July 23rd: My Olympics start sooner :-)

[ncw3642]

All and everything good now. Feel great.

Only thing holding me from going home is the INR level which is stuck at 1.3. @pellicle and @ncw3642 please stand by for pertaining information. Your expertise and recent experience respectively will be very useful. Let me know if you want me to start a new thread on the Post Op Forum, or this one itself suffices.

They’ll probably keep me here another day and inject higher concentration of Heparin. Then I heard them discuss an injectable which I can do myself at home tomorrow onwards.

Will share more shortly.

Hi! Glad that you are feeling better and sorry to hear about the low INR- it does happen.

They probably are going to send you home with a Lovenox injection- that is what I used when my levels were low (see the photo for my trend)-- as you can see it does fluctuate quite a bit. In-fact, I thought I was "in-range" with the 2, 2.7 readings but today's reading was 3.4- point being, it takes time to nail down and I wouldn't be concerned.

I will say- they underdosed me in the hospital. The pharmacist said I would likely need a higher dose and yet they kept me on 4mg daily. I am on 10mg now, but that wasn't until a lot of home health INR checks (when again as you see in the photo my INR was sub-2) before they bumped me up.

 

[pellicle]

Hi

All and everything good now. Feel great.

that's great news ... I was a little concerned for a while

Only thing holding me from going home is the INR level which is stuck at 1.3.

that happens, for a start the drug does not instantly take effect and that is because it takes time to reach a critical concentration. How many days have you been on warfarin now? (and what is your dose?)

Let me know if you want me

I'm OK either way

Best Wishes

 

[pellicle]

They probably are going to send you home with a Lovenox injection- that is what I used when my levels were low (see the photo for my trend)-- as you can see it does fluctuate quite a bit. In-fact, I thought I was "in-range" with the 2, 2.7 readings but today's reading was 3.4- point being, it takes time to nail down and I wouldn't be concerned.

3.7 huh ... interesting

yes indeed the whole in range thing is a bit vexxed. I feel its not helped by old people telling you stuff like "I'm always between 2 and 2.5" (yet can somehow never give you the graphs or the tabular data ..)

I know its not always related to "just past surgery" either, as I know well the sorts of short term (day to day) variations that people can have too.

@tjay, just hang in there mate and don't get concerned because as long as 1) you're on heparin 2) your INR is over 2 most of the time there is little cause for alarm.

Must get back to someone else about this too ...

 

[tjay]

@pellicle my Coumadin was started a few days ago but was interrupted since they had to do catherization. So 2 days were lost just like that.
I will get proper dose schedule and post here. Tonight they’re planning to restart Coumadin and tomorrow restart heparin IV.

@ncw3642 your recent experience is very helpful. Good to know doing injections at home isn’t crazy. I just haven’t done any myself ever but open to trying. Question: how did you get a Home Health? I’ve a pretty good PPO insurance and not sure if I need to call them directly or hospital can arrange it. They didn’t talk about home health at all.

Thanks both

 

[ncw3642]

@pellicle my Coumadin was started a few days ago but was interrupted since they had to do catherization. So 2 days were lost just like that.
I will get proper dose schedule and post here. Tonight they’re planning to restart Coumadin and tomorrow restart heparin IV.

@ncw3642 your recent experience is very helpful. Good to know doing injections at home isn’t crazy. I just haven’t done any myself ever but open to trying. Question: how did you get a Home Health? I’ve a pretty good PPO insurance and not sure if I need to call them directly or hospital can arrange it. They didn’t talk about home health at all.

Thanks both

I’m going to assume you’re USA based—

Home health was automatically ordered by the surgeon for me upon discharge however, it’s handled by case management or a social worker in your hospital usually. Has anyone from case management stopped by to talk about discharge plans with you?

If not, definitely ask your nurse about setting up home health and they will get you in contact with the right channels at your hospital- be it doctor or case management.

 

[tjay]

I’m going to assume you’re USA based—

Home health was automatically ordered by the surgeon for me upon discharge however, it’s handled by case management or a social worker in your hospital usually. Has anyone from case management stopped by to talk about discharge plans with you?

If not, definitely ask your nurse about setting up home health and they will get you in contact with the right channels at your hospital- be it doctor or case management.

Yes I’m US based in California.

Coincidentally, main nurse came by after the previous posting and they’ve set me up with Quest Lab which 10 mins from my home for INR testing.
Otherwise they wouldn’t release me until INR is above 2 she’s saying (meaning I won’t be doing anything else at home than taking oral pill of Coumadin). That will work great.

I’ll keep me Coumadin dosages posted which’s starting tonight. Let’s see how my INR levels respond now.

 

[tjay]

INR is now 2.0.
Thanks @pellicle and @ncw3642 for your help, and everyone else for encouragement before the surgery and during the early part of the recovery.

 

[pellicle]

Let’s see how my INR levels respond now.

Expect a few ups and downs. Also expect a change after a month or two.
This is only 14 years old but often takes clinics by surprise

https://pubmed.ncbi.nlm.nih.gov/19336266/

Best Wishes