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Hi Fische
For awhile my range was 3.5 to 4.0. Now I take Sintrom, not warfarin, and my range is 3.0 to 3.5.
AND
I eat "greens" containing Vit. K every day and dose the diet I take.
When a dose adjustment is necessary the amount is "tweaked" and maybe "tweaked" again a week later.
I sincerely hope you are able to get your own monitor because when you do your learning curve about INR management will accelerate. There's something about testing oneself that is very learning oriented.
Good luck!
 
Just a thought but what would happen if you left after your weekly INR check, they scheduled you for seven days later but you called and said you had to cancel and make the appointment for what would be ten days later..... that ONLY being if you feel secure about waiting a few more days. You can try to manipulate them onto ten days between by being 'unavailable' to come on the date they demand. In time, you can work them to the two weeks you feel more appropriate. It is your body, your health and you are not a robot. A patient has a right to a little control over their own care. IMO
 
I know exactly how you feel! I go once a month and I'm always all over the place.. either too low or a couple weeks ago 4.4 with a severe headache.. I'm so frustrated..

I asked my cardiologist to write me a prescription for a home machine (again) and need to look up again where to begin to order one and which is best, etc.. I'm thinking maybe if I do it myself I can regulate it better..

even if I'm off the charts, they just adjust my one day dose and say "See you back next month".. so I'm there with you on the frustration! :mad2:
 
By the way, I meant to add that I know the more I exercise, the faster my body metabolizes coumadin and I believe this is some of what is happening right now. I was hard core for 3 weeks, then stopped cold turkey for 2 because of some personal things that came up.. I'm just thinking a home machine would help!
 
I understand your frustration. Maybe it's time to look into a different Coum Clinic. I was having a heck of a time with my clinic, I am hanging on for the 3 month mark so I can home test myself. I was in search of going to a different clinic for a bit there. Just got off the Lovanox stomach shots and am in range for the first time. No thanks to the clinic I was at.
 
I feel alot better hearing all your ideas and thoughts.. I always consider changing .. I have had tons of issues w/ the office since last year .. I just switched to a new cardio in the same practice who I like and my coumadin clinic is the same place. I also get my pacemaker checked. I live in Buffalo, NY and there are alot of cardiologists but in researching switching to a whole new office I couldn't find one that one stop for all things.. Maybe I should just see if I can get my own meter.. they are supposedly working on it with PhilipsINR .. we will see .. but the girl I spoke to on Wed said that my insurance can be difficult
JKM7 I always think about doing that but chicken out..
 
I understand your frustration. Maybe it's time to look into a different Coum Clinic. I was having a heck of a time with my clinic, I am hanging on for the 3 month mark so I can home test myself. I was in search of going to a different clinic for a bit there. Just got off the Lovanox stomach shots and am in range for the first time. No thanks to the clinic I was at.
Lovenox won't get you into range. All it does is afford some protection until you are in range.
 
Bina is right, the clinic does not know what they are doing.

My range is 2.0 to 3.0 but 1.8 reading did not lead to a dose change & it was up the next week.

I would try for a second opinion.
 
Fischje:
Who is your insurance carrier?
You have several factors in your favor.
1. You have TWO mechanical valves.
2. You have had TWO double-valve replacement surgeries.
3. You are a chronic warfarin patient (meaning indefinitely).
If your insurance policy provides DME, it should allow for a home monitor. If I had a double-valve replacement, I would fight tooth-and-nail for my own tester. I would also get my doctor to specify that I am to test every 7-10 days because of the two valves. (Perhaps this is overdoing it, but it should get an insurance company flunkie's attention.)
The two valves is something to impress upon no-nothings at an insurance company.
 
That would be super frustrating, sorry you're going through that. I do hope you get your home monitor - I agree that it will help a lot! One other thing I've learned is to keep your dosing more consistent... like I take 5.5 every day not an alternating 7.5 and 5 or anything like that. Like everyone else said, the higher dose when they go in to adjust it actually throws off the INR. Sometimes I'll do my own dosing and see how it goes, and hopefully as you move forward you feel comfortable enough to do that as well... with the ease of a home monitor when you get it, you can check it yourself weekly and see how it's working out.

I'm also in the 2.5-3.5 range, but I know they also want me to be in the upper range, but they don't panic or change my dose if I'm at the lower end or even slightly lower than 2.5.

Good luck and keep us posted on how things go!
Kerri
 
My insurance is Independent Health which is a local provider-- my insurance is Self- Funded through my company so its actually my company that creates the plan.. I plan on stating all those factors though if I have any issues..
As time has gone by I do feel like I know better then my clinic .. I have been on coumadin for a year and a half now .. Does everyone get this question if out of range.. " Any changes this week?" I hate it.. Yes things change I am not a robot.. and I get every week

I will definitely keep everyone in loop once I find anything out..
 
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