Need to vent

[fischje]

Okay I hope u don't mind but I need to vent.. So I realized that there has been 31 weeks this year and I have had my INR tested 24 times.. Yes 24 times.. I have a range of 3.00 to 3.50 so kinda narrow .. also I am a 35 year old woman ..I really really try to be consitent w/ Vitamin K and alochol.. I don't know what I am doing wrong.. My BF is pharamist and I consult her .. My range really has been really low or really high about four or five times.. My coumadin clinic insists u have three in range before taking a week off.. at this point I hate them.. I DON"T KNOW WHAT TO DO.. it's a constant reminder I am not normal

 

[Protimenow]

Hey, don't feel too bad. I test EVERY WEEK. I have enough strips, and my own machine. Is your clinic using a machine, is it taking blood and sending it out? If it's just a simple finger stick, it shouldn't bother you that you've been tested 24 times this year. FWIW -- I had a strange drop in INR last month, and probably tested 40 times so far this year.

I'm surprised by how narrow your range is -- but I'm guessing that 3.0-3.5 is pretty difficult to stay inside of -- especially considering the fact that meters AND LABS have a variance of .2 or so -- which means that, even if you're 'out of range', you may actually be 'in range' when the inherent testing errors are factored in.
(Even with two mechanical valves, I'd wonder if that's really the range the doctors want you to maintain -- you may just want to reconfirm with your doctors that this small range is really what they're expecting you to maintain).

I wouldn't obsess about small voyages out of your range -- especially being a bit below.

 

[Freddie]

uhmmm, who gave you such a narrow range? I believe the normal range is 2.5 - 3.5 or maybe 3.0 - 4.0.

Maybe.....your trying to hard to be consistent or there's something your having has lots of hidden vit k in it.

I would first try to get a real good answer from someone on why you were given such a narrow range.

 

[RobThatsMe]

+1 Freddie,

I was gona ask the same question, "Freddie Quote - uhmmm, who gave you such a narrow range?

Rob

 

[fischje]

My surgeon at Strong gave me this range and then asked my cardio at Strong if it was possible to change and he said no. Same w/ my cardio here in Buffalo.. they said because of it being double valve and I think my age.. I don't get it.. all the research and feedback from others say it is pretty unusual..
As for Vitamin K I just have one serving of broccoli or spinach a week, one sald usually iceberg, and an occasional sandwich w/ lettuce
The last few weeks I have been trying not to drink or eat Vitakin K three days prior to being tested.. It is has worked a little bit 3.8, 3.1, 2.8
My dosage is usually 7 six days a week and 8 one day..
My clinic uses a machine and I am now trying to get my own
The nurses are not being sympathic..especially one today

 

[Protimenow]

If you're taking 7 on six days and 8 on the seventh, you'll have a variation in your readings depending on what day you get your blood tested (because your INR will be lower as a result of the 8 mg dose than it is after 7 mg - but it usually won't show up for 3 or 4 days AFTER a dose). If you CAN, you SHOULD get a meter -- and you might remind the nurses and doctor that your INR will change from day to day because your dose of warfarin isn't consistent.

It's been 6 months since your surgery -- the risk is greatest during the first three months (according to some of the literature) -- perhaps you can convince the doctor to broaden your range - or find another doctor -- and you should know that there WILL be variations in your INR. Unless you test with the same meter every time, take the same dosage every day, eat the same foods, and have the same activity - you'll have some variation in your INRs. You COULD do this - but life will become AWFULLY boring.

 

[fischje]

They vary my dosage every week depending on my INR. This week I tested 2.8 yesterday so now I took 8 mg yesterday and 7 rest .. They change it all the time unless I am in range
I am in the process of trying to getting a meter -- It has been 1 1/2 yrs since my surgery-- I was just talking about this year..
I tried to get my cardio to change --he wouldn't --I just switched so not sure if I want to switch again
The clinic just isn't very sympathic

 

[drivetopless]

are you taking a multivitamin daily with a small amout of Vit K in it? Once I started doing this my numbers got a lot more consistent.
It seems like you are not having many vegetables. I try to have 4 servings a day (about 1 cup/serving) of a variety of veggies. That seems to help too.

I also learned that if you eat low fat your INR will go up. So, if you have a varying amount of fat/oil in your diet it could mess with your INR numbers.

The trick is to be very consistent, but I do think avoiding Vit K makes your INR flunctuate more. At least that was my experience.

 

[fischje]

Right now I take a multi vitamin w/o Vit K.. maybe I should change??
I eat other veggies .. I was just talking about high Vit K items-- I eat all other types daily
Just seems complicated to me
Thanks for the info though

 

[Bina]

Right now I take a multi vitamin w/o Vit K.. maybe I should change??
I eat other veggies .. I was just talking about high Vit K items-- I eat all other types daily
Just seems complicated to me
Thanks for the info though

It's really not complicated at all....the problem is that your clinic is over reacting to your readings.
An INR of 2.8 can be left alone, no dose change needed, and test again after a week.
As long as they keep micro managing and fiddling with your dosing your readings will bounce. It's a shame that they
have gotten you nervous and scared in the process.
My dose is the same all year long and my readings can be 3.3 or 2.9 or 3.8 or 3.5 (it's all good).
Oh, I also eat broccoli and salad, nuts and seeds (natural oils) a few times a week.

 

[fischje]

Yes they change my dosage every week if I am not in my range ( 3 to 3.5) which is narrow.. Every week I am afraid/ nervous before I get tested and this week the nurse made me feel like I was doing something wrong..

 

[Bina]

Yes they change my dosage every week if I am not in my range ( 3 to 3.5) which is narrow.. Every week I am afraid/ nervous before I get tested and this week the nurse made me feel like I was doing something wrong..

Ask that nurse if she wants a smack in the head !!!

 

[crawal]

I am a 40 yr old female and am having the same issues. My inr is all over (from 1.3 to 3.1)
My range is 2-3. I am on 15mg daily and still bounce around with my inr.
I am also a vegetarian too....which accounts for the higher coumadin dose.
But I know how frustrating it can be!
hang in there .......you're not alone!
Amy

 

[piglet]

Ask that nurse if she wants a smack in the head !!!

NO KIDDING! give her a smack from me too! Some people's kids are soooo annoying!

 

[fischje]

Thanks for the support .. I really appreciate it.. I am glad I am not alone.. My INR is usually just +/- .2 or. 3 .. I haven't been under 2.0 since right after my surgery..
I am hoping to get my own meter soon..
but they would still dose me

 

[Bina]

IF your readings are indeed +/- .2 or .3 you can probably do a better job of dosing yourself. Chin up in the meantime

 

[Jkm7]

They have every incentive to have you in once a week and that is probably a financial benefit to them.

Just a thought but have you checked for hidden soy in your diet? That can tamper with INR.
I feel so bad to read this. These nurses are just trying to make you prove them right. With such a tight range, it's very difficult. You need a really good conversation with your cardio or PC doctor. It's awful how stressful they are making this for you when many seem to have a more modern view. Of course, we can't second guess about anyone and we must either listen to our doctors or get a new one.

 

[Greg a]

Yes they change my dosage every week ..........QUOTE]

They have every incentive to have you in once a week and that is probably a financial benefit to them.

.........

JOB justification running rampant

 

[catwoman]

My range is 2.5-3.5 but my cardio wants it to be at the higher end.
So, to some, that would sound like a range of 3.0-3.5.
I wonder if that's what your cardio had in mind?
The more narrow the range, the more difficult it is to achieve the goal.

 

[Protimenow]

FWIW -- when you have your own meter, and report your INRs to the nurses(?), they can think that they're making micro-adjustments. These constant changes can cause your INR to bounce around. If it were me, I'd probably hold off on what these nurses (who have proven that they don't really know about managing INR) and follow a dosing schedule (or not) that should keep things pretty consistent. I make very few changes to my dosing, unless I see a trend developing (and make minor changes) or hit a bump like I did last month (a 1.1) and make somewhat more aggressive changes until I'm back in range.

You may be better off managing your own dose -- and testing on the same day each week.