Perkicar's INR

[perkicar]

Alright, I'm starting to get cabin fever. My INR is up to 1.3--but they won't let me leave until it's 2.0. I've had 3 doses of coumadin--5mg on Friday, 7.5 on Saturday and 10 on Sunday. I'm also on a heparain drip--and I guess my PTT is therapeutic on the heparin. So now I can maybe go home? But take Lovenox too until I get therapeutic on my INR too???? This is not being explained very well......Plus they have been little to no help identifying where I should be going to get my labs done while I'm in Circleville at my brothers.
LOL, can you tell I'm feeling a little cranky????

 

[KMB]

I bet it was all that broccoli and spinach you were eating behind all of the hospital staff's back!!

Hang in there, you will be free as a bird in no time!!

 

[ALCapshaw2]

Alright, I'm starting to get cabin fever. My INR is up to 1.3--but they won't let me leave until it's 2.0. I've had 3 doses of coumadin--5mg on Friday, 7.5 on Saturday and 10 on Sunday. I'm also on a heparain drip--and I guess my PTT is therapeutic on the heparin. So now I can maybe go home? But take Lovenox too until I get therapeutic on my INR too???? This is not being explained very well......Plus they have been little to no help identifying where I should be going to get my labs done while I'm in Circleville at my brothers.
LOL, can you tell I'm feeling a little cranky????

WHAT !!! ?

A NURSE getting a little P O'ed at the care she is receiving from the Medical Community ???

I can't believe it!

Is the same Perkicar who was all worked up and worried for weeks beforehand?

Sorry Carolyn, I just couldn't help but pull your leg a little

Concentrate on the RED LINE in your signature message, "I MADE IT" !

That's all that counts.
Everything else is just 'bumps in the road'.

Now go WALK around the floor,
do your BREATHing exercises,
and take a nice little NAP.

We wouldn't want your NURSE to list you as a NON-Compliant Patient now would we?

I didn't think so.

'AL Capshaw'

 

[Ross]

Give em Hell, I did. Didn't make any difference either.

Judging by what they've given you and if they aren't sabotaging you with ensure or boost (Hidden Vit K) then you should be in range today or tomorrow.

 

[geebee]

You have way too much energy for 6 days out of OHS

Try and be a patient patient. You really don't want to come off the heparin until your INR is above 2.0. At least they see the importance in getting the INR where it should be before you leave.

Maybe someone with a home tester will have to come see you in Columbus

I am so very happy that you are feeling well enough to be cranky.

Take care.

 

[hensylee]

an rx w/instructions to fax #s to dr should get you into any hospital lab.

Perk up, Perki - home/brother's house is just a car drive away. Give em enough trouble and they will gladly be rid of you. You already know the drill.

 

[terryj]

My husband was suppose to come home on Friday after he had his AVR in 2001. He had surgery on Tuesday. We got to stay until the following Tuesday because hin INR was coming up so slowly. I learned to give him Lovenox shots and we finally got to come home. Then after three days on the shots at home his INR went up to 5.0 and we were able to stop the shots and start getting the coumadin adjustment correct. I remember well the Cabin Fever. I had been at the hospital eight days straight with him and I was ready for my home and him in it with me.

 

[perkicar]

Inr

Inr

You guys crack me up!

Gina--thanks for the advice re: the PTT and INR--that's what the CTS (surgery) NP was saying, but Cardiology was ready to let me go to the guest house with a dose of lovenox and an INR recheck in the morning.

NEWS FLASH__tomorrow is discharge. The cardiology team doesn't want to make Dr Lytle mad ROTFL.

You're right, I do feel pretty naughty

Carolyn

 

[Karlynn]

You "sound" great. Glad you're getting sprung!

 

[Mary]

This isn't a highjack; just an associated question.

If Carolyn is being kept till they get her INR in range, then it seems to me that I should get out earlier due to having a tissue replacement.

Does that sound right?

 

[ALCapshaw2]

If Carolyn is being kept till they get her INR in range, then it seems to me that I should get out earlier due to having a tissue replacement.

Does that sound right?

MAYBE and Maybe NOT.

Even with a tissue valve I *believe* they will put you on Coumadin for several weeks (maybe 3 months?), 'just to be safe'.

SOME patients who have a fast recovery (like Carolyn's) are sent home after only 3 or 4 days, especially if they live close by the hospital. ANY post surgical 'events' and you start adding additional days to your stay. They really do like patients to be stable when discharged.

'AL Capshaw'

 

[ALCapshaw2]

You guys crack me up!

Gina--thanks for the advice re: the PTT and INR--that's what the CTS (surgery) NP was saying, but Cardiology was ready to let me go to the guest house with a dose of lovenox and an INR recheck in the morning.

NEWS FLASH__tomorrow is discharge. The cardiology team doesn't want to make Dr Lytle mad ROTFL.

Carolyn

What is ROTFL?

You said "I've had 3 doses of coumadin--5mg on Friday, 7.5 on Saturday and 10 on Sunday. I'm also on a heparain drip--and I guess my PTT is therapeutic on the heparin."

On the serious side, AL Lodwick tells us that Warfarin isn't full metabolized until 4 days have passed. SO, you were given 5 mg on Friday which will be fully metabolized Tuesday (Day of DISCHARGE), presumably after they check your INR. (my guess is you will still be below 2.0).

IF your INR is below 2.0 on Tuesday, will they give you an RX for Lovenox? When do they want you to retest your INR? With your ramping up to 7.5 mg on Saturday and 10 mg on Sunday, you won't know where your INR will settle until at least THURSDAY, assuming they level your dose off at 10 mg in the interim. Most likely you won't level off until even later.

Does Cleveland Clinic have an affiliated Coumadin Clinic? I'd be getting on the phone with the Coumadin Clinic Director or CRNP to establish a testing and dosing PLAN, preferably BEFORE DISCHARGE.

FWIW, most Coumadin Clinic Nurses / Directors seem to have a MUCH better 'feel' for managing Coumadin than most Doctors (who really don't want to be bothered following such 'mundane' maintenance procedures).

How to pass the time until Discharge?

You could go back and review the Coumadin Forum (or AntiCoagulation Forum as it is now called). That should keep you out of trouble for a while.

'AL Capshaw'

 

[Mary]

MAYBE and Maybe NOT.

Even with a tissue valve I *believe* they will put you on Coumadin for several weeks (maybe 3 months?), 'just to be safe'.

SOME patients who have a fast recovery (like Carolyn's) are sent home after only 3 or 4 days, especially if they live close by the hospital.
'AL Capshaw'

Isn't tomorrow a week to the day since Carolyn had surgery? I know she's made a fast recovery, but she says they're still holding her to get the INR regulated.
I'm hoping I won't need that; I thought Tobago was discharged with aspirin only? Maybe he'll wander through and tell us.

 

[starkone]

Mary...
FYI....I am 9 weeks post op....can't believe it! Anyway, I was discharged on Aspirin only...I had a magna tissue valve.
Hope this helps....if you are going tissue it could be the same for you. At one point they told me coumadin for a few months then changed their minds.
Go figure.
My best to you,
Karen

 

[Sherry]

Carolyn,
I'm so glad you're going home tomorrow. I remember (like it was yesterday) how difficult it was to get me to a therapeutic level. Twas maddening!! Hey, BTW, it was nice talking to you from Fermilab Saturday.

 

[starkone]

Carolyn...
Yipee, you are coming getting out! I was nervous but the bed was sooooo
much better!
Hugs,
karen

 

[Barry]

...LOL, can you tell I'm feeling a little cranky????

Cranky is good. Kept me alive, anyway - kept me from insisting on answers to my questions about side-effects of meds, kept me on top of the nursing staff to implement my post-op regimen, and the nurse who prepped me for and asked me to sign consent to a bypass when I was in for a valve is doing much better after she got out of the psychiatric hospital for treatment of post-traumatic stress disorder from my response to that.

 

[perkicar]

Update--perkicar's Inr And Temp

Update--perkicar's Inr And Temp

All right, I think I'm in to the emotional roller coaster part of my recovery. I alternate between my manic and my depressed moments. Just found out that they've ordered blood cultures on me, since I have been running low grade fevers every afternoon. My temp at 7pm was 38C. I don't have a UTI (too much information, I'm sure LOL), my white blood cell count is still 19000. So I'm feeling really sorry for myself right now And I had irrecgular heartbeats this morning two different times. Not a-fib, just irregular. But it sure felt strange!

Anyway--keep those cards and letters coming. Thank goodness I brought the computer along.

 

[CCRN]

Take another look

Take another look

All right, I think I'm in to the emotional roller coaster part of my recovery. I alternate between my manic and my depressed moments. Just found out that they've ordered blood cultures on me, since I have been running low grade fevers every afternoon. My temp at 7pm was 38C. I don't have a UTI (too much information, I'm sure LOL), my white blood cell count is still 19000. So I'm feeling really sorry for myself right now And I had irrecgular heartbeats this morning two different times. Not a-fib, just irregular. But it sure felt strange!

Anyway--keep those cards and letters coming. Thank goodness I brought the computer along.

Okay, stop acting and thinking like me.......you're scaring me. Lots of patients run a low grade fever for some time after surgery. Also, that white count is high BUT what was your count pre-op? Lab results are relative......you need to know where you live. If you usually live at about 12-15,000, it's not that big a deal. It is nice to know they are taking such good care of you. These are things to be looked into but also could be just your body healing. Lot's of OHS patients get pericarditis which causes the same symptoms. SO....just because you've had blood cultures drawn doesn't mean you automatically have a systemic infection. Everybody gets irregular heartbeats......even people that havn't had valve surgery.

You're doing great......I wish I could be as perky as you. Please don't think I'm trying to belittle you for your anxiety. I would be way further over the edge than you. I'm just hoping a different twist on these new events might bring your roller coaster ride back on a more even rail.

I'm so happy your surgery has gone so well.

 

[Phyllis]

Dear Carolyn ,
Lots of people have run low grade fevers that just seem to resolve themselves and ad-fib or irregular heart beats are not unusal either. Try not to stress- that can't help and we have faith that you will be home before you know it!