. The Drs and staff we have talked to and dealt with through his whole surgery and recovery have been nothing but kind and helpful for the most part. I just think it was miscommunication, timing due to the weekend, backlog, low staffing, and/or all of the above with the clinic and phone tag issues. I'm not even sure what the clinic's reasoning would have been to half his dose the first day out of hospital but it's done and moving forward. You always want things to go smoothly for you with any medical procedure and when it doesn't it can feel like the end of the world.
These two statements should be in a banner headline on this site! (suitably corrected for typos!)
Need to talk to his Cardio and see what it might be. It is not unusual for a drop since he has been home. And the Warfarin Clinic. They will have instructions for him soon and should have done so at the clinic that day. Could be his meds, or if he is walking at home. It takes time for the body to adjust and they may to increase his dosage. Retesting is good, but they will spread it out longer soon. Good luck that they get this figured out soon.Hello all, I've been reading your forum for months and learning so much from all of you, so first thank you for sharing your stories and information.
I joined here because my husband had a bicuspid valve with severe aortic stenosis replaced the last week of February with an On-X mechanical valve. He left the hospital after 5 days, they had to wait until his INR was in range and it was 2.4 the day he left. The Coumadin clinic immediately called him that night and told him to take 1/2 tablet (1.25 mg) of Warfarin and have his blood tested the next day. He did that at the lab and it was 1.8. They told him to retest in 2 days, he did and it was 1.3. That was over this past weekend so calls to them were not answered, he called his surgeon's after hours service and they said to start taking the full 2.5 mg tablets again and re-test on Monday, today. Today's results were 1.0.
He's never had to take meds before in his life, he's 50 years old, active, and in good health other than the valve he had. He was sent home from the hospital with Amiodarone 200mg for 30 days, Aspirin 81 mg, Colchicine for 10 days, Metoprolol 25mg twice a day, Pantoprazole 40mg for 30 days and Warfarin 2.5mg.
Needless to say I'm freaking out about this low INR that has only dropped since his release on 3/1, almost a week ago. It's like he's not taking a darn thing to thin his blood!?! He has calls in now to his surgeon's office, cardiologist and Coumadin Clinic and waiting on their instructions. He hasn't eaten any leafy greens or any Vitamin K foods or drinks that we know of that would affect it.
I guess I'm looking for possible reasons as to why his INR is just dropping. From what I researched, Amiodarone should be making the INR even higher, as well as the aspirin he's taking. Any guesses or things we may not be thinking about? Is there something he can do to up the INR on his own since the people on the phones don't seem too concerned, which is maddening. I know we are new to all this and maybe I'm over-reacting by freaking out, so any advice? Thanks for letting me rant, wish it didn't have to be in my first post here
It's also a good idea to keep a few extra shots on-hand (being mindful of the expiration date) or at least a standing prescription/refill order at the local pharmacy in the event your husband quickly needs them again.
Note if you are in the U.S. and plan on going through your husbands health insurance for a home meter, you may find a delay/waiting period (60-90 days?) but you can purchase some machines and equipment on your own (e.g. on e-bay) immediately. This forum has plenty of info to help you out with this (use Seach button or post your questions). My wife uses the Coagucheck XS and it works for her.
Like you, I'm on this forum to help out my spouse and she (my wife) is certainly sick of me telling her stuff I find. She just wants to know what her dose is and tests weekly, nothing else. It's all good!
interestingly I recall that the Mayo did it exactly in hospital before release - with excellent results.
