New to coumadin---over 8 at first reading

[brendamarlene]

Before I left hospital, was given 1 dose of 5mg. Told to take 5 mg the next 3 nights at the hotel before I left Alabama. On MOnday at my first official "check" it was over 8. Was given oral Vitamin K (2 1/2 pills). I was so scared, I even ate some broccoli that night. When tested again a few days later, it was 1.6.

Now I am taking 2 1/2 mg dosage. Are there usually these wild fluctuations at first?

I am still on antibiotics post surgery, and I understand those can raise your numbers.

Should I avoid those leafy green veggies til I hit the target goal, or should I just try to eat as I hope to do normally?

 

[geebee]

Yes, you can have wild fluctuations at first. They probably overreacted and gave you too much Vit K.

If you vary from your regular diet during this "start up" phase, your INR will be a mess once you go back to your old diet. You need to eat just like you normally do and your dose will be adjusted around your diet.

It sounds like they took care of it being too low very quickly. Just make sure you test weekly until in range and then go from there as directed.

Good luck - everything will fall in place soon.

 

[catwoman]

Brenda:
Your antibiotics are probably what's causing the high INR. I went on 3 days of antibiotics last week and my INR shot up to 5.5, coupled with fever and not eating well due to illness.
Once you are off antibiotics, you will have to readjust your dosage of Coumadin.

Eat whatever you would normally eat. If you would normally eat broccoli, spinach, etc., do so. Just be consistent in doing it. Dose your diet, not diet your dose, as Ross says!
Most patients are started on about 2, 2.5 mg in the hospital. (I was and others have told me they were done the same.) There is some tweaking in the early stages of being on Coumadin. Some people are able to get into range quicker than others.
When a Coumadin patient becomes more active, the INR will probably dip because the drug is being metabolized faster. Some people are extremely sensitive to the drug and can get by on very little. A friend takes 2-2.5 mg and his INR is 3.5. I have to take 6.5 to get there.

Ask your PCP or whoever is prescribing your Coumadin to give you all the freebie handouts from Bristol-Myers Squibb. I got a new supply last Monday and mailed some to a friend in California who is on Coumadin due to pulmonary emboli & a DVT.

Hope this helps some.

 

[Ross]

8 isn't anything to fear unless your bleeding from somewhere. Yes it's high, but there have been much much higher. They did overreact with the Vit k. They should have simply had you hold until back in therapeutic level while making an adjustment. What antibiotics are you on? EAT YOU GREENS! Don't fall for the nonsense that you shouldn't eat what you want.

 

[tommy]

Brenda,

It sounds like you are recoverying well from surgery. Congratulations.

My experince was that post op the INR will bounce around. The initial dose is a guess and gets refined over time.

Large dose changes and Vit K can be overreactions that exagerate the bouncing and only confuse things. They are sometimes necesary if you are way out of range, but do not help find the optimum dose. Dose changes should be very gradual.

I'm concerned with the 8.0 a week after surgery.

Just try to take it easy and be consistent with your diet. I hope that you zero in on a dose soon.

 

[brendamarlene]

Thanks, all. Of course, being new to coumadin, I guess I get a little extra worried. I will try to settle down.

The only bleeding is a huge bruise in my thigh that was hurting and had gotten bigger and bigger, but the pain has subsided. So it was difficult to walk ( & I do intend to keep walking), but is is OK now.

 

[McCln]

Brenda, just keep an eye on the bruises. If they are there for more than a week without fading, get it checked. I always keep an eye out for buises and then on how long it takes them to go away. I am always bumping into something or pinching or whatever. Just hang in there, the dosing will become easier in time. And welcome.

 

[brendamarlene]

Thank you so much for your words of encouragement, everyone

 

[Guest]

You are in the Goldilocks stage of warfarin. "That dose was too high, That dose was too low ... "

If you avoid eating normally until you reach the goal, then you will throw the warfarin off and have to be adjusted again. Eat as normally as possible and let the warfarin dose be adjusted around it.

 

[Dee]

I had a hard time getting my INR levels to even out. I was all over the place and someone in the forums told me that sometimes it takes a full year for it to even out, so to just roll with it and it will eventually get there. I was self testing every week and I never knew what it might be.

Well, almost exactly one year post op, my levels evened out and now I only have to test about every 3-4 weeks and it's always right where it should be. Don't ask me why or how at one year it just straightened itself out, but it did. I haven't had to change my dosage for about 5 mths. now. So, there is light at the end of the tunnel. Sometimes the tunnel is a little longer for some of us than others. I have heard other people say it just takes a couple of months to get it evened out. I hope that you're one of those and don't have to wait a year for it to happen.

Hang in there!!