Question for my mother

[Wise]

My mom just started taking coumadin on June 9. How soon should her INR first be tested? I've read a lot in the "must have reference links", which has been very helpful, but I can't find the answer to that question. She was told to come back in a month. She's thinking that she can wait 5 1/2 weeks, which is when her next cardio appointment is. Help!!

 

[geebee]

Her first test should be no more than a week after she starts taking it, so she is already past due. I cannot believe they started her on coumadin and told her not to come back for a month. She could be in serious trouble by then if her dose is too high (or too low depending on why she is taking it).

 

[Wise]

Thanks so much Gina and my mother says thanks also. She's not definite that her cardiologist didn't tell her correctly when to have her INR checked. Her memory fails her sometimes since she's had chemo five years ago. He did tell her to come back in a month, but I think that was for a different reason. She changed the appointment date to later for work reasons. She's taking it because of atrial fibrillation, I believe.

I may have misrepresented the doctor's intent in my first post, but I just had to be sure that she was being taken care of. Mom was very happy that I asked. She's going to call the cardio's office Monday and get that taken care of. BTW, she is now seeing my cardio and the other info he's given her regarding coumadin has been accurate (I know this to be true because of a little website called vr.com ). Anyway, either someone forgot to clarify this to her or she forgot herself. Thanks again.

Wise

 

[ALCapshaw2]

When first starting out, it's probably best to be tested every Week until she is stable, then go to 2 weeks, and finally go to 4 weeks, again assuming she is stable.

Stable would be defined as at least 2 and preferably 3 or 4 consecutive tests that are 'in range' for her condition.

Atrial Fibrilation in the elderly is probably the leading reason for being on Anti-Coagulation Therapy. A-Fib can cause Clots to form and a Low INR (below 2.0) is a DANGEROUS precursor to stroke or other clot related events.

As you probably know, many of us prefer to be on the High Side of our range for the above reasons. Bleeding risk does not rise rapidly until INR is OVER 5.0 so a slightly high reading is NOTHING to overreact to, i.e. for an INR above range but below 5.0, NEVER Hold A Dose, just reduce the weekly dose by the appropriate percentage (and buy Al Lodwick's DOSING GUIDE for $5).

'AL Capshaw'

 

[hensylee]

I believe the doctor said to come back for regular checkup - not INR. My brother was also elderly and taking coumadin for the same reasons as your MOm = a-fib and stroke prevention. At first they checked him weekly to get him regulated and when it was regulated a monthly visit to the LAB was the order of the day - if the lab found he was out of whack, then it was weekly until it got straight again. We never missed that monthly trip to the hosp for his blood to be drawn. Very important.

 

[Blanche]

Wise:
Last June I developed a-fib/a-flutter..reasons unknown. The doctor instructed me to test every 5-7 days until I was in range. Once in range, he wanted me to test weekly for 3-4 weeks. He told me after that, I could test once a month or more frequently if desired.
Regards,
Blanche

 

[Wise]

Thanks for all the very helpful responses. My mother will feel better having this info. She was nervous about taking coumadin because of the misinformation she'd heard (can't eat anything green, you will bleed to death over nothing). She just recently switched to the same cardio I use and he told her she could eat mostly whatever she wanted, but to be consistent. I'm printing some info about warfarin to take to her and I ordered the warafrin dosing chart for her today.

I'm hoping that she finds that she bruises less now. She was taking Plavix prior to switching cardios. We'll see. She's had lots of bruises on her arms during the past year while taking Plavix. I think I remember that some people bruise less with coumadin than with Plavix.

 

[Guest]

I just got the message that you ordered the dosing algorithms. They will be in the mail tomorrow.

Thanks,
AL

 

[Wise]

I just got the message that you ordered the dosing algorithms. They will be in the mail tomorrow.

Thanks,
AL

Thank you Al. I'm sure this will prove to be a good benefit for my mom.

Wise