Is this my meter, or me? (I suspect me)

[slipkid]

I have a Coaguchek XS.

I have an On-x aoritic valve.

Although On-x got approval for range of 1.5 to 2.0 I've tried to maintain a 2.0 to 2.5 range for wiggle room and don't sweat minor peaks & valleys below/above 2.0 to 2.5.

Have been fairly constant INR on either 45 or 46 mg warfarin weekly for years.

Right now have been taking 46mg/week for a while - 6mg M, W, F and 7mg rest of week.

I do not test on the exact same days of the week or exact same times of day (partially on purpose, but also partially because of my work schedule). I try to test weekly but sometimes life gets in the way.

On 1/13 I became very sick with covid which I am still recovering from.

When I tested on 1/15 my INR went up .4 from previous test of 2.5 to 2.9.

My next test on 1/21 remained at 2.9 (I'll list some more #s below after I make another point).

I was not concerned about that kind of jump, assumed it will go back down once I return to normal and start working, eating, sleeping, etc normally again.

However test today, it has gone way up even further. But weird behavior with the meter gave me pause as to what is going on.

When I first turned on the meter today it gave an error code "8".

I did not have book handy so just turned it off and back on. Tested then at 3.4. Thought maybe it was something to do with that error, maybe batteries are low.

So I changed the batteries and tested again, this time using different finger on different hand. Tested at 3.7!!!!

I suspect meter is OK and this is all regarding my body. In addition to covid I supposedly have sinus infection of which I am now on an antibiotic starting 1/21 (ending after taking it tonight 1/27).

My life has been upside down the past 2 weeks with being sick. Fever for about a week. No appetite (barely eating anything but soup). No exercise or physicality, mostly doing nothing but sleeping and lying in bed exhausted, coughing, sneezing, etc.

Am going back to work tonight for 1st time in 2 weeks. My diet/schedule should be getting back to normal slowly. Am still suffering with supposed sinus infection and fatigue although covid is supposedly gone.

I am not comfortable with testing at 3.7 (and never tested 2 different fingers b4 within 10 minutes but was not expecting a variation of 3.4 vs 3.7 from that either, even though the 3.7 is with newer batteries).

Here are my #s from last 3 months or so:
09/22 - 04:40AM - 2.5
10/05 - 12:00PM - 2.3
10/16 - 01:00AM - 1.8
11/02 - 11:00AM - 1.9
11/13 - 05:30AM - 1.8
11/23 - 10:00AM - 2.2
12/08 - 08:00AM - 2.4
12/18 - 12:15AM - 2.0
12/26 - 02:30AM - 2.5
01/07 - 06:00AM - 2.5
01/15 - 11:35AM - 2.9
01/21 - 04:15AM - 2.9
01/27 - 03:15AM - 3.4 then 3.7 with new batteries

Note that the reason for so many "middle of the night" tests is because I work a godawful 12 hour nightshift starting Jan 2021 and have to maintain that same backwards my AM is your PM and viceversa schedule as best I can even on my days off because I've found it totally impossible to go back and forth staying up 24 hours at a time to switch etc.

Note also I take my warfarin when I get up each night, on an empty stomach. On workdays that is 5pm. On days off somewhere around there but sometimes later.

Wondering what you people think? Is meter OK? (I believe so).

Am thinking of cutting down from 7mg tomorrow to 5mg and 6mg next day to 5mg then retest then go back to normal doses next week. Have not heard from Dr overseeing my INR about any of this nor do I expect to (he rarely even gets involved other than saying "looks good!" every 6 months but I've not had any swings like this either).

Not looking for anyone to tell me what to do but am interested in others' thoughts.

Thanks.

 

[pellicle]

This happens, its usually correct. Just adjust dose to suite readings.

Insufficient data to make a better determination

 

[slipkid]

Thanks Pellicle.

Have you seen that weird variation of 2 tests about 15 minutes apart with different #s like that? I never tested like that b4, no reason to afaik, was just a by-product of the battery change wanting to see if it made a diff.

 

[pellicle]

All things being equal me neither, were the last two both within 15 seconds rule?
Same finger?

 

[ATHENS1964]

Since your food is only soups and without any vegetables it makes sense the same dose of warfarin with before it gives a larger number, eat vegetables or reduce the dose.

 

[catwoman]

Viral infections and fevers will increase INRs.

 

[MdaPA]

Taking certain antibiotics can also increase INR.

 

[slipkid]

All things being equal me neither, were the last two both within 15 seconds rule?
Same finger?

No different fingers, different hands even, and about 10-15 minutes apart as I had to look for new batteries, change them, reset the date/time etc, then did the retest.

 

[slipkid]

Since your food is only soups and without any vegetables it makes sense the same dose of warfarin with before it gives a larger number, eat vegetables or reduce the dose.

Thx I ate some broccoli at dinner tonight btw.

Also throughout the sickness in 2 weeks I lost about 8 pounds, just realized that (am not big anyway, went from 150 to like 142; reminds me how I dropped to like 120 after OHS hospital stay).

I think my increase is a combination of everything we've have been saying - illness itself, different diet, lack of activity, adding antibio into the mix, loss of weight, etc...

 

[dick0236]

I would suspect your current illness, weight loss, appetite change etc is the reason for the INR disruption. I would stop one daily dose and recheck in a week. The 3.7 should not concern you unless it stays at that level for a couple of tests.

 

[pellicle]

I think my increase is a combination of everything we've have been saying - illness itself, different diet, lack of activity, adding antibio into the mix, loss of weight, etc...

agreed ... all the above suggestions were on the money and from different angles. That's whats so good about this place; multiple views.

A cone from one angle looks like a circle, or a triangle from another. By having multiple views we see it for what it is

 

[slipkid]

agreed ... all the above suggestions were on the money and from different angles. That's whats so good about this place; multiple views.

A cone from one angle looks like a circle, or a triangle from another. By having multiple views we see it for what it is

View attachment 888392

Ah yes, I see what you mean now by that cone illustration!!

Here is a color representation:

 

[pellicle]

I see what you mean now by that cone illustration

The other cone wouldn't clarify it

 

[user 15848]

I have a Coaguchek XS.
I have an On-x aoritic valve.
Thanks.

Same here, my suggestion is CALL CoaguCheck C.Support they are REALLY good, i did once.
and they went the extra mile to clarify all my questions back in 2015 when i started.

I am also on the 2.0 - 2.5 target range, and like to be on 2.3, no more no less, works for me.

 

[user 15848]

Any non normal condition of the system or addition/subtraction of consumed items will act upon the organs , liver included therefore, things can change with the INR;

 

[tom in MO]

I have a Coaguchek XS.

I have an On-x aoritic valve.

Although On-x got approval for range of 1.5 to 2.0 I've tried to maintain a 2.0 to 2.5 range for wiggle room and don't sweat minor peaks & valleys below/above 2.0 to 2.5.

Have been fairly constant INR on either 45 or 46 mg warfarin weekly for years.

Right now have been taking 46mg/week for a while - 6mg M, W, F and 7mg rest of week.

I do not test on the exact same days of the week or exact same times of day (partially on purpose, but also partially because of my work schedule). I try to test weekly but sometimes life gets in the way.

On 1/13 I became very sick with covid which I am still recovering from.

When I tested on 1/15 my INR went up .4 from previous test of 2.5 to 2.9.

My next test on 1/21 remained at 2.9 (I'll list some more #s below after I make another point).

I was not concerned about that kind of jump, assumed it will go back down once I return to normal and start working, eating, sleeping, etc normally again.

However test today, it has gone way up even further. But weird behavior with the meter gave me pause as to what is going on.

When I first turned on the meter today it gave an error code "8".

I did not have book handy so just turned it off and back on. Tested then at 3.4. Thought maybe it was something to do with that error, maybe batteries are low.

So I changed the batteries and tested again, this time using different finger on different hand. Tested at 3.7!!!!

I suspect meter is OK and this is all regarding my body. In addition to covid I supposedly have sinus infection of which I am now on an antibiotic starting 1/21 (ending after taking it tonight 1/27).

My life has been upside down the past 2 weeks with being sick. Fever for about a week. No appetite (barely eating anything but soup). No exercise or physicality, mostly doing nothing but sleeping and lying in bed exhausted, coughing, sneezing, etc.

Am going back to work tonight for 1st time in 2 weeks. My diet/schedule should be getting back to normal slowly. Am still suffering with supposed sinus infection and fatigue although covid is supposedly gone.

I am not comfortable with testing at 3.7 (and never tested 2 different fingers b4 within 10 minutes but was not expecting a variation of 3.4 vs 3.7 from that either, even though the 3.7 is with newer batteries).

Here are my #s from last 3 months or so:
09/22 - 04:40AM - 2.5
10/05 - 12:00PM - 2.3
10/16 - 01:00AM - 1.8
11/02 - 11:00AM - 1.9
11/13 - 05:30AM - 1.8
11/23 - 10:00AM - 2.2
12/08 - 08:00AM - 2.4
12/18 - 12:15AM - 2.0
12/26 - 02:30AM - 2.5
01/07 - 06:00AM - 2.5
01/15 - 11:35AM - 2.9
01/21 - 04:15AM - 2.9
01/27 - 03:15AM - 3.4 then 3.7 with new batteries

Note that the reason for so many "middle of the night" tests is because I work a godawful 12 hour nightshift starting Jan 2021 and have to maintain that same backwards my AM is your PM and viceversa schedule as best I can even on my days off because I've found it totally impossible to go back and forth staying up 24 hours at a time to switch etc.

Note also I take my warfarin when I get up each night, on an empty stomach. On workdays that is 5pm. On days off somewhere around there but sometimes later.

Wondering what you people think? Is meter OK? (I believe so).

Am thinking of cutting down from 7mg tomorrow to 5mg and 6mg next day to 5mg then retest then go back to normal doses next week. Have not heard from Dr overseeing my INR about any of this nor do I expect to (he rarely even gets involved other than saying "looks good!" every 6 months but I've not had any swings like this either).

Not looking for anyone to tell me what to do but am interested in others' thoughts.

Thanks.

I think your reader is OK.

Your results show a slow increase in INR from 12/18. This could mean your daily dose is too high. For me, when I go out of range by at least 0.3INR, I adjust a single day's dose and check in 5-7 days. If I go out again in the same direction (low or high), I do it again, if I go out a third time, I adjust the daily dose, but not by much. This is what the clinic would do for me, now I self-dose using the same approach.