Now What Do I do?

[Lorraine]

Hi Everyone,

Not sure what to do. I came home last night and took my 7.5 mg dose at about 7:15pm. I woke up about 2:30am to go to the washroom, and the next thing I know I had taken my Friday dose of 7.5 mg at 2:30am. Guess I was sleep walking?

Don't have a home machine so I don't even know what my present INR is. Last time I was tested was Oct 9th and I was at 2.6. Low for me with two mechanicals. I believe I've been higher the past week because I started bruising again. For sure I won't take Coumadin tonight. I will call cardio but right now I'm worried that i could get internal bleeding from taking the two doses so close together. Any thoughts?

 

[Ross]

I doubt you'll bleed but you'll certainly want to check and see what they want you to do. I'm thinking hold half dose or one whole dose and then resume, but without knowing where your INR is at this moment, I'd rather not guess.

 

[tommy]

Lorraine,

What did the cardio say?
Let us know how you are doing.

 

[Lorraine]

Thanks Ross and Tom for your input. I've missed taken a dose a few times, but I never took a double dose. I was only worried about the possiblity of bleeding since I don't know what my present INR is. I fgured holding the dose would be the thing to do too. Here's what happen when I called cardio office.

I called the cardio nurse and she told me not to take another dose today. DUH! I knew that. Then she said just to resume my normal dosage tomorrow.

I ended up telling her that I think it would be wise if I came in and had my INR taken. I mean I hadn't been tested since the day the reunion began and as I said earlier, I had been having a lot of bruising this past week. So the nurse set me up for a appt at 2:30pm today. I'll let you know what my reading is. Hope its not too high, then I will be worried. I know the double dose I took in less then 7 hours, won't show up in my INR reading yet, but at least I'll know where I'm at today. Guess if it is high,I can have my beloved cilantro and avocadoes mexican salad this weekend.

 

[Ross]

Lorraine reinforce to them that you took 2 doses less then 12 hours apart. I think you should hold tomorrows dose pending the outcome of your INR check. It's Friday and it doesn't sound like that nurse was paying attention to what you were telling her.

 

[Georgia]

V-8

V-8

Good luck. I'm thinking spinach and broccoli, too. I'd like to know what happens, too. I'm sure we all have brain burps.

Hope all is OK, Lorraine.

 

[hensylee]

Lorraine that's scary. With tongue in cheek, I say - looks like you'll be everybody's experiment!

Anxious to hear when all is well.

 

[Perrster]

Nice Going!

Nice Going!

Way to go, you putz!!! Just couldn't stay away from the vampire bats on their day, could you?

Will stay tuned because as Hensylee said, you are the experiment of the day!

Hope you're ok!?

Yours truly,

 

[Guest]

Don't forget that it takes about 3 days before you see the full effect of a warfarin dose so racing to the doctor is not all that significant.

If you want to place a bet, then bet on nothing happening.

 

[Lorraine]

Well, just got back from the cardio. INR was 2.0. The nurse took it twice in fact. Not that she thought that what I did at 2:00am would be reflected in this reading. She just couldn't believe that I was so low and that by mistakingly taken that extra dose, I probably helped myself. I told her I that a few of my sisters and I are pyshic! Maybe sub conciously my brain did decide I needed an extra dose, even though at 2:30am I didn't know what my INR was. I also didn't conciously take the extra dose. I swear I was still sleeping, until I saw my 7 day container in my hand and the glass of water in the other. It was then that I looked in the container and realized I had just taken the second dose of my Coumadin, 7 hours apart. So if I wouldn't have gone in for a test today, I wouldn't have known what my INR was. Makes me glad i went. The only reason I wanted to go,, like I said, wasn't because I expected them to see the result of what I just did. It was more because i hadn't been tested in a few weeks and we had the reunion and all the different foods we were eating. Plus I had been very busy the following two weeks and eating out too.


Of course they want to see me Monday, yet again to see what my INR is. The one nurse told me she thought I should take my regular dose tonight and have a few beers! I told the other nurse if I took any Coumadin, I would only take 5mg. Between yesterday and today that would make 10mg a day. I do take 10 mg every Sunday, also. Here I was concerned about bleeding internally and in reality I was closer to possibly clotting. Strange, huh?

Yeah, Perry, guess I just wanted to see the vampires. Luckily they just prick my finger. Woulda hated to be stuck with a needle twice.

Roos, yes I did make them understand when and how much of the doses I took.

Georgia, I guess spinach, cilantro and avocadoes are out unless I spike on Monday.

Anne, now that I at least know what my INR level is, i feel somewhat better. Monday will tell if I jumped up in INR.

Al, you are probably right. I'll probably be fine. Not sure if I should follow nurses order to take my nornmal 7.5mg tonight or go with my own instinct of 5.0mg or just hold and wait and see what happens when i go for my test Monday. 2.0 INR scares me more than a 4.0 or 5.0 INR. I'll keep you posted.

 

[Ross]

I think 5mg tomorrow would be alright, but I certainly wouldn't take any tonight. Someone correct me if I'm wrong, but 2 regular doses in one day, even if current INR is low, should result in a small spike on the test Monday.

I'm not a Doctor so you know how the rest of this goes.

 

[Guest]

If someone comes to my clinic and they are more than 0.3 units low, I usually have them take an extra dose that day. So I think a double dose today would not hurt. Then I have them resume their regular dose the next day. Remember that you are unlikely to bleed if your INR is below 5.

 

[Lorraine]

Well went for my INR today. It was 3.3 I had decided to go ahead and take 5 mg Friday evening. The cardio nurse had said to take my usual dose of 7.5mg. I thought that was a bit too much, after taking 15mg within 7 hours between Thursday night and early Friday morning. Now she just said that because what my INR was Friday. I figured 5mg more would average it out to 10mg a day. Took my 7.5 on Saturday and my usual 10mg SUnday. So I'm back in range. Going back in three weeks for another INR.

So I guess as Al had said, there probably wouldn't be a problem. I just freaked though since I didn't have a home machine so I could test what I was on Friday. I do believe I'm metabolizing the Coumadin more quickly lately and I know I've been pretty busy. The next two months are going to be just as busy. So we'll see where I'm at in three weeks. I'm happy it did go up some. Was so afraid I was going to end up with an INR of 6.0 or something today. Glad I didn't. So just wanted to let everyone know where I stood. Thanks for your comments

 

[Ross]

Told you that you wouldn't explode! I bet if you'd taken the 7.5 you'd've been slightly over range though.

 

[Granbonny]

Al

Al

Can you explain the 0.3 units low?? Like if I am suppose to be between 2.5-3.5..what would 0.3 units low be at? Bonnie

 

[Guest]

If you range is 2.5 to 3.5 then anything 2.2 or below would be 0.3 units or more low.

2.5 -0.3 = 2.2

 

[Rain]

Now we know who our vr.com pyshic is!!

Now we know who our vr.com pyshic is!!

I'm sure glad to hear your INR is okay! How scary!

 

[Granbonny]

Thanks Al

Thanks Al

So, if I hold my dosage 3 days before my dental work on the 17th(Which now I have 3 Cardiologist to tell me it would be fine. (including having a private e-mail from our new member. Dr. Khan.Cardiologist)..He is basing it on the fact that I have an aorta valve..(mech) and no previous heart problems and my INR is in range, ect.....that if my INR is below 2.2 after my dental work..I can take 2 doses the next day? (Have my own protime)...and resume normal dosages the following day...Thanks for being here for us...Bonnie

 

[fyrfytr]

Hey Lorraine,
Glad to hear everything is OK.
Take Care

Dave
__________________________
Surgery: 4/21/03
Aortic Aneurysm Repair
AVR, with a St. Jude Mechanical