INR Rollacoster

[JimL]

weekly dosage

weekly dosage

I think it is very important to measure your Coumadin dosage by the week. The girls who do the pinprick INR test on me have guided me in that direction. Based on the reading, we together decide how many mgs I'll take the next week, and then I divide it out as evenly as possible. For now, I take a 3 on odd days and a 4 on even days, which is easy for me to remember.
I mention this because my new cardiologist called such a procedure "unprofessional," or something similar. Otherwise, he's been pretty good, but he needs some education on that point.

 

[Mb]

Hi!

I just thought I might post a short comment/idea/etc.

My husband has always had what we call a "fast" digestive system. Food does not stay in his system for long.

Over the past year, since he was finally diagnosed as needing valve surgery, a-fib, CHF, he has taken a lot of meds, coumaden being one of them.

The doses he takes of each med seem to be higher than most of the folks that post here. He is 6'2" and weighs in at 184. Not a huge person.

I have thought over the past 6 months that the reason they may have had a problem with his dosage is because of his fast digestive system. For example he takes 8.25 mg. of coumaden daily. 75-100mg of attenenol, and the list goes on.

Have you had a change in your digestive system in the past few months that you've been having this problem? Are you eating a lot more fruits and veggies..........just an idea.

Marybeth

 

[Guest]

I'm going away for a few days. From the volume 0f e-mail that I get, I'm estimating that it will be early April before I catch up with all of it.

 

[Marty]

Take care!

Take care!

Al, Have a nice vacation. I value your input to this website. Let me know if you ever get back to DC. I'll take you out to a good eatery and we won't worry about Vit K!

 

[Guest]

Marty,

I had a nice visit with Dr. Stephan Moll of the University of North Carolina Thrombophilia Program. We were discussing generic warfarin. I told him your statement about your brain knowing that the generic is just as good but your heart buying Coumadin.

Dr. Moll answers questions on the website www.fveiden.org

 

[Allan Mack]

For those of you who have the in-home unit, does it hurt to prick your finger? Do you ever get used to it? It's a chore to go to the lab every couple of weeks to get my INR levels checked, so I am considering getting one; I think my medical coverage at work will pay for 80 per cent of it.

My INR levels shot up to 7.0 back in September/October. I had to be taken off Coumadin for 6 weeks. I hope I never go through that again. You can read more about my ordeal here.

 

[Nancy]

Hi Allan, welcome

Hi Allan, welcome

Hi Allan-

Somehow, I must have missed your first post. But you have found the greatest website for valve replacement patients. There's such a rich source of information here from patients who have had so many, many heart procedures and surgeries. Its' a very supportive group and it works because we all understand the situation.

We hope you'll come here often and give us your input and ask questions as you like.

I just read your situation with the high INR. My goodness, how did it ever get that high? My husband's been on Coumadin for 25 years and I don't ever remember his being that high. That's scary and you're a lucky person that someone finally checked that out.

Hope it never happens again to you, or anyone else, for that matter.

Take care.

 

[Christina]

Alan Mack,

I read your "Little Ordeal" story. Boy oh Boy! Scary!
Alan, the Protime unit is a life saver to me. I had such a time getting my INR stable and mostly because of a doctor who didn't know what he was doing. He had me going to the lab up to 3 x a week sometimes and mostly because he changed the dosage every time. My INR was up and down, and I was a nervous wreck every week. I had no choice but to fire him after 6 months. He was very unprofessional towards me and I simply wasn't going to take his BS. I was without a doctor for about 2 months and I did fine on my own with the Protime machine. I did get myself another doctor though and together we make a terrific team.
The prick in the finger is NOTHING. Does not hurt! You will be used to it in a few months and never want to go back to the lab. I go on vacation and take it with me. Such peace of mind and I check whenever I think I need too
Eventhough I never wanted another surgery and was glad to take the mechanical valve, something always can go wrong. Read my personal story, as I had two AVR surgeries within 11 days due to a screw-up at the cardiologist office.


Good wishes going your way!

Christina
Congenital Aortic Stenosis
AVR's 8/7/00 & 8/18/00
St.Jude's Mechanical
Coumadin 140 mg per week.

 

[Allan Mack]

Re: Hi Allan, welcome

Re: Hi Allan, welcome

I just read your situation with the high INR. My goodness, how did it ever get that high? My husband's been on Coumadin for 25 years and I don't ever remember his being that high. That's scary and you're a lucky person that someone finally checked that out.

Hope it never happens again to you, or anyone else, for that matter.

Take care.

Thanks, Nancy. I don't know how my INR got so high. Perhaps it was a combination of a change in diet and taking one too many Coumadin tablets by mistake. Also, I wasn't eating much during that time because I was feeling a little depressed (even before 9/11/01). I also hope no one ever goes through what I did...

 

[Allan Mack]

Alan Mack,

I read your "Little Ordeal" story. Boy oh Boy! Scary!
Alan, the Protime unit is a life saver to me. I had such a time getting my INR stable and mostly because of a doctor who didn't know what he was doing. He had me going to the lab up to 3 x a week sometimes and mostly because he changed the dosage every time. My INR was up and down, and I was a nervous wreck every week. I had no choice but to fire him after 6 months. He was very unprofessional towards me and I simply wasn't going to take his BS. I was without a doctor for about 2 months and I did fine on my own with the Protime machine. I did get myself another doctor though and together we make a terrific team.
The prick in the finger is NOTHING. Does not hurt! You will be used to it in a few months and never want to go back to the lab. I go on vacation and take it with me. Such peace of mind and I check whenever I think I need too
Eventhough I never wanted another surgery and was glad to take the mechanical valve, something always can go wrong. Read my personal story, as I had two AVR surgeries within 11 days due to a screw-up at the cardiologist office.


Good wishes going your way!

Christina
Congenital Aortic Stenosis
AVR's 8/7/00 & 8/18/00
St.Jude's Mechanical
Coumadin 140 mg per week.

Wow! Two surgeries within 11 days? One surgery in my lifetime is enough, thank you very much! This must have been a very stressful time for you. Glad to see you're still around and kicking, and giving help to others on this wonderful forum to boot.

Thanks also for telling me about the Protime unit. You have greatly alleviated my fears. I will try and obtain one for myself in the near future...

 

[Guest]

Alan's story illustrates why it is important to mention at every doctor's visit that you are taking warfarin. Do not depend on the doctor to remember or read your records. The fact that he had taken warfarin successfully for years probably put a intracranial hemorrhage way down on the list of suspicions. However, mentioning warfarin along with the headache should bring it to the top of the list of suspicions.

With only one exception, every person I've heard from who had an ICH has a similar description to Alan's. That one guy probably had a slow build up over months. Oddly enough, he returned to my clinic yesterday on warfarin again. He did not have an artificial valve, so he was taken off warfarin after the bleed. However, he now has a clot in his leg and had to re-start warfarin.

 

[Allan Mack]

Thanks for imparting your knowledge, allodwick. What is the difference between a intracranial hemorrhage and a sub-parietal hematoma? I was told I suffered the latter...

 

[Guest]

I think that an intracranial hemorrhage is the broad name that covers everything and a sub-parietal hematoma is a more exact description.

Is that correct, Marty.

 

[Marty]

intracranial vs subparietal hemorrhage

intracranial vs subparietal hemorrhage

Al, you are correct. "intracranial hemorrhage" covers all kinds of bleeding inside the skull. Subparietal hemorrhage refers to hemorrhage beneath the parietal bone on the side of the skull.
They are usually broken down into subdural or epidural. The dura mater is the outer covering of the brain. It has two layers one hugging the skull bone and the other against the brain tissue. An epidural hematoma( collection of blood between the dura and the bone) that often occurs after trauma to the "temple" area is an emergency and can result in death in minutes or a couple of hours.Subdurals(blood collecting between the layers of dura) can also occur after slight trauma or spontaneously (particularly to us on blood thinners) ; they develop slowly and are sometimes very difficult to diagnose. Like Al says, always remind your doctor that you are taking warfarin , particularly, if you are having some strange headaches or other vague neuro symptoms.