Lisa, I talked to Carley again today and she said the reason they stopped using the Coaguchek was because she is the only one trained to use it. She was out on maternity leave and when she returned they were short staffed so they did not resume finger sticking but should soon. She also said that while Dr. B raised the level to 3.0-4.0 on his valvers, Dr. J still has his at 2.5 to 3.5. Weird. I will see Dr.J in a few weeks and will inquire. I also checked the Internet today and found many articles supporting the 2.5 to 3.5 range and many more that support the 3.0 to 4.0 range. I agree that I would rather be a bit on the higher end.
INR range with mechanical valve
- Thread starter DickV
- Start date
Help Support Valve Replacement Forums:
G
Guest
Only one trained to use a CoaguChek is a pretty lame excuse. I've trained dozens of people. It can be done in 10-15 minutes. I'd be suspicious that they don't get paid as much as for a venous draw. It may not be for your insurance but I'm sure that it is the way Mediacare pays. In other words they are out to get the money and not concerned about the patient's ease and comfort.
My Cardiologist said 2.5-3-5..Mine is always..2.7-3.0..Never higher..Coming up 2 years in March on coumadin. Never any problem..Take 5 mg. a day.. Test at home every 3 weeks. Clinical Nurse calls back and says..keep on doing what you are doing
Really missing my cabbage..cause St. Pat's Day is coming and I want cornbeef and CABBAGE.. Wonder if it would hurt my INR if I eat cabbage on St. Pat's Day? and I would have to have my homemade cornbread to go with it. Bonnie
Really missing my cabbage..cause St. Pat's Day is coming and I want cornbeef and CABBAGE.. Wonder if it would hurt my INR if I eat cabbage on St. Pat's Day? and I would have to have my homemade cornbread to go with it. Bonnie
G
Guest
Are you so close to the edge that missing one dose of warfarin would kill you?
If not, then go ahead and eat a serving of corned beef and cabbage.
The cabbage can't possible have an effect greater than a missed dose.
If not, then go ahead and eat a serving of corned beef and cabbage.
The cabbage can't possible have an effect greater than a missed dose.
Ross
Well-known member
Bon I thought we taught you better then that. Eat what you like ya darn mountain goat.
B
Birky
INR ranges
INR ranges
Now I am wondering why my Dr. 's range is between 2 and 3. Seems on the low side compared to the rest of you. Have to check into this. I would rather be a little thin than not enough.
I guess I will ask. Have a protime next week. Thanks, I take 5 mg. everyday but Mon and Thurs which I take 2 1/2.
INR ranges
Now I am wondering why my Dr. 's range is between 2 and 3. Seems on the low side compared to the rest of you. Have to check into this. I would rather be a little thin than not enough.
I guess I will ask. Have a protime next week. Thanks, I take 5 mg. everyday but Mon and Thurs which I take 2 1/2.
I sometimes wonder why my surgeon and cardio from Cleveland told me to keep my INR between 2.0 and 3.0. They stressed over and over again that I needed to find a doctor (cardio) that would keep my inr within that range. If they wanted to keep it higher, I was to find another doctor who would listen to the docs at Cleveland. I haven't had any problem with my new cardio since having the surgery, but I just remember how adamant they were about the inr level. I don't know if it had anything to do with the type of valve I received and in the position it is in or what. Most people on this site keep their inr level higher than mine. I was too new to this whole thing to question my surgeon/cardio at the time. My new cardio at UVA seems content with keeping my inr at the 2 to 3 level. If I ever get just slightly over 3.0, they readjust my meds to keep me between 2 and 3.
Take Care Everyone!
Gail
Take Care Everyone!
Gail
G
Gemma
Hi,
My boyfriend Jim saw his surgeon's registrar for his 8-week post-op check-up today and was told his INR range should be 2-3. It was 2.6 last Monday and they have increased the dosage a tiny bit (2mg over the whole week) so seems like they're aiming for nearer 3. Will know more tomorrow when we see the cardiologist, he seems to favour a bit higher INR but the guy today was adamant that it should be between 2 and 3 forever!
(Jim has a 27mm valve which may explain slightly lower INR,as TSH mentioned).
Gemma.
My boyfriend Jim saw his surgeon's registrar for his 8-week post-op check-up today and was told his INR range should be 2-3. It was 2.6 last Monday and they have increased the dosage a tiny bit (2mg over the whole week) so seems like they're aiming for nearer 3. Will know more tomorrow when we see the cardiologist, he seems to favour a bit higher INR but the guy today was adamant that it should be between 2 and 3 forever!
(Jim has a 27mm valve which may explain slightly lower INR,as TSH mentioned).
Gemma.
G
Guest
If it is a bileaflet, aortic valve, the INR can be 2 - 3.
However, I think that there is more danger from a low INR than there is from any number that is under 5.0. So I try to keep patients from getting to low.
I think that it is preferable to treat a nosebleed than a ruined valve or a stroke.
However, I think that there is more danger from a low INR than there is from any number that is under 5.0. So I try to keep patients from getting to low.
I think that it is preferable to treat a nosebleed than a ruined valve or a stroke.
Well after weeks of battling I finally got my INR back up to 2.5.
My cardiologist says he prefers a range of 2.0 to 3.0.
I have questioned this many times over these years but he just shrugs his shoulders.
Hopefully he is right.
He is a good doctor, he is now chief of cardiology for two sister hospitals which are rated as the best heart hospitals in the state of Michigan. And he is also president of the doctors medical association.
I will still get after him at my next yearly check-up late this spring.
My cardiologist says he prefers a range of 2.0 to 3.0.
I have questioned this many times over these years but he just shrugs his shoulders.
Hopefully he is right.
He is a good doctor, he is now chief of cardiology for two sister hospitals which are rated as the best heart hospitals in the state of Michigan. And he is also president of the doctors medical association.
I will still get after him at my next yearly check-up late this spring.
G
Guest
Rich, your doc is an Arnold Schwarzenegger type of guy. "If it bleeds ve can kill it." Therefore, keep the INR low and don't cause bleeding.
These guys are opposed to the Jesse Ventura type. "I ain't got time to bleed." Bleeding is easy to treat (most of the time) so don't cause a clot.
These guys are opposed to the Jesse Ventura type. "I ain't got time to bleed." Bleeding is easy to treat (most of the time) so don't cause a clot.
Thanks Al,
I think you are right and like I said he will get bombarded with some questions soon.
For those several months when my INR was running about 1.8 it really concerned me but not him.
His tech who calls me after each test said 1.8 or 1.9 wasn't so bad.
I told her to tell him I could live with a little bleeding but if I had a stroke it could easily end my life even if I lived through it.
I have upped my dosage by 25% and now seem to be in range(at least according to him).
I have also slowed down my activity level in an effort to stay in range.
Normally for seven years I was at 2.5 to 3.0 every month with no problem and only went above that when I was on anti-biotics.
Slowing down is tough for me, it's just not who I am.
I figure at my age I'll be forced to slow down soon enough so as long as I'm able I will keep doing what I enjoy.
It keeps me both physically and mentally active.
I think you are right and like I said he will get bombarded with some questions soon.
For those several months when my INR was running about 1.8 it really concerned me but not him.
His tech who calls me after each test said 1.8 or 1.9 wasn't so bad.
I told her to tell him I could live with a little bleeding but if I had a stroke it could easily end my life even if I lived through it.
I have upped my dosage by 25% and now seem to be in range(at least according to him).
I have also slowed down my activity level in an effort to stay in range.
Normally for seven years I was at 2.5 to 3.0 every month with no problem and only went above that when I was on anti-biotics.
Slowing down is tough for me, it's just not who I am.
I figure at my age I'll be forced to slow down soon enough so as long as I'm able I will keep doing what I enjoy.
It keeps me both physically and mentally active.
T
The Bionic Duo
Al I love this:
"Rich, your doc is an Arnold Schwarzenegger type of guy. "If it bleeds ve can kill it." Therefore, keep the INR low and don't cause bleeding.
These guys are opposed to the Jesse Ventura type. "I ain't got time to bleed." Bleeding is easy to treat (most of the time) so don't cause a clot."
My Orthopedice surgeon put me on Coumadin after my knee surgrery, but wanted my INR at 1.5 (PT at 15)-- he absolutely panicked when it shot up to 1.7 after taking Coumadin for two days! When I questioned him about this he told me he didn't want any bleeding. Well for three weeks I stuggled to keep my INR around 1.5 totally without success, when he uped my dosage to more that 2.0 per day I got it up to 1.43 the week I went of the medication--go figure
Bob's cardio for the longest time seemed happy when Bob was near 2.5 and would change his doseage all over the place every time he went above 3.0. Keeping his IRR at 2.5 is nearly impossible for Bob, he only takes 2.5 per day which doesn't leave much room for adjustment. He has even missed a couple of days (once he just missed his dose twice, and once for a colonoscy) and he still was in range! I guess he finally got tired of all those adjustment becasue the last few reading have all been above 3.0, but he hasn't changed his doseage.
Guess our doctors are of the "Arnold" school.
He He
Joan
"Rich, your doc is an Arnold Schwarzenegger type of guy. "If it bleeds ve can kill it." Therefore, keep the INR low and don't cause bleeding.
These guys are opposed to the Jesse Ventura type. "I ain't got time to bleed." Bleeding is easy to treat (most of the time) so don't cause a clot."
My Orthopedice surgeon put me on Coumadin after my knee surgrery, but wanted my INR at 1.5 (PT at 15)-- he absolutely panicked when it shot up to 1.7 after taking Coumadin for two days! When I questioned him about this he told me he didn't want any bleeding. Well for three weeks I stuggled to keep my INR around 1.5 totally without success, when he uped my dosage to more that 2.0 per day I got it up to 1.43 the week I went of the medication--go figure
Bob's cardio for the longest time seemed happy when Bob was near 2.5 and would change his doseage all over the place every time he went above 3.0. Keeping his IRR at 2.5 is nearly impossible for Bob, he only takes 2.5 per day which doesn't leave much room for adjustment. He has even missed a couple of days (once he just missed his dose twice, and once for a colonoscy) and he still was in range! I guess he finally got tired of all those adjustment becasue the last few reading have all been above 3.0, but he hasn't changed his doseage.
Guess our doctors are of the "Arnold" school.
He He
Joan
G
Guest
Some people seem to think that the target is painted on the wall. Keeping the INR right at 2.5 is about as easy as keeping your car's gas tank at exactly half full.
I think that the only to keep the INR exactly on target is to take 1/24 of your daily dose every hour, and to eat 1/24 of your daily food intake every hour and get 1/24 of your daily exercise every hour and take 1/24 of each of any interacting medications every hour. That would probably be about as close as you could come. Sort of like stopping at every gas station you come to and topping off the tank.
I think that the only to keep the INR exactly on target is to take 1/24 of your daily dose every hour, and to eat 1/24 of your daily food intake every hour and get 1/24 of your daily exercise every hour and take 1/24 of each of any interacting medications every hour. That would probably be about as close as you could come. Sort of like stopping at every gas station you come to and topping off the tank.
G
Gemma
Hi again,
I know I said I'd get back to you when we knew for sure about Jim's INR range - it's taken over a month to get a clear answer!!
He had an INR of 3.2 (I know, not that high!) a few weeks ago so rang to check what the clinic had his range as - they said "all mechanical aortic valves are 3-4". So we emailed the surgeon to ask what research they based the 2-3 range on. It's a combination of surgical data and the ACCA guidelines. Jim's valve is a "3rd generation" bileaflet valve hence 2-3 being OK.
So we wrote to the anti-coagulation clinic to ask for clarification. It turns out if they don't hear differently they just go with 3-4. In spite of the fact they had it in writing that it should be 2-3 in the first place. But the haematoligist agreed it was clear there was no problem with Jim's INr being 2-3, so that's what it is going to be. Has been in the 2.6 -3.2 range for the last 6 weeks or so anyway, 2.9 last week - so no real problems.
Oh well, got it sorted out now and seems like everyone's finally working to the same facts and figures
I know I said I'd get back to you when we knew for sure about Jim's INR range - it's taken over a month to get a clear answer!!
He had an INR of 3.2 (I know, not that high!) a few weeks ago so rang to check what the clinic had his range as - they said "all mechanical aortic valves are 3-4". So we emailed the surgeon to ask what research they based the 2-3 range on. It's a combination of surgical data and the ACCA guidelines. Jim's valve is a "3rd generation" bileaflet valve hence 2-3 being OK.
So we wrote to the anti-coagulation clinic to ask for clarification. It turns out if they don't hear differently they just go with 3-4. In spite of the fact they had it in writing that it should be 2-3 in the first place. But the haematoligist agreed it was clear there was no problem with Jim's INr being 2-3, so that's what it is going to be. Has been in the 2.6 -3.2 range for the last 6 weeks or so anyway, 2.9 last week - so no real problems.
Oh well, got it sorted out now and seems like everyone's finally working to the same facts and figures
S
Sierra Bob
INR Range
INR Range
My cardiologist has always had me at 3.0 to 4.0 with a goal of 3.5. St. Jude Silzone mechanical in the aortic position. It will be 5 years next month.
INR Range
My cardiologist has always had me at 3.0 to 4.0 with a goal of 3.5. St. Jude Silzone mechanical in the aortic position. It will be 5 years next month.
Marty
Well-known member
Congratulations, Bob, on your upcoming anniversary. I had my fifth last September and still clickin'.( though the truth is I don't hear the valve at all any more). I also keep my INR between 3.0 and 4.0 with a target of 3.5. I use the Coaguchek and havn't been to the central lab in over four years.
L
Lulabelle1
Hi.
Same with me...goal is between 2.5 & 3.5 .
My dose was just raised again....it'll go six months just fine, then be too low or too high. I take 7-1/2 4 days...5mg 3 days.
I have never withheld any greens from my diet. I eat as I always did, & let them adjust the coumadin around MY habits. After nearly 3 years , it has worked out fine. Just no sudden switches to a vegetarian diet allowed.
I have noticed that if my INR is low....I can feel it (does that sound stupid? Anybody else aware or experience this?) I seem to have more chest type pain when blood is too thick & must use nitro on occasion. When it's thinned down, no more familiar chest type pain .....don't have to use the nitro spray.
I have a 29 St Judes mitral valve....someone above mentioned the number of the valve designated the size...is this true?
Is a 29 large?
Take care. Lulabelle
Same with me...goal is between 2.5 & 3.5 .
My dose was just raised again....it'll go six months just fine, then be too low or too high. I take 7-1/2 4 days...5mg 3 days.
I have never withheld any greens from my diet. I eat as I always did, & let them adjust the coumadin around MY habits. After nearly 3 years , it has worked out fine. Just no sudden switches to a vegetarian diet allowed.
I have noticed that if my INR is low....I can feel it (does that sound stupid? Anybody else aware or experience this?) I seem to have more chest type pain when blood is too thick & must use nitro on occasion. When it's thinned down, no more familiar chest type pain .....don't have to use the nitro spray.
I have a 29 St Judes mitral valve....someone above mentioned the number of the valve designated the size...is this true?
Is a 29 large?
Take care. Lulabelle
M
McCln
I am glad to be not the only one that was confused for a time about INR numbers. This last week, Friday, was 3.0. Yeah. I have to be careful about salads and green vegitables. It is strange on the green beans, I ate once the day before and INR went down a bit. But am doing fine and still working on my daily diet. I will be talking to my PCP Doctor when I go for diabetes check about if I should consult a dietician. I may consult the one with the insurance company, they have one on staff for questions. I will be 150 pounds before the year is out. But hope not to spoil the INR. Take care all and keep hanging in there.
Caroline
09-13-01
Aortic valve replacement
St. Jude's valve
Caroline
09-13-01
Aortic valve replacement
St. Jude's valve
Lorraine
Well-known member
Double Valver here!
My range is between 2.5-3.5. Since the beginning of the year, I've been taking 7.5mg four days a week and 10mg three days a week. Last two months I've had an INR of 3.5.
I told my coumadin manager that I rather be at the high end then low end. She was perfectly in agreement with that. She did tell me that the overall range was raised to 3.5-4.0. I thought maybe it was because I was a dual valver!
I too seem to know when I'm too low. When I am out of range one way or the other, I let my coumadin manager give me instructions and then I'll tell her what I think I should be doing based on my three years of being on coumadin. For example if she tells me to hold when my INR reading at 4.2, I won't do it. I prefer to reduce the dosage because when I hold, my INR
plummets down into the 1.5 range. Then I tend to be on the coumadin /INR roller coaster. I've had the same coumadin manger for over a year and she has seen first hand what happens when I use to listen to their instructions. It just ends up being more hassle for me with the back and forth trips to the clinic.
I'm comfortable with my dosage because then I too can partake in eating my salads and green veggies! Not on a daily basis, but enough so I'm not missing my favorite foods!
St. Patricks day is Wednesday! Bon, I plan to have corn beef and cabbage of course and so should you!
My range is between 2.5-3.5. Since the beginning of the year, I've been taking 7.5mg four days a week and 10mg three days a week. Last two months I've had an INR of 3.5.
I told my coumadin manager that I rather be at the high end then low end. She was perfectly in agreement with that. She did tell me that the overall range was raised to 3.5-4.0. I thought maybe it was because I was a dual valver!
I too seem to know when I'm too low. When I am out of range one way or the other, I let my coumadin manager give me instructions and then I'll tell her what I think I should be doing based on my three years of being on coumadin. For example if she tells me to hold when my INR reading at 4.2, I won't do it. I prefer to reduce the dosage because when I hold, my INR
plummets down into the 1.5 range. Then I tend to be on the coumadin /INR roller coaster. I've had the same coumadin manger for over a year and she has seen first hand what happens when I use to listen to their instructions. It just ends up being more hassle for me with the back and forth trips to the clinic.
I'm comfortable with my dosage because then I too can partake in eating my salads and green veggies! Not on a daily basis, but enough so I'm not missing my favorite foods!
St. Patricks day is Wednesday! Bon, I plan to have corn beef and cabbage of course and so should you!
