numbers jumping around !

[coach]

well 6 weeks after avr. and my warfin has been as high as 5.5 and then for a week 2.9 great ! i was taking 2.5mg at that time . was starting to feel better and getting around more and then 1.8 for a week then she had me take a extra 2.5 for one day ,and checked 4 days later ( today ) it is at 1.75 . diet is the same but i am doing much more. could this be the reason for these #s. i have a on-x valve . she has told me i need to be around 2.9 ? im with kiaser and they out source this program ! HELP ! is this a big problem or do not worry and stay the course ! what should i look for in a good adviser. do not mind going in ,it only takes 10 min. and i can find results online that day . but 2 viles of blood everytime ! wow, my arm has been beaten ! can i get some feed back on my little prob. you folks have life savers as i went through this all , thank you !

 

[catwoman]

Coach:

Yes, as your activity level increases, your INR will probably decrease since warfarin is metabolized in the kidney and the more times your blood goes through your kidneys, more of the drug are removed from your blood stream. That's about the easiest way to explain it.

Therefore, all things considered, couch potatoes will probably require less warfarin daily than those who are active. For example, if Lance Armstrong were on warfarin, he would probably need more than someone whose only major exercise is going to a Walmart Superstore once a week.

It may take some time before your INRs stabilize because of this.

It's easier to stay in range if you have a larger range, rather than trying to hover around 2.9. My range is 2.5 - 3.5. I don't mind if it gets up to 4.0, and my cardiologist has suggested trying for 3.0-3.5. That's where it's generally been for a couple of months, taking 6mg X 3 + 5.5mg X 4.

 

[ALCapshaw2]

TWO Viles of Blood for an INR Test? GOOD GRIEF !

Find a REAL AntiCoagulation Clinic, preferably one that uses Finger Stick Testers (or have one of your Doctors prescribe a Home Test Instrument and learn how to test and dose yourself).

As you become more active, your INR will drop so you will need to increase your Dose of Coumadin / Warfarin accordingly.

The Best $5 you can spend on INR Management is to buy AL Lodwick's Dosing Guide through his website at www.warfarinfo.com While there, browse through his topic list and read the ones that seem to catch your attention.

'AL Capshaw'

 

[catwoman]

what should i look for in a good adviser. do not mind going in ,it only takes 10 min. and i can find results online that day . but 2 viles of blood everytime ! wow, my arm has been beaten !

Coach:

Where are you going for your INR tests?
My first two tests post-op were at my cardiologist's office. It is a huge practice -- about 20+ cardios and surgeons -- and has a Coumadin clinic, with an RN who runs the tests (CoaguChek) and advises patients on dosage changes. On my first visit there, she said, "Tell me about yourself -- your hobbies, your activity levels and your eating habits." I didn't understand it then, but I do now. She was wanting to get to know me so she could understand any ups or downs in INRs due to activity levels and any dietary habits.

Because I live two counties over from that doctor's office, I switched my management to my own family doctor. He's also in a fairly large practice setting that has a CoaguChek. I had my INRs there for about 4 months, then got my own INR tester.

The POC (point of care -- CoaguChek, INRatio machines) is the best way to go, far better than getting your INR results e-mailed to you, because you are able to talk to someone IMMEDIATELY before you leave the office about any dosage changes. If you'll watch the Discovery Health program on Anticoagulation Care Management, you'll see why the POC system is best. The health care professional knows that the patient has gotten the results, you can ask questions immediately, etc., without playing telephone or e-mail tag.

I was lucky that my PCP is knowledgeable about anticoagulation therapy management and that I don't have to defer to someone else. My PCP handles my entire health picture, so he's able to advise when/if I need to go on another Rx whether it will possibly affect my INR.

 

[dick0236]

I agree with Al, why two viles? I don't know your size, metabolisim or activity level, but 2.5mg is pretty low. As you increase your activities, your need for additional warfarin should also increase. I also agree that I would find someone to do "finger sticks"......look at home testing after you become comfortable that INR management is not rocket science.

 

[coach]

#s jumping around

#s jumping around

thaneks for the feed back , my health care folks , farm out this service to a outside source. she got back to me today and ask me to take a extra half of pill 3 times a week . that would be 3.2 mgs on thurs,sat ,and mon . and 2.5 rest of week . after taking advice and going to a few web sites and get ed. i found that her advice last week to only take a half of 2.5 pill after tests came back at 1.7 alittle week on her side . i really need to be doing this myself . i spent 2 years learning the surgery i had and picked my own valve , should have spent some time on this thread ! i will learn fast ! thanks for all the help , it has been great and im studying all advice. God bless u all .

 

[KristyW]

I agree with Al, why two viles?

With Kaiser (you have to go there or it's not paid) they only do venous draws (at least in my experience). I asked why no Point of Service machines and the response was "too expensive to furnish every clinic & to have an ACT manager on site. Kaiser uses a centralized "call center" for their ACT managers.

It works this way.

1. Go to lab
2. Have draw...first small vial is dropped into the infectious waste container. The second vial is filled and sent to the centralized processing lab.
3. If you get there early enough in the day, you'll have results that afternoon, otherwise it's tomorrow.
4. IF you are even a bit out of range, they want to adjust you and have you come back in 4 days (even if you'd been taking 5x 4 days a week & 7.5 3 days a week and they flip flop you 7.5x4 & 5x3). Heck 4 days isn't even enough to register that small of a change.

That's been my experience with Kaiser