Post-vacation testing

[EVELYN]

Just a quick note to let you know that Tyce tested tonight.....it wasn't a pretty picture!!! He had been 3.7 over vacation (2 weeks) and he went from his usual glass of wine on the weekends to a glass of wine every night, along with lots of stuff we usually don't eat!!!

Today he tested and was 7.1. He has already had a v-8, hotdogs and sauerkraut and I've faxed in his results to our cardio.....boy, was that one a shock!!! He took his regular 5.0 dose tonight, which I hope was right, and we'll get an adjustment from our cardio tomorrow......in hindsight, I'm thinking maybe we should have only had him take 2.5 tonight. What do ya'll suggest???

Ev

 

[Nancy]

How about a nice broccoli dish with dinner.

 

[Blanche]

Evelyn:
This is what Albert does when he can't get guidance from the doctor before the next dose of Coumadin is due. With an INR above 6.0,, he skips one day, that is, he takes no Coumadin for one day. He would never skip more than one day. When the INR is 5.0 or above, he takes half of his normal dose. He then tests in 4-5 days. Albert's range is higher than most, 3.0 to 4.0, because he had a stroke while on Coumadin. Hindsight is always 20-20. You did the best that you could with the information that you had. This has happened to him several times in the last 2 years. The doctor hasn't expressed any undue concern, but it sure makes me itch.
Blanche

 

[Ross]

Oh Ev what am I to do with you? Feed that boy some brussel sprouts and spinich. You know, the stuff he doesn't like. hehe

Take a look at the link below and go about half way down the page. You 'll see a dosing algorithm to use. If you want to try that idea, but I don't know what all you two indulged yourselves in besides transmissions and Dog Show's.

http://www.aafp.org/afp/990201ap/635.html

 

[Georgia]

Grrr-r-r-r

Grrr-r-r-r

Boy, Ross, I sure wish I'd seen that coumdin-dosing website before my doc got my inr screwed up. Two weeks ago I had a 3.7 (3 weeks earlier I'd been at @3). (At that point I thought it shouldn't have been touched - just retested - but I didn't say anything and went along with it) He reduced my dosage by 20%, which seemed like a lot; so of course last week I was at 1.7. So he increased it by @10%.

I'm afraid he & I are going to have words & I'll be looking for a new pcp before long.

Need to get regulated so I can get me one a them-thar protime machines.

 

[Marty]

INR 5-9 No Bleeding

INR 5-9 No Bleeding

Evelyn, A case like Tyce's is when its nice to have finger stick self testing. I suggest you test "frequently", like daily. Hold one day for sure and maybe two. When INR falls into therapeutic range start regular dosing with the total weekly dose 10 to 20% lower than it was before. This recommendation is based on information from Jack E. Ansell MD, Professor of Medicine at boston University School of Medicine. He is a hematologist with a special interest in
anticoagulation and patient self testing .He is very good about answering questions from doctors and patients.
[email protected]

 

[Ross]

I know what you mean Georgia. I'm just now getting around to monthly testing because I was following the nurses orders and decided to put a halt to the nonsense that she had me doing. We locked horns when I tested at 3.6 and she wanted to reduce my dosage by 10%. I looked at all my graphs and said NOPE, NOT GONNA DO IT! If I would've, I would have been back below 2.5 and testing yet again. I was feeling like a dang bouncing ball with all the dosage adjustments. To make a long story short, I stayed at the same dosage and retested at 3.3. I've maintained this dose and last Friday again 3.3. I now get tested once a month! Hurah I'm no professional regulator, but I'm really tired of needless needle sticks!

It's unfortunate that we have to put our trust in these people when they don't know how to regulate themselves. We must be our own advocates with this stuff. We understand ourselves better then most of them.

 

[EVELYN]

Hi Guys

Thanks for all the help. We just got back from dog class----don't you laugh, Rossman, and I read all the posts. Unfortunately, we had already had dinner after Tyce tested and he had already taken his coumadin, so I just gave him the v8 and carrot juice. He'll have a salad for lunch tomorrow and we will test again tomorrow night.....just to check. If his cardio hasn't called we'll decrease the dose by half......I just get nervous because I'm afraid it will go too low. See what happens when you go on vacation!!!!! Thanks for the article, Rossman. I truly love you guys.

Ev

 

[Guest]

That post from Limerick PA got me started

Tyce's was 7.1
On account a what he done
So he ate some kraut
To knock it right out
Gas or bleedin - which one?

 

[EVELYN]

Thanks, guys for all the help. I know how you feel, Blanche, about the "sure makes me itch!!!" Last night I was awake about 4 times checking to make sure Tyce was ok.....of course he was, he was snoring like a baby!!!

Actually, Nancy, we're going out for Chicken and Broccoli lunch today when he gets home. I have a call in to our cardio and faxed his results in last evening.....boy are they going to be surprised, he's been sooooo consistent!! Guess those glasses of wine really do take a toll!!!

Rossman, na nee, na nee, na nee....I'm not going to tell you what we were doing!!! Great website, though, thanks for it!

Al, you can now be known for "LIMERICKS BY LODWICK!!!! And the answer is.....gas!!

Thanks Max, you always have the best advice....will let you know what our cardio says.

Ev

 

[LUVMyBirman]

Evelyn......that happens EVERY time I vacation. Cutting my dose in half for one day and eating two small salads is the fix. Test in three days. Never fails..... I will them be back in range. Some require a full day or two on hold. Keep us posted.

 

[EVELYN]

Just got off the phone with our cardio's coumadin nurse. She said withhold 1 day, test again tomorrow and call her in the a.m....I told her that we rechecked him today and he was 5.0 from 7.1 (God bless v8) and she said the same thing. I think we'll cut his 7.5 dose in half tonight and have some more chicken and broccoli......Ev

 

[Ross]

Just don't forget that it takes about 3 days for things to settle.

 

[EVELYN]

GOTCHA, ROSSMAN......CHICKEN AND BROCCOLI TONIGHT FOR DIN DIN....YUMMMMMMMM WILL CHECK IN THE A.M. AND SEE WHAT HAS HAPPENED. WE REDUCED COUMADIN FROM 5 TO 2.5 TONIGHT, ATE BROCCOLI, DRANK V8, SO HOPEFULLY TOMORROW WILL BE GOOD.

SLEEP WELL.

EV

 

[ShezaGirlie]

Same old, same old...

Same old, same old...

Hi Evelyn -- the exact same thing happens to me upon return from holidays.....woohoo high INR!

I use the same drug protocol as Gina uses and it works.....so far. Never hold, just half for two nights and walah! Back in business.

Glad to hear you and Tyce are having fun holidays..and your doggie is so cute!

 

[EVELYN]

Thanks Gina and Sheza....I get so nervous when they say the "H" world....rather go half and then eat some greens for tyce....scares me to death to go below 2.5.

Be well and enjoy those vacations!!

Evelyn

PS There are 3 more doggies at home besided that one!!!!

 

[EVELYN]

Hi Guys.....

Just thought I'd fill you in on the latest. Friday Tyce's cardio nurse called and said to withhold coumadin for Friday and Saturday, go back to 5.0 Sunday through the rest of the week and retest next Friday......As you know, Tyce has been high, but coming down. Well, I definitely don't like the idea of "WITHHOLDING" SO WE CUT THE DOSE IN HALF FOR BOTH THURSDAY AND FRIDAY AND ATE BROCCOLI AND SALADS. Today Tyce was 2.7 and will go back on his 5mg. tonight, NOT SUNDAY.....there is no question that your advice was MUCH more accurate than our cardio's nurse!!!l Glad he's back in range again, hope he stays that way now that vacation is over!!!

Thanks again!!

Evelyn

 

[Georgia]

Now what?

Now what?

This is great news; and I learned early on from this site to not hold.

Now - do we tell our doctors (or whomever) that we have not taken their advice; and that we've gone about fixing things our own way and risk incurring their paternalistic wrath; or do we let them assume that their incorrect and risky instructions were followed to the letter and allow them to continue to misguide their patients?

I presume most of you speak primarily to your physicians' PA's or nurses. I've gotten a bit combative with my doc's nurse; I figure that I need to get things under control so that when I see the doc he'll understand that I'm really trying to control my inr myself and that I've been studying it. This is my pcp (the cardio wants the pcp to monitor coumadin use); I truly can foresee having to change pcp's if he and I don't come to a meeting of the minds about all of this.

Any advice or suggestions?

 

[EVELYN]

THE SAGA CONTINUES!!!

THE SAGA CONTINUES!!!

So, here's the deal: As I mentioned, our cardio's nurse told Tyce to hold for Friday and Saturday and then do 5 next Sunday through Friday and test again on Friday.

Of course, we did not follow instructions.....we halved his dose Thusday and Friday, took regular 5 on Saturday and tested today.....wouldya believe 1.9.....so we've decided to go back to his regular schedule of 7.5 3 days a week and 5 the rest.....along with a glass of wine today for Greek Easter. What do ya'll think? How about it, Al???

Evelyn

PS Georgia, you'd better know when we see our cardio in June they'll definitely know about this.....boy am I so glad we found this thread!!!! Who knows where his INR would have been if we had listened to them!!!

 

[Ross]

Can you just imagine what it would be if he held 2 doses? Can you say 1.? or the same as nothing at all!

I think I'd go back to the regular schedule and just watch the Vit K intake. Until he tests again. The lab may have been wrong on his high test. The reason I say that is, if you did half doses and then resumed he shouldn't have fallen that low. Of course, you were feeding him some pretty good stuff to knock it down too.

You two will get the right area and then it'll be hard for anyone to tell you to deviate from it once it's found.

I meant to ask, Are you keeping a diary of his testing and doseages? That's how I found my sweet spot of 7.5mg per day.