my self management results for 2020

[pellicle]

... Yes, I recall he had a heart attack and was supposed to not wrestle anymore but kept doing it.

Pay attention to his post surgery stuff, he had bypass surgery

 

[Soulfeelings]

for anyone who does self management (or is thinking of it)

	INR	Warfarin (daily mg)​
average​	2.6​	7.0516​
std dev​	0.3​	0.3​
max​	3.4​	7.5​
min​	1.5​	6.0​
over event​	1​	​
under event​	1​	​
inRange %​	96.4​	​

View attachment 887504

you can clearly see when I had my small surgery.

Happy New Year self managers

Interesting....l kept a very detailed chart of everything, even down to foods I'd eat if we went out...just incase. Was having INR done by a clinic, in 15yrs l never went any longer than 1mth before l was ordered to have another. I had, had a gutful...so then n basically over night l did my own.

 

[Protimenow]

You can rely on Coumadin 'clinics' to take control of your survival - with insistence on monthly testing -- or you can take better control of things by getting your own meter and testing weekly.

It's a lot safer to test weekly -- and many of us do -- than to go much longer between tests.

If you can't manage your dosing, there are people on this forum - especially Pellicle - who can assist you with dosing suggestions.

 

[pellicle]

If you can't manage your dosing, there are people on this forum ... who can assist you with dosing suggestions.

This 's for the kind mention. I know many are reluctant to reach out, so I have my blog posts to refer them to.

Eg
https://cjeastwd.blogspot.com/2015/10/managing-my-inr-example.html

 

[brijeshb]

My own results for 2020, I had the surgery in August 2020 so it starts from week 40. Also keep in mind that the anticoagulant is acetocoumarol.
I continue to add more information.
The doctor's recommendation is for INR 2-3 and as you can see 15% out of range is not important.
I have now learned how my body reacts to the pill and the diet and I can and do adjust the dose easily. I also eat spinach and green vegetables in reasonable quantities and I also have 2-3 drinks on Saturday - Sunday.The weekly measurement is easy about 5 minutes every Saturday morning and I make the appropriate adjustments. Self-management gives me peace of mind because I know that even if I get up or down it will only be for 2-3 days.

My anti coagulant is also acenocoumarol based (acitrom)..But my weekly dose is as high as 38 or 39 mg per week to hold by INR between 2 and 3 ...

 

[pellicle]

But my weekly dose

You will do yourself no good thinking in weekly doses. Stick with daily, especially with an anticoagulant with such a short half life.

 

[brijeshb]

You will do yourself no good thinking in weekly doses. Stick with daily, especially with an anticoagulant with such a short half life.

Yes my doses are controlled daily. I take 6 mg - 2 days , 5.5. mg 3 days and 5 mg 2 days. is there any significant difference between warfarin and acenocoumarol ? I mean pros and cons ?

Thanks

 

[Superman]

You will do yourself no good thinking in weekly doses. Stick with daily, especially with an anticoagulant with such a short half life.

I see people make this claim as though someone will actually take 38 mg Sunday morning and nothing the rest of the week. That’s silly.

Weekly dosing is helpful. Dose weekly, keep the daily dose as level as possible. When the clinics did daily dosing, they would do things like increase 1 mg a day. Well, that’s 7 mg’s over the course of a week and a change like that will start you on an INR roller coaster that’s hard to level out. What a person likely needs is one or two mg’s for the week. So how do we get that while keeping the daily dose as level as possible?

Daily and weekly go hand in hand.

 

[RAS]

a change like that will start you on an INR roller coaster

I agree 100%. I was on that roller coaster. Once I started self-testing and dosing and maintaining as consistent a daily dose as possible, my INR leveled out.

 

[ATHENS1964]

My anti coagulant is also acenocoumarol based (acitrom)..But my weekly dose is as high as 38 or 39 mg per week to hold by INR between 2 and 3 ...

Dosage is not fixed for everyone, diet, drink and liver metabolism have an effect on the INR.
The half-life is short and differs from warfarin so a dose change has an effect on the INR quickly. I have learned how much I am affected by food and I try to eat constant amounts of vegetables every day, it is not difficult. An example if I measure on Saturday and the INR is 3 I eat a little more salad and I throw it if it is 3.5 I reduce the dose a little, if it is 2.0 I increase the dose a little if I am between 2.3 to 2.8 I continue the dose normally until next Saturday when I will count again I will not be out of bounds for more than 2 days so it is not something that will worry me.
The advantage of acetocoumarol is that it reacts quickly to corrections and the disadvantage is that it is not good to miss a dose because the INR drops quickly. I have a notification on my mobile and one on gmail so I'm sure a message will come.

 

[pellicle]

Weekly dosing is helpful. Dose weekly, keep the daily dose as level as possible.

Stable means doses are the same no?
If so what is this benefit to weekly thinking?

 

[pellicle]

Dosage is not fixed for everyone, diet, drink and liver metabolism have an effect on the INR.

True, did you are my graph?
But between tests it is. So especially with acenocoumarol the dose fades fast. What you are probably seeing is the normal instabilities of acenocoumarol and incorrectly attributing another causal factor.

Also, the theory of salad is it contains vitamin k, so should lower your INR

 

[Superman]

Stable means doses are the same no?
If so what is this benefit to weekly thinking?

Comes from dealing with Coumadin clinics and explaining to them why I won’t be increasing my dose by 1 mg a day.

Stable means as close to consistent as possible. If I need to bump by 2 mg for the week. Maybe I go from 6mg’s daily to taking 7 on Tuesday and Friday. I’m not trying to take 6.3 mg’s a day to be perfectly stable.

Works for my brain so I’ll roll with it

 

[pellicle]

. I’m not trying to take 6.3 mg’s a day to be perfectly stable.

firstly that would be ludicrous to suggest and secondly there would be no clinical different outcome to you taking 6.5mg daily (44.1 vs 39). In my own experiments with trying to hover over a narrow range and taking alternating doses of (say) 6.0 and 6.5 I found no benefit that was stable.

So if thinking any particular way helps you then go for it, its just that I see no rational benefit (nor does any pharmacist I know) in thinking of weekly doses. If it works for your brain well fine, and you have a lot of experience.

However to explain to a newbie (even to me) its harder than just saying "daily dose" and leaving it at that.

 

[tom in MO]

For the last two years, I have noticed a seasonal fluctuation. In the summer when I eat more greens and am more active, I take 4.5mg per day (31.5 mg per week). As it moves into fall, I take 4 mg T/Th and now in the dead of winter I take 4 mg T/Th/Sat (30 mg per week). If I don't my INR creeps up higher than my 2-2.5 target. I do the reverse in the spring and summer, and if I don't my INR creeps down. That small change in dosage is important, if I don't pay attention to testing I've gone as high as 3.3 and as low as 1.6. When doctors ask my dosage, I give it by week (~31mg per week) since it's easier and basically more correct than a daily number.

 

[Shiv]

Vow. 2.6+- 0.3..wish I could learn and replicate this.

 

[pellicle]

Vow. 2.6+- 0.3..wish I could learn and replicate this.

you can't until you move away from the anticoagulant you are on.

 

[Shiv]

If I switch to warfarin. The dose will be 5mg per day right. As per acitrom dose of 2.5..I will buy warfarin next time.

 

[pellicle]

If I switch to warfarin.

then you should reach out and I'll do what I can to help
PS be wary of generics, they sometimes cause variances (complex) but if you can stick with a brand like Coumadin or Marevan

 

[Sheenas7]

then you should reach out and I'll do what I can to help
PS be wary of generics, they sometimes cause variances (complex) but if you can stick with a brand like Coumadin or Marevan

My doctor didn’t want me on a generic. I guess that’s why. So he put me on Jantoven. Where are you Pellicle? Not in USA? I am in Va. I ask because I haven’t heard of Marevan.