Thanks and update

[halleyg]

Thanks to all who posted input on my dropping pro-time levels. I didn't stick with my doctors recommendation (alternating 7 and 7.5 mg of warafin every other day) and instead took 7.5 everyday for a week. Got checked today and level was 2.4 up from 2.1 last week. Good it's going up somewhat, but dr. says I should just stick to 7.5???? I was thinking I should probably start taking 8 mg if not daily then every other day. I'm not in a panic or anything, but since it has been low for at least a month and dropped 3 weeks in a row before this week, I don't see how staying at 7.5 will make it go up any higher? I was taking 7 daily before. Any advice, experts?

Also, after testing nurse actually told me to lay off green vegetables. I told her I want to adjust my dosing to my diet, but she kept insisting I shouldn't eat the green stuff. She actually said try laying off for a week... I told her if I did that it my level might go up but when I resume eating them it'll go right back down. She looked really confused about that. I really feel like my dr. is just guessing - I'd rather listen to you guys! And I am not changing my diet, I do know better than that but the dosing I'm not so sure of yet. Thanks!

 

[geebee]

7.5/day is not a big jump from 7/day - only about 7% and I would have upped the dose by at least 10%. You could take 8mg two or three days/week and 7.5 the rest and retest in a week.

Good for you on not changing your diet. I am still amazed that people are still getting those instructions.

 

[Bina]

Halley, good for you, making wise choices so far.
Good, the 7.5 daily is moving you in the right direction, slow, but steady.
I agree with Gina, you could take 8mg twice a week to continue the upward trend. And of course, re-test.

I think the Docs who want people to lay off the greens, must be used to the binge eater style.....eat a bucket of spinach, then no greens for days....then eat a dinner plate of broccoli and no greens for several more days. This is exactly how my husband would eat, (if he had his way), he would be scary on Coumadin.

 

[Ross]

7.5/day is not a big jump from 7/day - only about 7% and I would have upped the dose by at least 10%. You could take 8mg two or three days/week and 7.5 the rest and retest in a week.

Good for you on not changing your diet. I am still amazed that people are still getting those instructions.

They don't know any better They are taught this way and it's wrong. Maintain your diet as you normally always eat. Whatever dose it is that keeps you in range is the right dose, so when you find that spot, stick with it and you'll see what we mean.

I don't see where 8mg would be a problem either, especially if you've consistently dropping.


For those reading--we are NOT EXPERTS we are not Doctors, we are self dosing hometesters that know what it takes to maintain a stable INR.

 

[Bina]

Ross, Halley is not dropping. She was 2.1 last week and 2.4 this week.
You may be thinking of IMHayley on the other thread, she is dropping like a rock.

 

[Ross]

Well 2.4? Ok we'll give the clinic one week and see. I've been wrong before. I just think for whats been going on, she's going to be just at or below on this dose. If it were 8mg, I think it would be right on for 2.5 to 3.0.

 

[halleyg]

For those reading--we are NOT EXPERTS we are not Doctors, we are self dosing hometesters that know what it takes to maintain a stable INR.

That makes you an expert in my book

Seriously, that is true and you should definitely make it clear. In my own experience (which isn't much) I just feel better with you guys backing me up since I am new at this, and in my case you've all given me good advice - so thank you once again!

 

[Blanche]

Halleyg:
The link I am leaving is from the National Institute of Health. You might want to make a copy and provide it to the "nurse." This is certainly a reliable sourse for information of this kind.

http://ods.od.nih.gov/factsheets/cc/coumadin1.pdf

While you are at it, you might want to ask her what type of nurse s/he is. I have found that most RN's are relatively good when dealing with anticoagulation concerns. The person you are speaking with may not be a nurse at all. I have found a number of nursing assistants (used to be called nurses aides) giving the impression that they are nurses. I had a "nurse" tell me she was in the medical field for 14 years. Imagine my surprise to find out that her participation in the medical field was limited to answering the phone and scheduling.

Good fortune to you. Hold your ground. It does get easier.

Blanche

 

[halleyg]

Hi guys - my INR is still dropping. It stayed at 2.4 two weeks in a row, even w/slight dose increase (I have a MV, so need to be between 2.5 and 3.5). This past Friday got tested and it was 1.8! That week I had been alternating between 7.5 and 8.0. Also started cardiac rehab the week before so my activity has increased a lot... dr. said just take 8.0 daily now. It was dropping with the 7.5/8.0 routine, so I don't see how that is going to boost it any??? I am getting frustrated with this, I feel like my dr. doesn't know what she's doing but then neither do I. 2.4 wasn't quite high enough but wasn't so bad; however, 1.8 doesn't make me feel good. I want to start home testing but was hoping to get my level steady first. Anyhow, as usual, opinions welcome!

 

[Ross]

It's because of your increase in activity. It's just a matter of hitting the spot that keeps you stable. I think trying 8 is a little conservative. I'd of pushed for 9 everyday and retest in a week.

Just small 10 to 15% increases until your sweet spot is found.

 

[njean]

Dear Halley,

I just want to share my experience with the coumadin lab I used to go to.

My first home monitor was a pain to use. I had to conduct a pre-test using little viles with "dried up rabbit brains" REALLY, prior to doing the finger stick. Anyway, my INR readings at home & the ones being done at the lab almost never matched! This went on for months & I became so frustrated that I sent the home tester back to the company & they sent me another one. Same thing happened. My tests & the lab's didn't match. And the readings I was getting at home were almost always on the high end -- 3.6, 4.2, etc. When I would go to the lab, their readings would be in the lower ranges -- 2.1, 2.3 so they would increase my coumadin dose according to their readings & kept telling me, I had a faulty monitor! Finally, I had enough & returned the monitor I had & got me a new one from QAS. (best thing that ever happened! )

This time, I took my monitor & conducted a test right there in the lab. Then the lab did their finger stick. And guess what?? The readings didn't match. My reading was higher, 3.4, the lab's was 2.2! They conducted one more finger stick & it was 2.6. Now they start to wonder?? So they conduct a vein draw. Vein draw comes back with 3.6! It turns out their equipment needed to be re-calibrated & they had to start vein drawing all their patients until their equipment was brought up to par! Scary, huh!
Because if I had not taken my monitor, my coumadin would have been increased which would have thrown me into a dangerous zone! And that is exactly what had happened for many months & I kept thinking my monitor was bad!!!!

With all that said, if you are not getting vein drawn, ask that you get vein drawn or have your doctor request it. Just because these are medical facilities & they are suppose to be state of the art, equipment will fail & these mistakes can be life threatening, especially when dealing w/blood thinners!

Good luck to you & I hope you get your levels where they're suppose to be!

God Bless,
njean