Stopping Warfarin?

[Jkm7]

When I received my bovine valve, both my surgeon and cardio ordered I be on anti-coagulation for two to three months. It took four weeks until they finally got me into range and I am taking VERY large dose. It worries me to be taking over 70 mg per week in order to be in range but that is what it is taking for this very average size, healthy weight woman. Maybe part of the reason is because I eat a large amount of green leafies but they have all agreed it is fine for me to do so. (Very interesting, long conversations with a number of people at Mass General in that regard and all agreed I can eat all the greens I want as long as I am very consistent and eat the same amount daily.)

When they allow me to stop warfarin, will I simply stop taking it 'cold turkey' or do they wean me down slowly?

Thanks, as always, for the huge help at VR.

 

[Ross]

You simply stop taking it. Nothing more to do.

Never worry about how much you take. The proper dose is that which keeps you in range. Some people take more then you do and others less. You just happen to be a quick metabolizer of the drug. For as much as you have to take, you should be full coagulated when you stop within 2 to 3 days. I'm betting 2. None of us worry about our greens and we eat them all. You name it, I'm game.

 

[Jkm7]

Thanks, Ross. They started me on 5 mg which didn't even register. Doubled it, raised it, raised it again, got to 57 mg, then 72 and now 75. Thanks for assuring me I don't need to worry about it being such high dose. I was concerned about it being so much for an average size person. Sounded to me like a dose for an elephant.

 

[Ross]

Not at all. Christina I think is taking like 20-25mg per day, so as you can see, it depends on the person and how well they metabolize.

 

[Karlynn]

I take 76/week.

You are just an over-achiever!

 

[ctyguy]

Im taking 5mg a day at this point but a still working my way back to my normal lifestyle, I expect my dosage to go up as I ramp up my exercise and get back to a normal diet.

 

[Bina]

I barely metabolize and/or barely function ....3mg and 2mg per day.... 19mg per week
It must be a nice feeling when the day comes that you can go off of Coumadin and know that's your last dose for hopefully a good long while.

 

[Jkm7]

Thanks for your help, everyone. I feel better about it now.

Bina.... To be truthful, Yes, it will be good the day one of my doctors tells me I can stop the warfarin. It isn't the worse thing in the world, certainly, but it will be one less thing to have to deal with. One less reminder of the 'journeys over the mountain, twice in four years. I'm tired of it all at the moment but I know tomorrow is a bright, new day.

Ctyguy..... I have been fortunate that I was able to get my walking back to a fair distance and steady pace early in my recovery and while I am eating smaller portions (slightly ), I am eating a very good diet. For years, I've eaten tons of veggies and, indeed, some soy so that is some of the explanation for my high dosage. (I use soy milk in my cereal almost every morning and sometimes have a soy burger or soy nuggets for lunch....other soy foods. I think our surgeries were just about the same time, weren't they? (Feb. 28)

 

[Bina]

The soy milk on your cereal can be easily replaced by goat milk....it's very healthy

 

[Jkm7]

Yes, surely, the soy milk can be replaced with goat. Nothing wrong with skim milk either.

It's funny my cardio is a huge proponent of soy. He encourages his patients to eat it regularly but if he mentioned to me it could effect my INR, I don't remember him saying so. Nor did the dietician/nutritionist I spoke with in the hospital. But I don't recall bringing up soy to her.

Another valuable thing I learned here.

 

[ctyguy]

similar except that you went bovine and I went mechanical so Im stuck on the Coumadin for life I'm not sure what its going to do to me over the next 30 or 40 years (assuming Im here that long) but that decision has been made already so all I can do is wait and see !

I was pretty healthy other than my bum valve prior to the surgery so Im hoping that the rest of my genetic template (which is very good) holds true. When I had my heart cath test prior to surgery one of the techs told me that if he were having my procedure, he wanted my arteries. Also when I left the hospital my final cholesterol test measured a whopping 121 !

 

[tobagotwo]

A lot of surgeons (like mine) are prescribing other products to lessen chances of post-surgical clots. Of course, everyone is different, and pehaps there's a reason why your doctor feel that extra caution was required for you.

Best wishes,

 

[Jkm7]

Seeing as my cardio and surgeon are in agreement, and both say I'll only be on it for 2-3 months, I made the choice to abide by their recommendation. I figure if I felt comfortable enough to have this same Mass General surgeon do two OHS on me, I guess I should take his therapy recommendations. As you say, each case is handled individually.

 

[Ross]

Yes, surely, the soy milk can be replaced with goat. Nothing wrong with skim milk either.

It's funny my cardio is a huge proponent of soy. He encourages his patients to eat it regularly but if he mentioned to me it could effect my INR, I don't remember him saying so. Nor did the dietician/nutritionist I spoke with in the hospital. But I don't recall bringing up soy to her.

Another valuable thing I learned here.

We are the Vitamin K blood hounds. Between all of us, we've pretty much found what will really make you bomb out and what is ok for semi consistent use. You'll learn it too. It's just a matter of time.

 

[catwoman]

jkm:

My husband took warfarin for 7 months post-op MV repair. He was up to 8mg X 7 (56mg) and was struggling to stay at 2.0. He had a-fib post-op, thus the warfarin. His target range was 2.0-2.5. (I would have taken a higher dose to get it closer to 2.5, but we're not talking mechanical valve here.) John just turned 62 and isn't an athlete, but he does walk every day, whether at home or at the track or in the halls at the community college where he works.

My target range is 2.5-3.5, and I'm taking 6.0 X 7 right now. My INR is usually 3.2-3.9. Go figure why John needed more warfarin than me and his INR range was lower, too.