Low INR, then missed dose.

[JetService]

Hi all! My INR was checked last week (Friday) and my level came in at 1.7. That's after steadily rising to correct range over the last month. Last reading was 2.7. The clinician asked me about meds, diet, etc and I explained that I'd been eating a lot of salad lately. She said that's probably it and to continue with the 10mg Mon. & Wed. and 7.5mg all other days and be check next week (this week). Well Monday I travelled to Phoenix for a business meeting, and I took my normal 10mg Monday on time which was 3pm in Phoenix (5pm back home). But the next night, I went to dinner with our group and we went out. I didn't get back to the hotel room until 10pm Phoenix time (Midnight home time). So I was 7 hours behind. I didn't know what to do, in that situation. Since I was already low (and now late), I decided to take 10mg for the Tuesday dose. Wed, I flew back. Of course my Coumadin was in the bag I checked and I didn't land until Midnight. I then was able to get to my pills and took the normal 10mg dose at around 12:30am (a half hour ago). Did I make the right decision on taking it 7 hours past normal time and an extra 2.5mg? I suppose I'll find our later this week, but wanted to know what to expect. Thanks!!

P.S. I got a nice treat in PHX. Waiting to board my plane at the gate, Air Force 1 flew in with President Bush and I got to watch it land. It was neat seeing the live shot on CNN on the TV monitor in the terminal and the real thing out the window. That is one beautiful bird! (BTW, CNN's live shots have about a 10 sec. delay.)

 

[Ross]

Did you get to see the men in black with sunglasses and those silly looking coils running out of their ears?

I'll have to reread your situation, but if you miss a dose, just continue your normal dosing and take the missed dose evenly spread over the remainder of the week if possible. If it's not possible, just tell them you missed a dose. I usually don't worry about it unless I'm more then 12 hours late taking it. I've gone 7 and even 10 hours, taken it, and had no troubles.

 

[Guest]

This is the way the real world works. People forget dose and they also go back and take an extra one because they forgot that they already took it. You did the right thing. Just do the best you can. If you are so close to the edge that one forgotten or one extra dose now and then is going to do you in, you are in really bad shape.

Joanne, on this forum, times hers to take it at the same time no matter what time zone she is in. That is probably the ideal and she is probably the best at it. However, a bunch of us are klutzes.

 

[JetService]

Al, thanks. I wouldn't have given it another thought, but I was so low, I kind of got worried. I heard one whould never double up. One more question is should I gradually get back to my time; in other words, take tonight's at 11pm, then 10pm, 9pm, etc until I'm back down to 5pm or is that not necessary and I should just go right back to 5pm? Thanks again!

Ross, I DID see those guys! LOL! Also, a division of Phoenix police officers and a gaggle of media types. I don't know if you've even been to PHX, but the concourse I was in is basically a long glass building that's perpendicular with the runway AF1 landed on. Everyone knew it was coming so all were crowded to the one side of the concourse gawking as the plane was approaching. As it touchdown and passed the end of the concourse, everyone ran to the other side in one unified herd. It reminded me of the movie Airplane! when the plane wouldn't stop and they kept changing the gate number as people ran from gate to gate. Funny as hell!

 

[tommy]

I take my Coumadin every evening just before going to bed. I remove my med alert necklace only after taking my evening meds. Also, I use a 7-day pill box. It's a double check. It has become routine.

When I travel, the pill box goes on top inside my suitcase where I can't miss it upon arrival. I carry a few extra pills in my tolet kit as well in case my trip gets prolonged.

I've never stressed over taking Coumadin at exactly the same time every day. Maybe I should, but having OD'd on the stuff once, I'm more concerned with being sure that I get exactly my dose, exactly once a day, but not exactly the same time of day. My dose is only 2.5 alternating with 5.0. I figure if my body can handle the daily alternating, it can handle a couple of hours variation.

Perhaps precise timing is more critical at higher doses.