Need input - INR too high grrrr

[Freddie]

Putting aside that most of you think my doc is an idiot when it comes to INR, she's all I got.
Been taking 6mg daily for almost 18 months and I go the lab every 2 weeks for testing. 2 weeks ago INR was 3.8, doc told me to skip a dose at that time - I didn't.
So here's the scoop. Today's reading is 4.3, too high for her liking. Doc recommended for me to skip today's dose and starting tomorrow take 5mg until I test again next week.
One member suggested to take 3mg tonight (which I have done), 5mg tomorrow then go back to 6mg until I retest.

So I'm thinking that maybe if I would alternate 5mg & 6mg if that would be better decrease than taking 5mg for the next 6 days?

There is no two ways about - I have to get my levels down.
Your input would greatly be appreciated, thanks.
Me

 

[njean]

At 3.8, I would not be skipping anything except maybe a rock across a stream!

I was at 4.9 about 2 weeks ago & I just cut my dose in half for 2 nights & then went on my regular schedule the 3rd night. Checked it again in a weeks time & it was at 3.0. Perfect!

So, I don't know about you, but I don't feel comfortable with skipping tonight at all, my opinion!

 

[njean]

At 3.8, I would not be skipping anything except maybe a rock across a stream!

I was at 4.9 about 2 weeks ago & I just cut my dose in half for 2 nights & then went on my regular schedule the 3rd night. Checked it again in a weeks time & it was at 3.0. Perfect!

So, I don't know about you, but I don't feel comfortable with skipping tonight at all, my opinion!

sorry, at 4.3, I still would NOT skip tonight's dose. Just half it & do the same tomorrow & then on to your regular dose & check in a week.

 

[catwoman]

3.8 is nothing to worry about, so why did your doctor say to skip a dose then????
4.3 isn't really too bad. I've gotten those from time to time.
How much are you currently taking? Sounds like maybe 6mg???

I'd probably go for taking 1/2 dose tonight, then reducing my current dosage by maybe 10%. Do you have any 1s that you could halve to get 5.5mg?

I've been nudging my INR up by tweaking it a little, boosting it up by 1.5-2mg split over a week. I had been taking 5X4 and 5.5X3, but that didn't do it. I found that 5.5X7 didn't do it, but 6X3 + 5.5X4 does.

You may need to play along those lines. Would be easy to try -- if you had a home tester and could check weekly to see how your INR was dropping.

 

[Freddie]

Thanks Marsha & Norma, don't ask why the doc wanted me to skip at 3.8 - I didn't and continued with my 6mg until now.
- I do have 1's masha
So, I've taken 3mg for today's dose (which is half) and I could take 3mg again tomorrow.
But with this adjustment what difference will it make when I test next thursday, if I go back to my regular 6mg on Saturday?

 

[Freddie]

Just "off the wall question"
What are the chances of my liver not functioning properly? I've so stable, except for this past month and I've been more active - something just doesn't seem right.

 

[njean]

Thanks Marsha & Norma, don't ask why the doc wanted me to skip at 3.8 - I didn't and continued with my 6mg until now.
- I do have 1's masha
So, I've taken 3mg for today's dose (which is half) and I could take 3mg again tomorrow.
But with this adjustment what difference will it make when I test next thursday, if I go back to my regular 6mg on Saturday?

Well if all goes well Freddie, you'll see a drop in your INR with the adjustments on today's & tomorrow's dose. You have to go back to your normal dosage so that you can see how this adjustment worked for you. If your INR is still on the high side next Thursday when you check, then perhaps you're going to have to slip in 2 days on 5mg & then the rest of the week, 6mg.

 

[njean]

Just "off the wall question"
What are the chances of my liver not functioning properly? I've so stable, except for this past month and I've been more active - something just doesn't seem right.

Ok, I know I've been laughed at by many except for my cardio that I had for over 25 years.

In the summer months, I have always had to reduce my coumadin dosage because my activity levels rise. This goes completely againist the grain of what everyone has been told will happen when our activity levels go up. We're told that our INR will drop ---- it has NEVER dropped for me. If I don't reduce my dosage in the summer months, my INR will be sky high.

What I'm saying Freddie, is that perhaps this is what is happening to you here. Think about it......

 

[Bina]

Just to repeat my PM of this afternoon:
I agree that you may want to lower your INR a bit because I know that you have been bruising.

You were taking 6mg daily, which is 42mg per week.

To decrease by 10% would be about 4mg per week....a new total of 38 mg for this week.

So I am suggesting take 3mg tonight, 5mg Friday, then 6mg sat, sun,mon,tues,wed.
3+5+6+6+6+6+6=38mg

Then next week see where you are at and go from there.

 

[Bina]

I agree with Norma, that you may need to keep your dose a bit lower for a while.
Probably two days of 5mg.....we'll see what happens next week.
(I've lowered my own dosing one day a week by 1mg also.)

 

[Freddie]

Thanks Bina & Norma. Interesting tid-bit Norma about the increase activity level.

So, staying on 5mg until I retest is too much of a decrease....correct? (retest will be next Thursday)
I guess the only thing I can do is try Bina's theory and NOT tell the doctor the truth (OMG)

Alternating 5 and 6mg won't work?

 

[Bina]

5mg for 7 days would be 35 mg weekly....that is a 15% decrease from your previous 42mg, which may be too much.

 

[Bina]

It's a good idea to try to talk to your doc and explain that holding a dose for an INR of 4.3 really isn't warranted with no other symptoms.

 

[Freddie]

I wish I could Bina. Even though she called me on my cell, she called thehouse first and left a message saying "Your INR are dangerously high", on the cell she did mention the possibility of a Vit-K injection that a 'bleed' was very high.

I'm afraid if I try to tell her the truth she'll drop me a patient - and I've tried to find another doctor, but no one is taking new patients - so I'm stuck.

 

[njean]

Sometimes you just have to let them (the drs) think that they know everything & then just do the opposite of what they tell you!

I've done that many times!

 

[Bina]

Freddie, at least write everything down.....even what the ding dong doctor says.
Some day it may be good ammunition to prove her incompetent.

 

[Freddie]

Good idea, I'll do that right now and show it to my cardio (if he'll know anything??) on the 15th.

 

[Bina]

you can try......my cardio won't discuss any meds.....

 

[Freddie]

Okay, now some of you may think I'm looking into this too deep. But I'll try to explain my thoughts here:
Bina's method: 3+5(Fri)+6(Sat)+6(Sun)+6(Mon)+6(Tues)+6(Wed)=38mg
The 3mg would be for today (Thursday) and retest next Thursday.

Now.......if it takes 3 days for a dosage change to take effect.....the 6mg dosage will be well into my system, so therefore showing no change with the retest on Thursday. Right?

(sorry Bina) maybe I just don't get it? Perhaps I should just say screw it.
If stress causes INR to drop (so I've been told) maybe I should get my gander up for a few days LOL - or maybe have a V8 every other day - that should work

 

[ALCapshaw2]

If you're taking a Poll, I vote for Bina's proposal
3..5..6..6..6..6..6