Is 2.0 to low ?

[EireCara]

Hey..... I had my blood tested today for my INR. It came back at 2.0....I take 5mg warfarin daily. Was told to continue with this and retest in a month.

Does this sound ok. I have moderately leaking MV, Tricuspid valve, a.fib and VT.

I have had a few 'strange' things happen during this last week or so. Felt like possibly a few TIA's. When the nurse told me my INR was 2.0, I wasnt surprised and immediately thought...hmmm so thats what the ''funny business'' was about.

I think my range should be 2.5 / 3.5 ?

 

[halleyg]

If your range is 2.5-3.5, then 2.0 is too low.. that is my range as well. It seems the nurse should have increased your dosage to bring it up... I was 2.5 yesterday but don't like to stay at the bottom of my range because there is no room if I were to drop. If your same situation happened to me, my nurse would increase my dosage and recheck it in a few days to make sure it's going up.. b/c if it got any lower, which it did once, I'd have to give myself the lovenox shots.

 

[Eva]

Jacqui,

I would go along with the doctor's recommendation...if the doctor asked you to continue on the same dose, then probably you are fine! He knows why he prescribed to you and the preferred range in your case....It was not clear to me from your profile while you are on Warfarin; but I am sure that 2.5-3.5 is the preferred range after Mitral Valve replacement! I hope others have a better advice.

 

[Nancy]

Eva is tright, 2.5-3.5 is the range for mitral valve mechanicals. Other conditions might have a lower range.

 

[EireCara]

Jacqui,

I would go along with the doctor's recommendation...if the doctor asked you to continue on the same dose, then probably you are fine! He knows why he prescribed to you and the preferred range in your case....It was not clear to me from your profile while you are on Warfarin; but I am sure that 2.5-3.5 is the preferred range after Mitral Valve replacement! I hope others have a better advice.

*Eva, I was prescribed warfarin because a.fib causes clots to form due to blood pooling in the heart.

*Thank you all for your replies, much appreciated as always.

 

[geebee]

Jacqui,

Typically the range for a-fib with no other factors (such as a mechanical valve) is 2.0-3.0 so, from that standpoint you should be okay. The only concern I would have is whether your INR is still dropping. Once you get below 2.0, the chance of problems go up considerably.

Is there a chance of retesting in a week instead of a month?

 

[Ross]

If it were me, I'd increase the dose by 5% total over the week. So if you normally take 5mg everyday, you'd now take 37mg or make one day a 7.5mg day and the rest 5.

That's what I would do, but I'm not a doctor.

 

[catwoman]

I have had a few 'strange' things happen during this last week or so. Felt like possibly a few TIA's. When the nurse told me my INR was 2.0, I wasnt surprised and immediately thought...hmmm so thats what the ''funny business'' was about.

Jacqui:

Describe these few "strange" things for us.

 

[EireCara]

Marsha, one day last week I was driving and thought I had suddenly got something in my eye. My vision was cloudy. I didnt think anything of it for a bit, but after about 30 seconds or so I realised it wasnt going away. I had a strange feeling over me at the same time. It only lasted about 2 or 3 minutes, but I did feel unwell for a couple of hours afterwards.

Iv also had a couple of times where I get a 'vacant' feeling, as though I cant think. Its hard to explain, but almost as if someone has plugged out the 'computer' (me) for a bit. It can be just a few seconds or up to 30 seconds, ish. I know its happening and feel a bit scared, but it passes.

Iv had these things happen before. On one occasion, I was having a conversation with my daughter, Sarah, when suddenly I couldnt speak, I was concious of my mind being 'blank'. But that was about 2 years ago.

Im having a LOT of irr hb lately, and quite a few 'pauses' in my hb, where my vision actually goes 'grey'.

My EP has prescribed fleicanide, but I have read up a lot on it and am 'terrified' of its pro-arrhythmic effects..(cardiac arrest) I wish I could get past this, as he said the next thing would be to implant a pace maker if the fleicanide did not work. Of course I dont know if this is a good thing or a bad thing, but for some reason I dont have a fear of the pace maker.

Sorry for rambling on....

 

[EireCara]

*Gina, no way to test any sooner, will have to wait a month.

*Thanks Ross. I took 6mg last night, and will do the same tonight.

 

[Woodbutcher]

Hi Jacqui,
Why do you have to wait a month ? Surely if your given range is 2.5-3.5 and your inr is 2.0 (too low) then you need to be tested in a week, after adjustments to your dose ?
If your nurse got a reading of 2.0, surely she should have taken steps to correct your dose ?
This is all a bit confusing, and sounds to me like your health care leaves a lot to be desired ?
I'm tested on thursday, tomorrow, If my inr is in range they'll want me back in two weeks, if it's out of range they'll want me back in a week. If it's in range in two weeks time then they'll want me back three weeks later, and so on up to a max of eight weeks... I've never got beyond two yet though !?
There's absolutely no way you should be expected to wait a month if you're inr is too low though... Especially with the other "odd" episodes you've had of late ?

Take care,
Justin

 

[Lisa in Katy]

If you are taking it for a-fib, then I believe that your range is 2-3. Is that what they've told you? Remember, most of us on Warfarin have mechanical valves, so our perspective is a little different. If you have been on track up to now, and your range is 2-3, then why make an adjustment? Granted, I would rather not be at the bottom of my range, but I don't adjust based on one month there.

The symptoms you described could be TIAs, but I've had TIAs when my INR is much higher, so raising the INR doesn't necessarily prevent them. TIAs are caused by tiny clots which can be caused by mechanical valves (in my case) or irregular heartbeats (in your case). The point is to prevent strokes, which would be caused by these tiny clots joining together to form a larger clot. My personal recommendation would be to keep your Warfarin where it is and take a baby aspirin each day.

 

[ALCapshaw2]

Whenever I get 'Visual Effects', I chew either 1/2 or a Full 325 mg Aspirin. My Cardiologist thinks "this is a good idea." Ask your Doctor about chewing an aspirin for such events.

 

[Bina]

You are doing good to take the 6mg for two days. It's too bad you can't test again sooner.
Would your doc object to you taking a low dose Aspirin?