INR today

[CA Pigg]

I tested at 1.8 today so I've come a little bit. She has me taking 4mg tonight and going back and testing tomorrow, yeah, tomorrow.... I think she is going to go day by day until I get in the zone.... I sure hope I hurry!! I was a good girl so she won't say I'm a uncooperative patient, but I 'll sure be glad when I just test at home and don't have to worry with them!!! I'm not telling her I have my own machine!!!!! Hope eveyone has a good Monday!!!

 

[Bina]

You and she can test everyday as long as she doesn't make crazy changes every day.
The 1.8 is a very good start.

 

[Ross]

Like I said, she needs to quit screwing around, give you 5mg every day for one week, then if it needs changing up or down, we'll know which is the right dose.

 

[sheridan07]

I'm glad your level is going up. Good luck tomorrow

 

[ALCapshaw2]

I tested at 1.8 today so I've come a little bit. She has me taking 4mg tonight and going back and testing tomorrow, yeah, tomorrow.... I think she is going to go day by day until I get in the zone.... I sure hope I hurry!! I was a good girl so she won't say I'm a uncooperative patient, but I 'll sure be glad when I just test at home and don't have to worry with them!!! I'm not telling her I have my own machine!!!!! Hope eveyone has a good Monday!!!

You are right, testing Tomorrow (after only 1 day) is CRAZY.
At least it is a "Conservative" approach and will catch any 'radical' changes if / when they happen.

This suggests 2 things to me:
1- She really doesn't know what she is doing
(i.e. she has never had a patient like you and is out of her comfort zone)
2- She is Running Scared (and knows she is being WATCHED)

If this had happened to me (weasel words for avoiding making Medical Recommendations) I would have suggested taking 4 mg /day and testing again on Wednesday and Friday. (My thinking is that testing every other day is still 'close enough' to catch a 'spike' and as you already know, you are protected from clotting by the Lovenox).

FYI, starting up on Coumadin can be 'tricky' and is somewhat of a 'hit or miss' situation for many/most patients. You just happened to have the Misfortune of exhibiting an unusual response (and receiving Very INCONSISTENT Dosing - weasel words for 'somebody goofed').

You really would have been a good candidate for Genetic Testing so that the Doctor(s) / Managers would have had a better starting point and known how to manage your dosing.

'AL Capshaw'

 

[Freddie]

Lets see if I get this right.
Looking back on your previous thread, you said;
So she told me to take 4mgs again tonight then 2 mgs sunday night and I test again Monday. So she had me taking 1/2 mg for 4 nights then 2 mgs for one night, now 4 mgs for two nights and then 2mg for one night and get tested!!!!
Now she wants you test again tomorrow (which is dumb) so, come tomorrow you may very well get the same reading of 1.8 or 1.9 maybe even 2.0. That would be because you took 4mg two nights in row (you took the 4mg Friday and Saturday night right?)- remember it takes about 3 to 4 days for a dosage to work.
Sooo, I'm thinking that the reading you get tomorrow will be the reflection of the dosage you took on Saturday which was 4mg.
Now it is Monday........and I hope I'm thinking correctly.....yes?

 

[Bina]

Immediately postop the testing is done everyday.....mine was everyday for 16 days.
The docs need to know the daily INR to regulate heparin drips, and to spot trends in the INR.
BUT, the minute the INR has stabilized for a couple of days in a row, the testing moves to weekly.

 

[Tbone]

Well it's getting there, but I agree with Ross.

 

[Karlynn]

Carole - can you give us a weekly total dose for today's INR. (ex - if you had 4 mg/day for 7 days your weekly total would be 28) This will also help us see a few things.

 

[CA Pigg]

Lets see if I get this right.
Looking back on your previous thread, you said;
So she told me to take 4mgs again tonight then 2 mgs sunday night and I test again Monday. So she had me taking 1/2 mg for 4 nights then 2 mgs for one night, now 4 mgs for two nights and then 2mg for one night and get tested!!!!
Now she wants you test again tomorrow (which is dumb) so, come tomorrow you may very well get the same reading of 1.8 or 1.9 maybe even 2.0. That would be because you took 4mg two nights in row (you took the 4mg Friday and Saturday night right?)- remember it takes about 3 to 4 days for a dosage to work.
Sooo, I'm thinking that the reading you get tomorrow will be the reflection of the dosage you took on Saturday which was 4mg.
Now it is Monday........and I hope I'm thinking correctly.....yes?

This is totally correct!!! I will get my doseage thing and start doing a per week. It is been such different dosing every night!!!! I will be glad when I am in range and I totally agree with Ross and AL, I sure don't TRUST HER and will be happy when I don't have to deal with her at all.... I'm being nice and keeping my mouth shut... I'm just so thankful I have all of you and that you told me about the Lovenox!!!!

 

[CA Pigg]

From Monday 3/30 until today 4/6 I have had 17 1/2 mg.... Does that help any??? I had 1/2 mg on Sunday 3/29 and before that it had been a week since I had any from the hospital since they had me spiking so high. I'll post what I test tomorrow......THANKS FOR ALL YOUR HELP!!!!!

 

[Karlynn]

rounding that out to 18 - that means you had a little less than 3 mg/day on average - and you're still not in range (but getting close!)

I'm willing to bet you end up on 5/day eventually.

The thing that really puzzles all of us - which we'll probably never know: What occurred in the hospital to throw things off whack so much?

 

[CA Pigg]

I think it might have been all the antibiotics and then them throwing me the 10mg????? I wasn't eating much at first but at the end I was eating almost normal..... Today I tested 1.7 and she has me taking the 4mg again tonight and going back tomorrow to test again! The good thing she actually kept me on 4 mg, so that will be 2 days in a row so far, YIPEEE!!! I can't wait to get in range and not see her anymore..I had to get a refill on the Lovenox she hasn't even mentioned that she didn't tell me about it, I wonder why, LOL!!!!

 

[Lisa in Katy]

I think it might have been all the antibiotics and then them throwing me the 10mg????? I wasn't eating much at first but at the end I was eating almost normal..... Today I tested 1.7 and she has me taking the 4mg again tonight and going back tomorrow to test again! The good thing she actually kept me on 4 mg, so that will be 2 days in a row so far, YIPEEE!!! I can't wait to get in range and not see her anymore..I had to get a refill on the Lovenox she hasn't even mentioned that she didn't tell me about it, I wonder why, LOL!!!!

I agree that the 10 mg mixed with other stuff probably caused the spike. I'm also betting on about 5 mg a day once you stabilize. The frequent testing doesn't make sense, but at least she is bringing you up slowly and not bumping and chasing.

 

[Bina]

I agree...... Slow and steady is the way to go. It sure worked for me.
In a few more days, if the INR is not increasing, make sure to ask about taking 5 mg per day. Write everything down.

 

[Karlynn]

Carole - if you go in tomorrow and you're still hovering around 1.7, 1.8, I think you need to insist that she put you on 4 or 5/day and not test until Monday. She is being ridiculous at this point. Have you asked her if she is aware that the dose she gives you for the night is not the dose that's giving her the INR the next day? Please do so, and see what she says. If she tells you otherwise - this tells you that she had no earthly idea what she is going and is making guesses from no point of reference.

Now if YOU feel uncomfortable with waiting until Monday to get tested, why you have your shiny new machine - give it a go on Friday or Saturday and let us know what the INR is. But by continuing to put up this daily testing from Nurse Know Nothing, is really silly and a waste of your time.

 

[Freddie]

Here, Here.........I second what Karlynn said.

Carole, do you have to pay every time you go in to get tested? If so, tell Ms. Nurse Who Knows Nothing that you can't afford to continue to come in everyday. Maybe she'll loosen the ropes a bit and ask you to go in on Friday.

 

[CA Pigg]

I don't have to pay the insurance takes care of it. Today I did tell her "well it takes 2 or 3 days for the coumadin to be in my system" and she said correct, you are getting there. I am glad she is not giving me high doses, I think she is scared lik Al said and knows she is being watched and that is why she keeps having me come back daily, I'm glad it is the machine prick instead of drawing blood so it's not that bad just a pain and I know it is a waste of time. Maybe tomorrow some the of the 4mg will finally be in my system.. I'm very glad she didn't lower me back to the 2 mg and is at least keeping me the same where I can maybe get an actual reading.....

 

[Ross]

Well my lovlie, 4 is going to be too low and she'll be moving you to 5 soon. Like I said, that hospital really screwed something up and your not sensitive at all. I bet, right now, your going to require between 35 to 40mg per week to keep your range.

 

[CA Pigg]

I sure wish you were my coumadin nurse Ross!!!!! I know I will already be in range!!