Welcome, @KLS39 - like you, I have found the people on this site incredibly helpful since my surgery over 7 years ago. My need for the valve replacement was an emergency, and so to be honest I have done most of my research into valves after the event! But I am happy with my choice.
The therapeutic range for my valve is 2.5 to 3.5, as set by my surgeon. I aim for at least 3.0, as to me it seems there are greater risks from a low INR than from a high one. The onset of a cold can see my INR drop significantly, eg by 0.5 or 0.6, and so I would rather have a safety margin for that to happen.
I self-test at home with a CoaguChek XS, a machine that has now been replaced by a newer model, the CoaguChek INRange, also known as the CoaguChek Vantis depending on where you are in the world. They still take the same test strips as mine. Every 6 months my meter is checked at my doctor's against their own, or sometimes against a full blood raw. The difference has been my meter being up to 0.2 above their result, so again this possible discrepancy encourages me towards the "keep it over 3" approach.
I manage my own doses. I don't think I am supposed to, but as @pellicle said, we have a greater interest in our own health outcomes than a clinic, and it is not as hard to do as some people say. Once you understand that it takes about 3 days for a change of dose to be seen in your INR level and adopt a cautious approach, I mostly get it right first time now. Sometimes I take a "loading dose" - a one-off change of, say, 1 or 2mg extra if I am low, to bring my INR up if it has dipped. Testing again 3 or 4 days later reveals whether that was enough, or if a more sustained change is needed. I can, of course, seek advice from my anticoagulation clinic if the change continues and I can't stabilise myself. Colds provide a short-term dip in INR, and antibiotics an increase. If I go on holiday and drink more alcohol than usual that, and the different diet of another country, will also cause me to test more frequently and gently tweak my dose.
The therapeutic range for my valve is 2.5 to 3.5, as set by my surgeon. I aim for at least 3.0, as to me it seems there are greater risks from a low INR than from a high one. The onset of a cold can see my INR drop significantly, eg by 0.5 or 0.6, and so I would rather have a safety margin for that to happen.
I self-test at home with a CoaguChek XS, a machine that has now been replaced by a newer model, the CoaguChek INRange, also known as the CoaguChek Vantis depending on where you are in the world. They still take the same test strips as mine. Every 6 months my meter is checked at my doctor's against their own, or sometimes against a full blood raw. The difference has been my meter being up to 0.2 above their result, so again this possible discrepancy encourages me towards the "keep it over 3" approach.
I manage my own doses. I don't think I am supposed to, but as @pellicle said, we have a greater interest in our own health outcomes than a clinic, and it is not as hard to do as some people say. Once you understand that it takes about 3 days for a change of dose to be seen in your INR level and adopt a cautious approach, I mostly get it right first time now. Sometimes I take a "loading dose" - a one-off change of, say, 1 or 2mg extra if I am low, to bring my INR up if it has dipped. Testing again 3 or 4 days later reveals whether that was enough, or if a more sustained change is needed. I can, of course, seek advice from my anticoagulation clinic if the change continues and I can't stabilise myself. Colds provide a short-term dip in INR, and antibiotics an increase. If I go on holiday and drink more alcohol than usual that, and the different diet of another country, will also cause me to test more frequently and gently tweak my dose.
