INR Update--Dropped to 2.0

[perkicar]

Today I got tested and I was 2.0. (last time I was 5.4--they took me from a 7.5*5 days, 5*2 days per week to 5*7 days). So now they want me to go back to the original schedule, and I'll get tested next week. So, doing the math, I did a reductions from 47.5mg/week to 35mg/week--pretty big reduction. I did tell the nurse that while he told me to skip 2 doses I only skipped one! So we'll see where I end up next week when I have my appointment to see him in the office AND get my INR checked.

Carolyn

 

[EVELYN]

Hi Carolyn

INR----It's never right!!! Tyce has been bouncing around lately, too....He was 4.8 on Saturday, so he halved a dose Saturday night and will probably half again tomorrow when we check him.......It seems everyone is crazy.....maybe it's spring!!!

Ev

 

[Karlynn]

Carolyn, I'm not surprised you dropped to 2. They decreased your dosage by 26%! http://www.aafp.org/afp/990201ap/635.html

It's been my personal experience that high INR's treated by significant decreases are almost guaranteed the bouncing ball outcome. An INR of 5.4 is high, but not a freakout # unless the person is experiencing bleeding. As long as there isn't any bleeding occuring, I think the conservative approach needs to be taken and not try to bring the INR down in one fell swoop because that invites the drastic decrease and leads to boing, boing, boing - an INR headed all over the place. A decrease of 26% tells me the doctor was going and took a hatchet to your dose.

Once again - it proves the point that some doctors fear bleeding more than they do stroke.

It's much much harder to raise a low INR and it's pretty easy to lower a high one. The way some doctors treat out of range patients it appears they view it just the opposite.

 

[Ross]

I think a drop to 42.5mg over the week would have been sufficient.

 

[perkicar]

Carolyn, I'm not surprised you dropped to 2. They decreased your dosage by 26%! http://www.aafp.org/afp/990201ap/635.html

It's been my personal experience that high INR's treated by significant decreases are almost guaranteed the bouncing ball outcome. An INR of 5.4 is high, but not a freakout # unless the person is experiencing bleeding. As long as there isn't any bleeding occuring, I think the conservative approach needs to be taken and not try to bring the INR down in one fell swoop because that invites the drastic decrease and leads to boing, boing, boing - an INR headed all over the place. A decrease of 26% tells me the doctor was going and took a hatchet to your dose.

Once again - it proves the point that some doctors fear bleeding more than they do stroke.

It's much much harder to raise a low INR and it's pretty easy to lower a high one. The way some doctors treat out of range patients it appears they view it just the opposite.

Yeah, at least I hadn't skipped two doses like he told me to! I gave the nurse our quote about fixing blood but not fixing brain cells! I seriously considered taking a double dose today but decided that might be too aggressive.

 

[Karlynn]

Yeah, at least I hadn't skipped two doses like he told me to! I gave the nurse our quote about fixing blood but not fixing brain cells! I seriously considered taking a double dose today but decided that might be too aggressive.

Carolyn, it's just one more class in the "How to manage Coumadin" that we all take. It's just sad that it's a course that some doctors slept through.

 

[Guest]

47.5 to 35 mg is a 26% dosage drop. You need a better warfarin manager.

 

[ALCapshaw2]

Carolyn,

You never did say if you purchased Al Lodwick's "Dosing Guide" so I'm ASSUMING (and we all know what that means) you did not.

IF NOT, send him 5 Bucks and take that guide with you every time you get checked.

It wouldn't hurt to look for a REAL Coumadin Clinic as well. It would appear that your Doc doesn't have much experience keeping Coumadin patients STABLE.

'AL Capshaw'

 

[perkicar]

Carolyn,

You never did say if you purchased Al Lodwick's "Dosing Guide" so I'm ASSUMING (and we all know what that means) you did not.

IF NOT, send him 5 Bucks and take that guide with you every time you get checked.

It wouldn't hurt to look for a REAL Coumadin Clinic as well. It would appear that your Doc doesn't have much experience keeping Coumadin patients STABLE.

'AL Capshaw'

OK Al, you convinced me. I just ordered my dosing guide from Al. I will take it with me to my appointment next week!
Carolyn

 

[Guest]

Yep, I just looked at PayPal and there is the payment. It will be in the mail tomorrow.

 

[perkicar]

Yep, I just looked at PayPal and there is the payment. It will be in the mail tomorrow.

Thanks Al's Capshaw and Lodwick LOL