Lordy Lordy..........

[Freddie]

Bet you haven't heard a story like this.............

Regarding my SO mom; 83yrs and/was taking 2.5mg of warfarin daily. Range is to be 2.0 - 3.0
She only has 5mg and has been breaking them in half (giving her 2.5). INR this week was 1.7, saw the doctor and he prescribed her 1mg and to break the 1's in half--------figuring 3mg daily would be her "sweet spot" AND to recheck INR in 1 month She's only been on warfarin for 6 weeks and has never been in her range.
- *The doc started her off with 100 pills of 5mg and didn't want to waste that prescription and didn't prescribed 3mg (shaking my head at this one) so now she has to break 5's and 1's. Yep we have a winner here!

Question: correct me if I'm wrong, but .5mg isn't going to raise her INR that much....will it?

**Also, is it realy wise to wait a month before having another vein draw after even this small increase? (I think I know the answer to this)

Is it time for me (with your help) to get involved with these people and their ignorance?

 

[geebee]

Hi Freddie,

Going from 2.5/day to 3/day is a 20% increase so it should do the job. However, I would not wait a month to retest. I would retest after a week of the increased dose.

 

[Dina]

I don't believe that the INR should be affected too much with .5 unless
she is sensitive, (and she doesn't seem to be) but if she does get within range it may be difficult to keep her there. I agree that she should have
her blood level checked sooner than a month.
So much mismanagement going on--it makes it difficult to know where to
draw the line and when to fight your battles.I have become rather laid
back and have been keeping my mouth closed when I shouldn't.
My best-Dina

 

[Freddie]

Thanks Gina and Dina.
I agree one should be retested in 1 week after a dosage change, just didn't think 0.5mg would be a 20% increase and be enough to get her over her 2.0 range.

 

[zipper2]

Freddie i agree with both reply posts and also
the mismanagement part stated in Dina's post
My mom has been on coumadin since 96 for a
blood clot in her leg and she now goes in once
a month to test inr her range also is 2.0 to 3.
In the beginning it took afew changes and she
had to get vein draws regularly and she also was
breaking pills in half etc.till they regulated her inr
But it's the regulating now that concerns me and
the Dr's involvement and her involvement (THEY)
as a team. If no teamwork on either part,like
her getting inr's and Dr. working with her closely
to regulate this or she won't get inr's done,then
i'd be concerned on teamwork of communication
she and Dr. have. Then i would get involved.
All the best with this.

zipper2 (DEB)

 

[lance]

When my husband was put on warfarin the cardiologist recommended 2 mg per day. --useless resulting in an XS reading of 1.3 5 days later.

So his dose was increased to 10 mg per day for 5 days and then reduced to 6 mg. per day and that put him in range. He tests weekly.

I don't agree with testing once per month.

We share prescriptions for 1, 2, 5 and 10 mg of warfarin. When I was on it alone 1, 5, and 10 worked for me. I wasn't aware 3mg are available. Warfarin has a long shelf life and being a Canadian sr. I'm surprised the Dr. was concerned about the cost (paid out of tax dollars).

 

[Bina]

I am another one of those "low dose" patients.
I take 19 mg per week.....five days of 3mg and two days of 2mg.
Increasing .5 mg per day would be a big increase for me.
Fred, I hope they re-test after a week. Monthly is not good right now.

 

[catwoman]

Freddie:

Ditto with what others have said.
Anytime you change dosage, either up or down, you should retest in a week to determine if that's working. If it is, stay at that dosage. If not, change the dosage again.

 

[Freddie]

I knew testing weekly after a dosage change would be the right thing to do - but I've been told "the doctor should know what he's doing". After some heated words (again-I'm the one that got heated) I'm not sure if I have gotten the message across. So be it!! I'm done!!
Its just not worth my frustration plus the animosity the siblings have towards me (the 'happy family' feeling has never been there-even before we were married). Heaven-for- bid if I said something wrong in regards of her meds and her doctor.
No other family member is or will get involved. Their attitude is "the doctor is always right you know - don't ask questions you'll get him upset"
Ignorance!!

Thanks for the replies gang - at least I was thinking right.
Cheers to all!

 

[Bina]

Fred, if she takes 3mg every day for the next month she will be over her range for sure!!
She must test after a week, or decrease the dosage (on alternate days for example).

 

[Freddie]

Fred, if she takes 3mg every day for the next month she will be over her range for sure!!
She must test after a week, or decrease the dosage (on alternate days for example).

You know that, I know that and everyone here knows that, but she wants to listen to her doctor.......apparently "he knows her best".

She was also told it takes 3 days for her INR results to come in...........oh, and "he doesn't have time to phone her and all his other patients with results". I was quick to tell her all that was B.S.

 

[Bina]

When I was doing blood draws at the local hospital my results were often 2 days later since my doc worked out of 2 offices, and he wouldn't let his nurse give me the results. That's when I got P O'ed and decided I would have my own machine.

 

[zipper2]

You know that, I know that and everyone here knows that, but she wants to listen to her doctor.......apparently "he knows her best".

She was also told it takes 3 days for her INR results to come in...........oh, and "he doesn't have time to phone her and all his other patients with results". I was quick to tell her all that was B.S.

This is the communication,teamwork Freddie.....not good
He needs to call her that is B.S. i agree with you.
You need to take a deep breath and .......Breathe yourself
This kind of stress isnot needed for you.
Hopefully she understands if she won't change Doc to get
the inr result from him.........stubborness they can be at age 83
and alot of misunderstanding at their part also.
The doc. sounds like he's not teamwork material.
Hang in there.....(((HUGS))))

zipper2 (DEB)

 

[Ross]

Get her away from that guy now. He'll kill her doing things like that.