More help with INR questions! Salads, amiodarone, etc...

[Natanni]

Nathan's INR was 2.3 yesterday morning, and we wanted to get started on our normal diet with a salad every night. We have been avoiding those big Vit K things since his surgery 9/29/05 until his INR got closer to theraputic levels. We plan on one serving of a salad every day with his next INR check this Friday. Just wondering if now is the best time to start this, as he will be halfing his dose of amiodarone next Monday and the coumadin clinic expects his INR to be messed up for 2 months after he is finally weened off amiodarone. Is this just asking for trouble and wait until he is off the amio for awhile? How much can we expect his INR to come down from one salad every evening? Am I worrying about too much again? Thanks!

 

[Ross]

As long as the salad isn't Supper all itself, he should be fine. It may lower it a touch, but he's going to be haywire until this Amiodarone thing is over. Don't worry so much. If he's between 2 and 4, he's fine. No lower then 2 though!

Don't withhold the foods. You need to get him on his usual loving diet and dose that diet, not diet the dose of Coumadin he's on. It's not going to be right until he's eating the way he normally would.

 

[JimL]

Amiodarone doubles the effectiveness of coumadin, a very large effect. Regular testing for a while sounds very good.
Salads are delicious, and a consistent salad a day sounds perfect. However, there are different kinds of lettuce, with greatly varying amounts of vitamin K. I enjoy a regular head lettuce salad, and tend to avoid the fancier kinds of lettuce.

 

[ALCapshaw2]

I try to eat something green every day (lots of spinich salads and broccoli etc.). That way, if I eat more or less on a given day, it makes a smaller percentage difference than if I avoided vitamin K foods entirely and suddenly ate something with vitamin K.

As one member wrote, eating more or less vitamin K is like changing a light from 50 to 100W (or vice versa) versus turning the light ON or OFF.

'AL Capshaw'

 

[Cris N]

Then you can concentrate on getting the dosage adjusted for the amiodarone. I was on amiodarone for a month & after I stopped it we had to adjust my warfarin dosage every week - actually I'm still trying to get it normal. (I was on amio from 5/23-6/25 this year.) As far as starting the salads/greens - you might as well get it over with & get the dosage adjusted to meet the diet. When I introduced frequent salads back into my diet I did every other day til I tested. I did this for a couple weeks, testing every week, and then increased consumption to my regular level.

Definitely get tested weekly until a couple months off amiodarone. The longer someone is on it, the longer it takes to disappear.

Cris

 

[lance]

Salada and greens

Salada and greens

As Ross has mentioned "dose the diet, don't diet the dose"

Speaking from experience he's absolutely right.

An awfully lot of really tasty veggies and cauliflower contain Vit k so it is difficult to eliminate them completely from your diet. Not healthy either.

Similar amount every day should work.

 

[catwoman]

Nate & Annie:

Luckily, I've never had to deal with amiodarone (and hope I never have to!).

When I was getting my INR stabilized, I ate one small salad every day. Told the anti-coagulation nurse that I was NOT going to avoid green stuff and she said just be consistent.

Since then, I've increased my intake of green stuff and dosage of warfarin. I eat a medium-size salad every day. Sometimes I have a salad entree for dinner in the summer -- a Greek salad, chicken Caesar, whatever.
Sometimes I have broccoli instead, such as a stir-fry, or cole slaw.

 

[Georgia]

Now's the time to settle into your usual eating mode. His INR will be all over anyway - between changing meds and getting healthier and exercising more it'll be the most difficult time to get it regulated. No sense in not eating healthy and enjoying your food.

 

[Ross]

Your going to find that in the end, your diet plays a very small role in your INR management. It's just enough to make you sort of look at what your eating, but not enough to be overly concerned with. I love Brussel Sprouts and they are loaded with Mr. K. I eat all those little buggers I want, spinich too, throw in some spearguts (Asparagus) broccoli, well you get the picture. Your body needs these foods, so please oh please, don't diet the dose.

 

[Natanni]

Thanks!

Thanks!

Thanks for the input! We are going ahead with our plan....we may not be heading out to Olive Garden and pigging out on our salad and wine....but it will be good to have some of our old food again

 

[Karlynn]

Thanks for the input! We are going ahead with our plan....we may not be heading out to Olive Garden and pigging out on our salad and wine....but it will be good to have some of our old food again

Don't forget those yummy bread sticks!

 

[Guest]

What you should expect with lowering the dose of amiodarone is lower INRs and increasing the dose of warfarin. It will be several months before this effect will kick and and be dealt with and the warfarin dose stabilizes.

 

[Natanni]

Salads could not have been too bad....

Salads could not have been too bad....

Hey guys...

Turns out the salads could not have been too bad because today (Fri Oct 14) Nathan's INR shot up to 3.6 from Monday's 2.3 pre-salad introduction
He has been on 5.0 mg Coumadin every day. So we are doing 2.5 today and back up to 5.0 until Monday when we half the amiodarone.

Thanks for all the support