Please tell me I am doing this right..

[jenebug]

If anyone recalls, my last post was re my conversation with cardiologist about "dosing the diet". Sooooo, after INR on Thursday (was WNL) I had normal diet Friday, then Saturday we had company for dinner. I had 1/2 high K greens, 1/2 c. salad. On Sunday I also had 1/2 c. high K greens.
My normal dose would have been to take 1/2 of 5 mg coumadin on Sat, but I took 5 mg, since I knew I would be eating another high on Sun. After that, I returned to regular dose- in other words, I've had 3 high K's this week, when I've normally been only having 2 servings(Yeah, it was a pain) and I've just taken 1/2 more of the dose on one day. I just might eat a high K tomorrow also! Thoughts please..

 

[Lynlw]

If anyone recalls, my last post was re my conversation with cardiologist about "dosing the diet". Sooooo, after INR on Thursday (was WNL) I had normal diet Friday, then Saturday we had company for dinner. I had 1/2 high K greens, 1/2 c. salad. On Sunday I also had 1/2 c. high K greens.
My normal dose would have been to take 1/2 of 5 mg coumadin on Sat, but I took 5 mg, since I knew I would be eating another high on Sun. After that, I returned to regular dose- in other words, I've had 3 high K's this week, when I've normally been only having 2 servings(Yeah, it was a pain) and I've just taken 1/2 more of the dose on one day. I just might eat a high K tomorrow also! Thoughts please..

I was a little confused on your last post when I read
" He said it is not rocket science, and I know when I have probably had too much vit K, to take a whole tab instead of the half, etc. We had a really long talk about it. I felt so much better when I left. He of course stressed consistency, which I had already heard"

But thought I was reading wrong, But FWIW I'm not quite sure that is usually what is meant by "dose the diet not diet the dose" which usually just means eat likely you normally would not worry about the amount of vit k and then when you have your next blood test, go from there, if your INR is low take more Coumadin until you get to the point you are in range, then you continue to eat as your normally do. Of course things will probably need tweaked as you recover and get back to living your life and eating like you normally do. but hopefully that way since your dose was based on your normal diet you'll be in range for the most part.


I'm not sure what your INR was thursday by WNL but the amount of Coumadin you take until your next test should be determined by that INR and not change depending on what you ate that day. So If Thurs INR was wit in range, I wouldnt change anything, if it was low then your weekly dose would be a higher depending how low it was and see how that was when you had your next INR done. If Thurs INR was too high then the dose would be lower.

I dont think Im describing this well, but it seems what you are describing is alot of work and it wll be hard to find out what your normal dose would be. It might help to think weekly not daily,

 

[jenebug]

I was thinking that if it takes 3 days for the coumadin to effect the INR, that taking more once, might help keep it within range 3 days from now(?) I am so new to this and have a lot to learn. I do understand what you mean by looking it on a weekly basis, I guess I just hate to see them freak out when I go in and it's too high or low, like they've been doing. Time will tell. Thanks so much for the input, and I certainly welcome all info.

 

[dick0236]

I agree with Lyn. I would not try to guess, ahead of time, what MIGHT happen to my INR if I ate/drank anything out of the ordinary. What you eat or drink may, or may not, affect your INR significantly and the extra warfarin could cause an unusual increase in your INR. Eat what you enjoy and lay off the vit K vegs for a few days, until you test again, and then make whatever dosing adjustment is necessary. FWIW, I've never had an ocassion, as far as I know, where my INR was significantly affected by a short term diet splurge.

 

[lance]

Oh boy, oh boy. Have I understood you correctly?
A warfarin dose was changed based on how much Vit K may or may not be in a few servings of Vit K containg food and how it may or may not effect INR levels?
It's much simpler to eat what you want and dose that diet. I would never deliberately change a dose of warfarin without a test result and I seldom think about how much K is in my food.
How much lettuce, broccoli, cauliflower would have to be consumed to lower INR from 4 to 3?

 

[Bina]

No, No, No....Please don't try to predict your INR, that never works and doesn't make sense.
Just eat normally, a small portion of broc or spinach etc with dinner. And test weekly if you need to.

 

[catwoman]

Jenebug:

First of all -- R-E-L-A-X!!!
I know it's hard to do that when everything is new, but trust us veterans that you'll be just fine if you eat your normal diet. You just gotta do it consistently. Eat a balanced diet, without wild swings all the time, and you'll be fine. Your body needs a balanced diet anyway.

When I think back on how anally retentive I was right after surgery, I laugh. I had read that green cucumber peel has vitamin K, so I wanted to peel all cucumbers for my salads. That extended to pickles. And I passed up sushi because of the nori (seaweed). If I had already had one salad in a day, I passed up broccoli soup at dinner. I also avoided green apples!! I tried to memorize lists of vitamin K foods. I wanted to buy one of those "Coumadin Cookbooks."

Then I SAW THE LIGHT -- I learned to dose the diet.

 

[lance]

Marsha
No one could have put it better than that and with humour, too.

 

[jenebug]

Marsha, have you been sneakin' in my head? LOL I promise you - -you just described what I've been living. In the beginning, you have such a fear of doing something wrong, that you over analyze each food decision. Thanks friend.

 

[Freddie]

Marsha, have you been sneakin' in my head? LOL I promise you - -you just described what I've been living. In the beginning, you have such a fear of doing something wrong, that you over analyze each food decision. Thanks friend.

Been watching this thread and my first thought was "yikes, this sounds like me" during the early stages of INR.
I was a mess, some here may remember it well lol. (bet some of them wished they could physically give my head a shake)

I now eat what I want to eat, yes I watch the quantity but I will not deprive myself of something I enjoy.

Keep in mind that INR = It's Never Right, if you try to keep your INR in the higher end of your range you'll have some room to enjoy those "k" foods.

Now go and enjoy!
Cheers

 

[scott.eitman]

I would add, there are foods like Grapefruit, that increase your INR. If I have too much K, I will consider eating a Grapefruit, but not changing my dose without a test. With that said, I have increased salad intake the week of a test and have seen no change in my INR. I have also not eaten salads the week of test and still the INR holds at a good level.

 

[jenebug]

Thank you Freddie and Scott. It's so nice to know that someone understands and I am not alone in this new venture. When you first start this journey, you have the notion that if you go in and the INR is too high, you're gona bleed out on the spot or have an immediate clot if it's a little too thick. I am going to try to relax . I appreciate you all not" giving my head a shake". This is such a learning process and I am grateful for this site to vent and learn.

 

[Protimenow]

For a long time, I was buying packets of vitamins so I could throw out the Vitamin E capsules that were in the packets. I still get the packets, but the E goes along with all the rest.

The perspective on Vitamin K over the years has changed, too. There are cookbooks (The Coumadin Cookbook) that had a lot of no-K recipes. Now, the 'specialists' believe that we 'need' to have some K in our diets - it gives us benefits that the Vitamin provides (in addition to pro-coagulation effect) and actually makes it EASIER to manage your INR.

As others have said -- DON'T change your dose just because you've had some foods with Extra K. Get a meter, if you're concerned about it.

Managing INR is like steering a large ship -- a change in dosing today may not really show up for a few days.

Too many changes, too quickly, will only create problems.

 

[Jkm7]

Blood is not too thick or too thin. Hopefully pointing this out will be helpful.
What it refers to is if too anticoagulated or not anticoagulated enough it will take a longer or shorter time to clot.
Thinking of blood too thin provokes an image of possibly bleeding out but to think of it as taking a Slightly longer time to clot is a more accurate description.

 

[dick0236]

Blood is not too thick or too thin. Hopefully pointing this out will be helpful.
.

My doc often refers to warfarin as a "blood thinner". When I challenged him on it, his defense was "most patients understand blood thinner a lot easier than anti-coagulant". Docs don't seem to understand the horrors that the phrase "blood thinner" creates in the minds of "lay" people.

 

[chaconne]

As Bill B told me in a previous post, there is significant amounts of K only in a narrow amount of foods (spinach, kale, collard greens). Anything else (even Broccoli) will not likely affect your INR unless you eat a HUGE amount. Since K in these foods can vary, and are not controlled like a warfarin tablet, I wouldn't make changes to counteract temporary diet changes.

 

[lance]

There's an analogy here if I can present it properly.
Blood thinner is two words, so is anti-coagulation. It seems doctors believe patients are as unable to understand a hyphenated word as they, the doctors, are unable to understand INR management.

 

[jenebug]

Just a quick update- INR today was up from 2.5 to 2.7. Since "they' had wanted to thin me a little more, they were pleased enough to start my 2 week visits now, instead of every week. Needless to say, I won't be making any more changes to dosing, though it did not negatively effect me this time. ( I did inform them I had made the change last Saturday)
I agree that we don't give lay persons enough credit for undertanding(having been a nurse for nearly 30 years-not in cardiology, LOL). They need to realize the wealth of information available to so many online; as well as misinformation, and I think that might be the clinker. Not all info online is factual, depending on your choice of good and reputable sites.
Thanks gang; I'm off on a 2 week run now and pray it will be okay next visit.....had me a nice serving of fresh turnips with roots, and buttermilk corn bread tonight! Yum.

 

[Protimenow]

Your dose on Saturday would probably not effect your INR today. It's interesting that even professionals - who should know this stuff - would make a change ONCE in a week, and expect the results to last the whole week. (I had a physician assistant propose a one time change. I didn't even bother explaining to her how this would not effect my INR a few days later). I'm a strong believer in weekly testing - although I just went 10 days between tests.

I STILL believe in weekly testing -- and I take issue with those who believe that less frequent testing is okay. (In my past, I've gone much longer without testing -- but was really taking a big risk, no matter how consistent my INRs seemed to be).

 

[AgilityDog]

Right, PT, on all counts!
Also, Jenebug's 2.5 to 2.7 is within margin of error, and may not signify any change at all!