Question on Eating Habits

[NC-Cutie]

Friends, can someone explain to me what they mean by being consistant with what you eat when eating foods high in Vit K? I love turnip greens and they are on the very high list. Does this mean I can not eat them or if I eat them on Sunday I need to eat them every Sunday. I am still very very new to this Coumadin thing and still haven't figured out what I can and can not eat. I saw the lists that you guys sent me and I appreciate that, but I need to know if It is best to eat the same foods on the same days of the week. It seems that everything I am use to eating and love, is high in vit k. I also love beef liver and they say it carries quite a high volume of vit k also. How do I plan my weekly menus?

Also, I am not a real breakfast eater because when I am working i have to be at work at 630 am. I usually don't eat until maybe 1130 or 1200 (when I am able to take a lunch break). Since my surgery I have had to eat more smaller meals more times a day. How can I do this when I return to work? I don't want to get those dizzy spells from not eating while I'm at work and there are days when I am so busy that I don't stop for lunch, therefore, I don't eat until after work which is after 3pm. These are things that concern me about going back to work. I will be 6 weeks post op on this Friday and I have a doctors appointment. I am really considering asking if I can go back to work on next Monday instead of being out 3 more weeks. What do you think?

 

[SJJ]

Nessie,
I know what you mean about consistency. I'm pretty new to this but today was the first time since my surgery (2/25/04) that I was within range at 3.1 and I'll share with you what I've been doing. Just this past week, I started adding 1 glass of red wine each evening. Because I love my leafy greens and have always eaten lots of them, I consistently eat 4-5 large servings per day. I pay attention to the really high vitamin K items like green cabbage and broccoli and balance them with the medium level items like carrots or celery within the same day. I also decided to have the small cans of V-8 juice on hand if I needed to add a quick, easy and portable Vitamin K source. As you can see, I've set it up to make sure I get ENOUGH vitamin K each day rather than too much as that works with my normal eating habits better. It looks like my Coumadin dosage with be 5mg or less so that seems reasonable. As to your eating schedule, I've never been particularly hungry early in the day but I've learned to eat something, usually protein, like a cup of low fat cottage cheese, every morning. We're talking no prep time and 3-5 minutes to eat so this is workable with just a little effort.
I also take a multivitamin a day (the kind with no vitamin K) and exercise 1 hour a day. I'll later be adding light weight training and may need to adjust around that. I don't have enough experience with this yet to know if the above program will work for me over time, but I'm gonna give it a go and see if it's a winning combination.
Sue

 

[NC-Cutie]

Thanks Sue,
I was afraid I was not going to be able to eat my greens. I don't know about several servings a day, but adding the v-8 is a thought. I can not drink plain V8 but I like the splash. I may just have to eat something green each day like maybe greens 3 or 4 times a week and garden salads the rest. I am going to have to play with it i guess. Today my INR was 3.3 which is good. I was 2.5 on last Thursday. It had been below 1.5 and as high as 7.9 so I am getting there.

 

[Blanche]

Nessie and Sue:

My husband has been on Coumadin since 1990. I think the a good strategy is to eat less of the things that are high in Vitamin K, as Sue said. You are both just weeks from surgery and need to give your system time to stabilize. Right now might not be the best time to experiment with foods high in vitamin K. At least check with your doctors. Individuals metabolize vitamin K and Coumadin differently, based on much more that food intake. Environmental factors, exercise level, medications, condition of the liver, among other things affect metabolism. Before you can decide what is best for you, you must be stable on your anticoagulation. That takes some people months.
If you were doing a research study, you might say that you need baseline data before you start manipulating the variables.

Kind regards,
Blanche

 

[SJJ]

Blanche,
I checked with my cardio and the nurse who runs the coumadin management part of the office. They both encouraged me to eat like I normally would and they would work around that. I let them know that I normally eat LOTS of leafy greens and they okayed it, reminding me that consistency was the main issue. Are you thinking I should be concerned with their advice and consider cutting back on my vitamin K intake?
Sue

 

[bvdr]

Nessie,

It will fall into place. I'm like so many others here who prefer the high INR (which is a non-factor unless you are bleeding and thankfully is usually the case) over even a temporary low INR.

I have settled on my coumadin dose based on a heavy daily green intake. That way, I don't have to worry about my INR dropping when I eat greens. It also is a good reminder to keep eating that which is very healthy for me.

 

[Blanche]

Sue:
I claim no expert status here. I could be wrong, but I do have concerns. When doctors say, "eat your normal diet,"I believe that they assume that patients don't generally chose those foods that are especially high in Vitamin K, or if they do, they don't choose alot of them in any quantity. I was especially concerned with your statement, " decided to have the small cans of V-8 on hand if I needed to add a quick, easy, portable Vitamin K source." Would you normally have a source of Vitamin K on hand?

I think that moderation should be included in the direction to be consistent, especially until your body adjusts to the anticoagulant. My advice to someone who is a few weeks from surgery, if I were want to give it, would be to search the net and this site and learn all that you can about anticoagulation, diet, prothrombin testing. Taking Coumadin changes one's life style, but it should be a natural, smooth chance. Feeling the need to have access to a Vitamin K source, V-8, seems to make a chore out of what should be an easy transition. It also seems unusual to me because we really don't have any idea what the Vitamin K content of V-8 is.

I hope this makes some sense to you.

Kindest regards,

Blanche

 

[SJJ]

Blanche,
Thanks for your response and interest. Let me clarify; I have NOT changed my diet since beginning coumadin. I have for years eaten 4-5 servings of what I can now identify as Vitamin K rich foods per day. Who knew? I just ate 'em cause I liked 'em. My cardio understands this. What IS different since beginning coumadin is my awareness of the need to be more consistent with that intake than I formerly might have. I did not discuss the V-8 juice with my cardio or coumadin management nurse, that was my own idea and maybe it's not a good one. I just figured that if I was aware I was one vitamin K source short on any given day given the normal intake I have established, I could balance it out by drinking a small can which would be simpler than making a salad, for instance. Ultimately, only time will tell what will work for me, but I do value the experience of those of you who have years of trial and error under your belts and am eager to learn. I do think I was in error to respond to Nessie's question given my lack of experience, even though I was voicing my cardio's and nurse's guidance. There are many infinitely better qualified people in these forums to make a response on this issue than I and I should have left it to them. Sometimes I'm slow, but I'm definitley educable. Thanks again for your concern.

Sue

 

[Abbanabba]

Liver and turnip greens..??!!!!! I didn't think anyone actually LIKED to eat those things!!

Don't know too much (..anything..) about coumadin & vit K, but I've had to deal with hypoglycemia for many years and have needed to eat small amounts on a fairly regular basis.

I don't know what your work situation is like, but I would keep some healthy snacks in my desk draw (..fruit, nuts, health bars, etc..) which I could nibble whenever my sugar started to drop. I didn't need to make a meal of it, but a mouthful here and there would really help to keep me "level" until I could have a proper meal break. I also can't eat breakfast (..it makes me horribly nauseous..) so "snacking" until lunchtime seems to work better for me anyway.

Cheers
Anna : )

 

[JimL]

V-8

V-8

I experimented with cans of V-8 shortly after surgery. If my INR was a little high (around 5.0), I would have some V-8. I found that the V-8 guaranteed that I would bottom out rapidly (INR 2.0 or less).

Be very careful with V-8, since it is loaded with Vitamin K. I have always loved V-8, I would love to have a large can every day, but I have decided that the better part of wisdom is never to drink V-8.

I'm planning to indulge in asparagus soon, when it comes up. Since I don't usually have this, it will be inconsistent with my diet. So I'm wondering if I should be inconsistent with my coumadin dosage. Since it takes three days for the coumadin to take effect, then three days before I plan to have the asparagus, I should take so and so many extra mgs of coumadin. I think I still have a few weeks to debate and decide this issue.

 

[SJJ]

Jim,
Thanks for the tip, haven't actually had any yet as I've stayed fairly close to home and have easy access to my leafy greens in the fridge. But it's good to know V-8 juice is so potent! If I need a quickie, I'll try just a sippy.
Sue

 

[Harpoon]

I think you're better off sticking to the "routines" you've developed over the years. If that means eating lots of foods that happen to be vitamin K rich then so be it.

Consistency is what's important. If you suddenly stop or suddenly start, it will through levels off. Same with other things like medications or exercise or coming down with a cold, all of those can upset the "balance" you have now with your coumadin and INR....


As far as breakfast in the morning. Maybe you could try going with a granola bar, banana, apple, an orange, or some other "portable" snack.

You could pack an orange and bring it to work. Have it, and if you get hungry before lunch eat it, if not, just keep it for lunch or bring it home when you're done with work. Maybe you're not in work environment that would alow you to snack on something while working, but if you are it would solve the problem.


For the record, stuff like V8 is LOADED in sodium and it's not all that good for your heart actually, inspite of all the vitamins and such.

However, there is a low sodium variety that's just is good.

 

[NC-Cutie]

Sue,

Please don't feel that you spoke out of place. I do believe that we are all here to help and learn. I appreciate what you told me and I hope that you will continue to voice your opinions and concerns. We all (The New Group) have to weigh our options when it comes to these things. We are new at it and there is a chance that we can learn fromeach others trials and errors and then lean on the veteran members to share their experiences with us.

I know I have learned a lot in the few days I've been on this site, and I appreciate every post I have read. I think It's something to be gained from others experiences. We learn by trying and that is what this is all about. I'm just as new as you are, but I like joinging in on conversations. So don't beat yourself up about it.

Nessie

 

[Nancy]

Joe's been on Coumadin for 26 years. We don't obsess about everything he eats. His diet has to be extremely low sodium, for several conditions he has, but aside from that I cook a varied and, I hope, healthy diet for him.

He eats everything. I just make sure that it's balanced and I don't cook up a HUGE plate of greens or other vitamin K loaded items for him. He eats moderate portions of all vegetables and I don't measure. Over the course of a week, things all even out. Most of the fluctuations he has are due to activity levels and additions to or deletions from his long list of medications. It can also have something to do with whether he is having a bout of CHF. That seems to be in fairly good control right now.

Be reasonable with what you eat, keep things in balance, don't go overboard on vitamin K items. And, I don't think it's a good idea to try to manipulate your INR with vitamin K items. It's too iffy and a real guessing game. Let the dosage adjustments do the work.

Also make sure you have someone who is monitoring your INR who knows what the heck they're doing and is not overcorrecting or undercorrecting your dosages.

Relax, be reasonable, enjoy your life.