Restoring INR Levels After Vitamin K

[warrenr]

that's great

that's great

Quoting my Drs during my recent stay at their village...

"Very "crisp" sounding valve."

Glad to hear that your valve sounds are crisp

 

[witzkeyman]

Well, here I am, 10 days out of hospital and 14 days after vitamin K intervention. I am on 2/3 of my normal maintenance dose of warfarin and my INR is still at 1.0 after 5 days at this level and 4 previous days at 1/2. The studies that I've read indicate the a loading dose of warfarin is no more effective than a return to regular maintenance doses in these cases so I should be seeing some movement by now. It won't be enough to bring me in range but surely..... something!

My reading has also led me to believe that vitamin K's half life is roughly 1/2 that of warfarin so it should be flushed from my system by now even though it was administered both orally and through the IV. All my hemoglobin and hematocrit tests so far (stable but not increasing) indicate that the bleed has stopped or is minimal at worst but still the INR won't budge.

Today I'll do a veinous draw at the hospital and have the result sent STAT to the doctor. If the H&H levels are all rising (confirming the bleed has stopped) then I'll have to insist on Lovenox as a bridge.

Does any of this sound familiar to anyone or am I unnecessarily making myself anxious? Two weeks of a 1.0 INR is a bit of a worry for a mech valver.

Thanks

Jerry

When I was firs given Coumadin, I was given 10 mg, because Iwas considered to be be a big guy. My INR shot up to 4.9. I was given 10 mg of Vitamin K and my INR was 1.07 for the next day. I was then given 15 mg of Coumadin, and my INR only went to 1.12. The next day I went to 2.7 with 5 mg of Coumadin. Today, I tested at my cardiologist and my INR was 4.2. He told me to skip my Coumadin for today and tomorrow. that's where I stand.

 

[Ross]

If your INR is 4.2 and you skip two doses, your going to be 1.something or the same as not anticoagulated. You need to find someone who knows how to manage Coumadin. Giving Vit K for an INR less then 10 tells me this person hasn't a clue.

 

[ALCapshaw2]

Witzkeyman -

GOOD GRIEF!

Advising you SKIP your Coumadin for TWO DAYS because of an INR of 4.2 borders on INCOMPETENCE.

It seems your Cardiologist is trying to drive at the speed limit and his only methods are to Stand on the Gas or Stand on the Brakes.

RUN to a REAL Coumadin Clinic and don't look back!

If there is NO Coumadin Clinic in your area, then at least read the guidelines on this link http://www.aafp.org/afp/990201ap/635.html and give a copy to your Cardiologist.

AL Lodwick sells a very nice single sheet Dosing Guide for $5 through his website www.warfarinfo.com


'AL Capshaw'

 

[Bina]

Witzkeyman, I'm with Ross and Al, your Coumadin clinic does NOT know what they are doing. The way they are over-reacting and dosing you just does not make sense. An INR of 4.2 is nothing to freak out over. For me, a half dose would easily correct that.

 

[Blanche]

I wondered what you ment when you said "they gave me 10 because I was considered to be a big guy." That should have been the first warning. My husband took between 10.0 and 12.0 for years, and at that time he weighed 125 pounds... There are people on this site who take 20.0 or more daily. I assure you, they are not big guys or gals. If your doctor thinks that your dose of anticoagulant is dependent on your size or weight....RUN AWAY FROM HIM/HER at once.

An INR of 4.2 is not a crisis. My husband's range is 3.0 to 4.0 because of some special circumstances. He is often slightly above 4.0. No adjustments needed for him. Now, then, you would probably need just a small adjustment of your anticoagulant intake to lower your INR...Nothing drastic.

I noticed that you are a teacher. Teachers are learning professionals. May I suggest that you invest some of your time reading about anticoagulation in general and as it applies to you. Information is power, and it is right here at your finger tips. You must become pro-active in your health concerns and that should be easy for you since you are a professional in learning.

Regards,
Blanche

 

[Bina]

.......May I suggest that you invest some of your time reading about anticoagulation in general and as it applies to you. Information is power, and it is right here at your finger tips. You must become pro-active in your health concerns and that should be easy for you since you are a professional in learning.

Good point.