Nurse suggests a glass of wine to raise my INR?

[RobNDenver]

I have been holding very steady between 2.5 and 2.9 until this month's draw. Today I was at 2.16. I have been taking 4mg on odd days and 5mg on evendays of Warfarin with these results -

10/09 2.68
10/13 2.6
10/27 2.5
11/12 2.96
12/17 2.16

My cardiologist's nurse called me today and told me that I should have a glass of wine each evening to thin my blood, but that I don't need to make any changes in my dosing and don't need to have another blood test for a month.

I don't want to get sideways with her, because we are going to have a long term relationship and I see my cardiologist on Monday 12/22. I stopped drinking when I had my surgery and don't really want to start again.

Also, I am doing WeightWatchers and have lost 3 pounds since Thanksgiving. I am exercising a little less than I had been, because it has been really cold and snowy, so I don't walk as much as had been before the weather turned cold a week or so ago.

Thoughts and suggestions would be much appreciated.

 

[lb151]

If you dont want to drink,,dont..I understand the relationship between you and the nurse. I have a nurse and at times I suggest an increase or maybe something different to her and then ask,"what are your thoughts on that" I know you want smooth sailing,but,this is your body we are talking about. I will leave the dosage increase to the ones more knowledgable,but sounds like thats exactly what is needed and quickly. I would want to be tested every 2 weeks if possible till you get in the zone.

 

[Ross]

I'd say your nurse doesn't know too much about Coumadin. Don't drink wine if you don't want too. Yeah the health officials say a glass of wine a day is good for you, but no need to start drinking just to support their philosophy.

Personally, I wouldn't change your dose either, but I'd test in another week to see if it's still that low. If it is, then increase the dose by 10% over the week and retest in another week.

Where do they get this .68, .96, .16 crap? It's 2.7, 3.0, and 2.1.

 

[Ross]

My cardiologist's nurse called me today and told me that I should have a glass of wine each evening to thin my blood.

Ask her to change your blood to 5W30 and change your filter while your at it. When are they going to stop using "Thin" as a term? It's an anticoagulant, not a "thinner". The viscosity of your blood doesn't change.

 

[Bina]

I agree with Lou and Ross.....don't drink for the sake of your INR....that is useless.
A better suggestion would have been to increase your exercise and test again in one week to see if there is a downward trend.

We find it much easier to base our doses on the weekly total.
I have a 7 day pill box......Monday and Friday I take 2 mg, the other days I take 3 mg.
This is the most simple way to keep track of doses and make adjustments.
If my INR would need a small adjustment, all I have to do is swap a pill in the box.

 

[ALCapshaw2]

I agree with Ross about the 3 digit INR numbers.

The last digit is Totally Meaningless and the second digit has a moderate variance.

That said, you last reading raises the questions of
What could have caused your INR to Drop?... and...
Could that be an Erroneous Reading?

Either way, I would want to be retested NO Later than 2 weeks and maybe even in 1 week. Ask your Cardiologist for his recommendation during your Dec 22 appointment.

If you like his answer, ask him to instruct the Nurse per his recommendation.

'AL Capshaw'

 

[Karlynn]

I wish a glass of wine was the only thing needed to raise a lower INR. Don't know why she just doesn't have you bump the dose a bit. I'd go 5% and see what happens.

 

[lb151]

"When are they going to stop using "Thin" as a term? It's an anticoagulant, not a "thinner"."

Because that is exactly how many of them think this works. More than one nurse has told me this. Sometimes I go through the spill and correct them,,when I'm tired I just nod my head.

 

[catwoman]

Don't understand what the nurse says and your subject line: She says to drink a glass of wine a night to "thin" your blood, but you're wanting to increase your INR. Those are opposites.

It's difficult to say what a glass of wine would do over the long haul to your INR. I believe that Coumadin's manufacturer says alcohol can both lower and increase the INR.

You would need to figure a glass of wine a day into your WeightWatcher points, if you're on the Flex plan. A 4-ounce glass of wine is 2 points. If I was trying to lose weight, I'd rather spend those 2 points each day on something with more substance and that will satisfy your hunger more, such as fruit. Of course, you could go into your weekly points allowance for those 2 points per glass. Wine is alcohol, which is empty calories (no nutrients).

I would ask your cardiologist's nurse to increase your dosage.

 

[ALCapshaw2]

UH Marsha, I believe that the (admittedly inappropriate) use of "thinning the blood" is used to indicate that there is less chance of clotting which corresponds to a HIGHER INR.

Bottom Line: (so called) "Thin Blood" = Higher INR

and (so called) "Thick Blood" = greater chance of clotting = Lower INR

I second your recommendation to ask the Nurse to increase the Coumadin/Warfarin anticoagulation dosage.

 

[Herb M]

Drink 4 ounces of pure pomegranit juice every day and you will raise your INR. The juice has anticoagulation properties. I drink it every day and it has raised my INR. I was at 2.3 and now am at 3.48. The juice also has many other beneficial properties.

 

[Ross]

Bottom line, everything can be adjusted for, but don't start drinking wine unless you want too.

 

[catwoman]

UH Marsha, I believe that the (admittedly inappropriate) use of "thinning the blood" is used to indicate that there is less chance of clotting which corresponds to a HIGHER INR.

Bottom Line: (so called) "Thin Blood" = Higher INR

and (so called) "Thick Blood" = greater chance of clotting = Lower INR

Duh... Chalk it up to moving desks and work operation from 2 blocks away amid an annual Christmas project I was in charge of...

But ... I still can't understand why someone who oversees anticoagulation therapy would say to drink a glass of wine to raise your INR...... Does not compute.
(And what if you are a friend of Bill W.??? i.e., a member of A.A.?)

 

[Nancy]

To me, it sounds like a very inappropriate and unprofessional suggestion.

One home health nurse who was taking care of Joe after he had a major bleedout thanks to having his liver nicked during gallbladder surgery, suggested that Joe have a glass of wine every day to build him up.

Unfortunately, Joe had developed cardiac cirrhosis from ascites scarring, and also was on a medication for his PH which compromised his liver function.

So he had to be extremely careful with alcohol.

I wanted to tell that nurse off so badly. But it would have upset Joe, so I didn't. But he never came back. I did tell him about the medical problems that made it a terrible idea though.

People just don't think sometimes.

 

[RobNDenver]

Well I haven't started on the wine therapy, but I may have a glass of pomegranate juice, DW has some of that in the fridge right now. Since I have a standing order for PT/INR testing at the lab, whenever I choose to go, I think that I will have one first thing in the morning on the 22nd, then see the the doc later on . . . I have pretty much decided that I will drive myself crazy if I try to adjust my INR by eating this or avoiding that. . .

If I add .5 mg to my doses on the 4mg days and that would represent a 5% nudge like Al suggests. I think I would rather get my INR up, with a slight increase than have it below the therapeutic range, so that is what I intend to do.

And THANKS you all are the BEST!!! Except for Ross, who wants me to get an oil change. . .

 

[Ross]

Rob never try to control INR by what you eat. Just eat and then adjust the dose to accommodate that diet. Once you have everything in place, it'll be fine. Personally, I think the 2.1 was a bogus result.

 

[Bina]

Rob, you may find that you only need to increase your 4mg dose on 2 or 3 days for this week.
Then test, and see where you stand.

 

[RobNDenver]

I am following up on the advice I got from this post. Last night I took 4.5mg of warfarin, tonight I will do my usual 5 and Sunday night I will do 4.5 again. I will have my blood drawn at about 8 or so Monday so that the results will be in the doctor's file when I see him in the pm. . . that should tell us what we need to do. . . I have decided that I am not going to mention the "take a glass of wine it will thin your blood" comment. I think I just want to avoid the drama that might result.

I will let everyone know what I learn on Monday . . .

 

[Ross]

If your higher then 4, don't let them tell you to skip 3 doses!!!! Let us know what the number is and we'll figure it out from there.