Testing my knowledge re Home ACT

[Eva]

Hi, I hope my knowledge about INR testing at home is improving.

My INR last week was 3.3, and today it is 2.2!!

The only change is that yesterday I had a CT Scan and I drank 950 ml Scan liquid and I was injected with a dye during the scanning.

Could this drop be due to the drink or the dye?!

My judgement is to take my regular dose (which is 7 1/2mg Warfarin nightly) and retest tomorrow! Or take an extra 1/2 mg. (i.e. 8 mg.) tonight and restest in three days, to be on the safe side!
My Warfarin pills are in 1 mg and 6 mgs.

What do you think? Also,

General Question: How many strip tests did you waste until you got it right?! I wasted another strip this morning--total of 5 strips since start!!

 

[catwoman]

My INR last week was 3.3, and today it is 2.2!!

The only change is that yesterday I had a CT Scan and I drank 950 ml Scan liquid and I was injected with a dye during the scanning.

Could this drop be due to the drink or the dye?!

My judgement is to take my regular dose (which is 7 1/2mg Warfarin nightly and retest tomorrow! Or take an extra 1/2 mg. (i.e. 8 mg.) tonight and restest in three days, to be on the safe side!
What do you think?

Eva:
Don't know what affects the scan drink or dye have on warfarin absorption. I'd be looking at any other changes -- extra activity, a missed dose perhaps.
Retesting within 24-48 hours won't tell much. I'd wait until at least 72 hours. If you're still low, I'd bump up the dosage some. Consult your algorithm chart for any increase.

 

[Dale]

Eva -- I just started home testing and wasted 3 strips and pricked 3 different fingers one day last week. The blood drop just wouldn't go onto the tiny strip of film! Phewy! At least I didn't have a problem getting a big enough drop. Hopefully, practice makes perfect!

 

[Bridgette]

Eva:

I think I mostly agree with Catwoman.

What we all may be missing, is that the dyes they inject may be rough on the liver -- if it's working overtime to clear the dye out of the system, it's probably metabolising the warfarin at a faster rate than normal.

If it was me, I'd take my normal dose, but not even consider checking tomorrow -- it's too soon to see any effect. With an INR at 2.2, you're probably not at much risk. I suspect that, once your liver gets back to normal, its breakdown of warfarin will also slow down, bringing your INR back up.

Perhaps your idea of taking an extra 1/2 dose and testing in 3 days would also be a good idea -- but may not be necessary if you're this close to 2.5.

Not being an expert (yet), I'll step back and see what some of those with more experience have to say. (However, with a 2.2, I wouldn't panic)

Mark, take note that Eva has had a double valve replacement therefore her desired INR range would be higher than yours (you have aortic valve replacement only). Those people with mitral valve replacements are usually told to keep their range 2.5-3.5, and my surgeon even said try to keep above 3 all the time.
Not sure what Eva's range is, but if I was her I'd be increasing my dose a bit, consult AL Lodwick's chart Eva, or maybe Ross will come along soon and chip in with some advice.

Good luck Eva

Bridgette

 

[njean]

I would definitely take 8.0 or even 8.5 tonight Eva & then resume usual dose tomorrow & check INR Saturday or Sunday.

2.2 is kind of low for us double-valvers so that's what I would do. Like Bridgette, my doctors are quite pleased if I can keep my INR around the 3.5 level.

Hopefully you'll get more responses & then you can make your adjustment accordingly.

Later & good luck my friend!

 

[CThrock]

Hi Eva,
I agree with Norma. Take the extra tonight and resume your normal and reck on Friday or Sat.
I've had all sorts of scan and never had a drop in my INR and I'm a double valve too. You might call Ross too, he's real good for what to do with your INR level.
Are you adjust your own or do you still have to call the INR clinic?

Thanks too Bridgette alot of people forget about double valve people are range is 2.5-3.5.


Hope that helps!
Crystal

 

[Eva]

Eva:
Don't know what affects the scan drink or dye have on warfarin absorption. I'd be looking at any other changes -- extra activity, a missed dose perhaps.
Retesting within 24-48 hours won't tell much. I'd wait until at least 72 hours. If you're still low, I'd bump up the dosage some. Consult your algorithm chart for any increase.

Marsha, thanks for your response. I did not miss a dose, but I took he pills of Sunday on Saturday but since it is the same dose everynight, so that should not have made a difference. Right?!

Eva:

I think I mostly agree with Catwoman.

What we all may be missing, is that the dyes they inject may be rough on the liver -- if it's working overtime to clear the dye out of the system, it's probably metabolising the warfarin at a faster rate than normal.
..........
Perhaps your idea of taking an extra 1/2 dose and testing in 3 days would also be a good idea -- but may not be necessary if you're this close to 2.5.

Not being an expert (yet), I'll step back and see what some of those with more experience have to say. (However, with a 2.2, I wouldn't panic)

This is a good theory, Mark. Makes sense to me. Thanks for responding. It is true that 2.2 is close to 2.5 yet close to 2.0 too! My surgeon prefers me to be around 3.0.

Eva -- I just started home testing and wasted 3 strips and pricked 3 different fingers one day last week. The blood drop just wouldn't go onto the tiny strip of film! Phewy! At least I didn't have a problem getting a big enough drop. Hopefully, practice makes perfect!

Thanks, Dale. I was wondering if it was just me! Let's hope that 'practice makes perfect'!

.........consult AL Lodwick's chart Eva, or maybe Ross will come along soon and chip in with some advice.

Good luck EvaBridgette

Thanks, Bridgette. I bought Al's chart but not sure when I will receive it. I looked up the FFAP and they recommend a 5-10% increase. I would go 5% if I have to as I am the sensitive type.

I would definitely take 8.0 or even 8.5 tonight Eva & then resume usual dose tomorrow & check INR Saturday or Sunday.

2.2 is kind of low for us double-valvers so that's what I would do. Like Bridgette, my doctors are quite pleased if I can keep my INR around the 3.5 level.

Hopefully you'll get more responses & then you can make your adjustment accordingly.

Later & good luck my friend!

I agree, Norma, that 2.2 is low considering the variation of the + or - 0.2.

What I cannot understand is that if I need to increase my dose by 5%, this means I take an extra 3.75 mgs. Is this extra 3.75 mg to be taken daily?! or increase the weekly dose by 3.75? I keep forgetting this percentage

Hi Eva,
I agree with Norma. Take the extra tonight and resume your normal and reck on Friday or Sat.
I've had all sorts of scan and never had a drop in my INR and I'm a double valve too. You might call Ross too, he's real good for what to do with your INR level.
Are you adjust your own or do you still have to call the INR clinic?
.....Crystal

Thanks, Crystal, I will make sure to reck on Friday
Hope that helps!

 

[njean]

If my INR had been stable for several weeks, I would just increase my dosage for tonight & then resume your 7.5 the rest of the week until you check on Saturday. Now, if your INR is still in the 2's on Saturday then that would be a clue to me that perhaps I need to take 8.0 or 8.5 twice a week & then 7.5 for 5 days & check on the 7th day.

My usual dose is 10 for 6 days & 7.5 on 1 day. Then I check INR at the end of the week, usually on Sunday before taking that night's dose. And I always write in my calendar what my INR reading was & mark the dosage I took every day of the week so I'll know how & if I have to adjust for next week.

 

[Bina]

Eva, with your double VR, you may want that INR staying around the 3 range.
I would take 8mg tonight and tomorrow night.....re-test on Friday.
And what is this talk about wasting strips?
Silly girl, what is the problem? Me help you.

 

[Eva]

Will do so, Norma. Thanks.

 

[njean]

The trick that I've learned from self testing Eva is that increases in small doses work better than taking a huge dose hoping to increase your INR. What happens is that you will be all over the place when you check next so small increases I find work better for me.

Bina's suggestion of taking 8.5 for 2 nights is a sound suggestion except that I would check on Saturday instead of Friday but if you want to check Friday then do so, because you CAN!!!! You have a home tester woman---- you are FREE make that choice!!!!

 

[Bina]

NOrma, I suggested 8mg for 2 nights.

 

[njean]

NOrma, I suggested 8mg for 2 nights.

Ooops, my Bad! Thanks for catching that Bina! Did you copy that Eva??

 

[Eva]

Eva, with your double VR, you may want that INR staying around the 3 range.
I would take 8mg tonight and tomorrow night.....re-test on Friday.
And what is this talk about wasting strips?
Silly girl, what is the problem? Me help you.

Thanks, Bina. I like it around three too. will take an extra half tonight and another extra half tomorrow.

Yes! I wasted all those strips. I get enough blood but getting the blood into there does not always work. Today I did both tests the same way...the first one gave me an error, the second one worked well!!! Any advice will be appreciated, dear Bina.

The trick that I've learned from self testing Eva is that increases in small doses work better than taking a huge dose hoping to increase your INR. What happens is that you will be all over the place when you check next so small increases I find work better for me.

Bina's suggestion of taking 8.5 for 2 nights is a sound suggestion except that I would check on Saturday instead of Friday but if you want to check Friday then do so, because you CAN!!!! You have a home tester woman---- you are FREE make that choice!!!!

I agree Norma that small changes is better than one big one. I am so easy to please...I agree to follow Bina's suggestion. It is so nice to be FREE!! no driving hassle or walking on eggs while waiting for results anymore!

 

[Bina]

Okay, girls, it's almost my bedtime.....Eva, don't worry about anything. Tomorrow we can yak about your finger sticking.

 

[njean]

Okay, girls, it's almost my bedtime.....Eva, don't worry about anything. Tomorrow we can yak about your finger sticking.

Give your little nubies a kissee, kissee for me!!

 

[Eva]

night night, Bina

 

[Bina]

Norma, they are BAAAAAAAACK. Pic coming tomorrow.

 

[Eva]

Thanks, Mark,

I am using the Coagucheck XS...still learning to get it right!

An extra half a mg tonight and tomorrow may be OK...will find out on Friday and will keep you posted.