Montrealer
Well-known member
I had replacement aortic valve surgery 6 weeks ago and my INR has been to say the least up and down. Just wondering if the people I`m dealing with know what the Hell doing. Thanks.
jacques
jacques
Problems with my INR
- Thread starter Montrealer
- Start date
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Adrienne
Well-known member
I can't help you, but I just want to say hi from another Montrealer (actually a Brossardoise).
Montrealer
Well-known member
K
Karlynn
We need some information from you before we can help you out.
What have your INR's been and what has your dosing been.
If you can - give us your weekly dose (ie 5mg/day = 35mg/week) and the INR you had with that dose. You need to keep a record of your INR and dosing - this will allow you to see trends and help you get to know what your body does with dosage changes.
For example:
35mg/week - INR 1.5
40mg/week - INR 2.0
45mg/week - INR 2.4
These show the dose for the week and your INR achieved on that dose. (Not prior to the dose was changed.)
It can take a bit to get your INR in range and steady. Your body is healing and changing. Your metabolism increases as you feel better and your need for Coumadin goes up.
Don't feel that Coumadin is like other drugs where you reach a dose that works for you and then you stay on that does forever. We have a few lucky member who had never changed their dose. I usually have to change mine (tweaking it) every 2 or 3 months.
What have your INR's been and what has your dosing been.
If you can - give us your weekly dose (ie 5mg/day = 35mg/week) and the INR you had with that dose. You need to keep a record of your INR and dosing - this will allow you to see trends and help you get to know what your body does with dosage changes.
For example:
35mg/week - INR 1.5
40mg/week - INR 2.0
45mg/week - INR 2.4
These show the dose for the week and your INR achieved on that dose. (Not prior to the dose was changed.)
It can take a bit to get your INR in range and steady. Your body is healing and changing. Your metabolism increases as you feel better and your need for Coumadin goes up.
Don't feel that Coumadin is like other drugs where you reach a dose that works for you and then you stay on that does forever. We have a few lucky member who had never changed their dose. I usually have to change mine (tweaking it) every 2 or 3 months.
Bonjour Jacques, j'espere que nous pourrons vous aider.
Jacques, welcome to the forum. Six weeks after surgery and "new" to warfarin is not a long time. It can take a little time to regulate INR as you get stronger and return to a normal life style. What are your INR's and dosage since leaving the hospital ?
I have found that keeping a simple spread sheet in my computer helps me, and my doc, manage my INR. Charting the date, dose, INR and noting any changes in other meds, illness, life style, etc. helps to understand possible INR fluctuations.
If you are new to warfarin, I strongly suggest a "pill box". Warfain management is not that difficult if you take your med as prescribed, use common sense, and test routinely. Warfarin is a drug that requires a consistant regimen.
I have found that keeping a simple spread sheet in my computer helps me, and my doc, manage my INR. Charting the date, dose, INR and noting any changes in other meds, illness, life style, etc. helps to understand possible INR fluctuations.
If you are new to warfarin, I strongly suggest a "pill box". Warfain management is not that difficult if you take your med as prescribed, use common sense, and test routinely. Warfarin is a drug that requires a consistant regimen.
Jacques:
You're still in recovery mode. So don't worry too much about your INR right now; in fact, you will no doubt see it drop as you resume your normal physical activities. This is because warfarin is metabolized by the liver, and activity increases the metabolism, leaving less warfarin particles in your blood because the liver is filtering out the warfarin. People who jog, bike, hike, play sports, etc., on a regular basis will find they require more warfarin to stay in range; if they stop being active and become couch potatoes, they will find their INR will increase.
Other things can affect your INR, such as other meds (some people are put on heart meds for a short time post-op), fevers (not unusual to run a fever from time to time in the weeks immediately post-op, since you can get viral and/or bacterial infections) and foods. Some people lose their sense of taste right after surgery; as they return to a normal eating pattern, their INR may drop. Also, some patients have been scared by medical professionals into thinking they can't eat broccoli, spinach and other vitamin K-containing foods, so they avoid them. Then, when they decide to heck with this, their INR drops.
Nearly all of us here have been there, done that, like what you're going through.
Don't worry -- it does get better. When I had 2 consecutive INRs in range, I was ecstatic.
You're still in recovery mode. So don't worry too much about your INR right now; in fact, you will no doubt see it drop as you resume your normal physical activities. This is because warfarin is metabolized by the liver, and activity increases the metabolism, leaving less warfarin particles in your blood because the liver is filtering out the warfarin. People who jog, bike, hike, play sports, etc., on a regular basis will find they require more warfarin to stay in range; if they stop being active and become couch potatoes, they will find their INR will increase.
Other things can affect your INR, such as other meds (some people are put on heart meds for a short time post-op), fevers (not unusual to run a fever from time to time in the weeks immediately post-op, since you can get viral and/or bacterial infections) and foods. Some people lose their sense of taste right after surgery; as they return to a normal eating pattern, their INR may drop. Also, some patients have been scared by medical professionals into thinking they can't eat broccoli, spinach and other vitamin K-containing foods, so they avoid them. Then, when they decide to heck with this, their INR drops.
Nearly all of us here have been there, done that, like what you're going through.
Don't worry -- it does get better. When I had 2 consecutive INRs in range, I was ecstatic.
Welcome to the zoo ... I echo what the others have said.... consistency is the key for me ... I take it every day at the same time and have a stable diet.... some people seem to control it easier than others ... Also speaking for myself I don't get freaked about it ... If I am between 2 and 5 I'm a happy camper
Ross
Well-known member
Jacques welcome aboard.
Provide us with as much detail as possible about your dosages, how frequently your being tested and dose is being changed, other meds, diet and excercise level, then we can help tell you whats wrong. By now, you should be reasonably stable, though it does take some people longer. Oh yeah, it's most likely the people managing you and not something your doing. It's unbelieveable, but most of the people that are supposed to know what they are doing, don't.
Provide us with as much detail as possible about your dosages, how frequently your being tested and dose is being changed, other meds, diet and excercise level, then we can help tell you whats wrong. By now, you should be reasonably stable, though it does take some people longer. Oh yeah, it's most likely the people managing you and not something your doing. It's unbelieveable, but most of the people that are supposed to know what they are doing, don't.
lisou
Well-known member
Bonjour Jacques, welcome I am 3 months post surgery and finally I would say in the past 3 weeks I've been in range, but since surgery it's been like a rollercoaster ride, give it time everybody heals differently. Best of luck hope you get in range soon.
Hi Jacques and welcome,
I am 8 weeks post-surgery, and only the last two weeks my INR is stable and within range. As said before, medications and healing play a part in this.
I am 8 weeks post-surgery, and only the last two weeks my INR is stable and within range
. As said before, medications and healing play a part in this.
Montrealer
Well-known member
Well....long story short....last week my INR hit 8.9 and my Cardiologist decided to send me to a private clinic. This is the 2nd time in 4 weeks that it has hit that high. The 1st time got me a trip back to the Hospital for 5 days.Last Friday the clinic took me off for a few days to bring it down.This past Tuesday my reading was at 3.9 and was put on 5mg per day. My next test will be next Tuesday.
Ross
Well-known member
Give us your total weekly dose, heck give us the whole low down. We can't do anything with partial information.
Montrealer
Well-known member
I`m being tested every Tuesday as of last week and today they just called and want me to start at 7.5 mg per day. I won`t go into the last four weeks to due to the fact that I`m with a private clinic as of now. I`ll see how it goes with this clinic for the next few weeks.
ALCapshaw2
Well-known member
To properly manage Anti-Coagulation, the Manager needs to UNDERSTAND how the Drug works in the body.
Testing and Management techniques changed radically (for the BETTER) in the early 1990's. Unfortunately, there are MANY so-called managers who were trained Before 1990 who used outdated methods and misinformation. These out-of-date managers are a BIG part of what gives Coumadin / Warfarin a 'bad name'.
YOU (the patient) would be wise to learn about anti-coagulation management. Read the 'stickys' at the Top of the Anti-Coagulation Forum Listing and then go to AL Lodwick's website www.warfarinfo.com for ACCURATE information on living with / on Coumadin / Warfarin. Buying AL's Dosing Guide ($5) is a wise investment in your health care. Then you will KNOW if your managers are making proper recommendations.
'AL Capshaw'
Testing and Management techniques changed radically (for the BETTER) in the early 1990's. Unfortunately, there are MANY so-called managers who were trained Before 1990 who used outdated methods and misinformation. These out-of-date managers are a BIG part of what gives Coumadin / Warfarin a 'bad name'.
YOU (the patient) would be wise to learn about anti-coagulation management. Read the 'stickys' at the Top of the Anti-Coagulation Forum Listing and then go to AL Lodwick's website www.warfarinfo.com for ACCURATE information on living with / on Coumadin / Warfarin. Buying AL's Dosing Guide ($5) is a wise investment in your health care. Then you will KNOW if your managers are making proper recommendations.
'AL Capshaw'
Ross
Well-known member
What was your INR on the last test and what dose were you taking at that time?
lisou
Well-known member
My surgeon told me that it's not good to change dosage too often, that by doing that it'll never get in range, he says people change to often for nothing he says if your in range doesn't matter what the number is, just let it be. otherwise it's going to be like a yoyo.
K
Karlynn
If you aren't already, please start keeping a record of your doses and INR like I explained above. This is the first step in learning how your body reacts to Coumadin changes and keeps the management of your INR from being a mystery that only the "professionals" know how to handle.
Montrealer
Well-known member
This private clinic is keeping a record and they give me a copy and like I said I just started with them last week. I`ll give them a couple of weeks to see how it goes. They would like to keep my INR at about 3.0. As of today I`m taking 7.5 mg till Tuesday`s test.
