When I got out of the hospital from surgery 9 weeks ago my cardio took over my warfarin management. I would have a blood draw once a week & later that day his nurse would call with the results & dosage adjustment. I was being tested on Fridays and my INR was way up one week, and down the next.
Once I went back to work (part-time at first), I wasn't by the phone when she called and, for what ever reason, she would not call me at work. Then came the day that she called & left the message to call her. I, of course, got the message when I got home from work (around 4:45) and the office was closed. After cussing for a few minutes and then crying for a few more, my husband told me to call back & talk to the on call dr. I was too upset so he made the call, talked to the on call dr. (not my regular cardio), who said he would have his nurse call. She called back a few minutes later, accessed my medical info on the computer and told me my INR had dropped to 1.8 - she adjusted the dosage. I was really ticked... my cardio's nurse really left me hanging. (She did a similar thing a week later when I gave her my blood pressure info & asked about some medication to lower it... I wrote my work number on the sheet I gave her & told her I would be at work & to call me there. Again, she left a message on my answering machine - while I was still at work - and I waited over the weekend to get the prescription - what a ditz!)
Anyway, I saw my PCP recently and he asked who was managing my warfarin. I told him the cardio and he said the group he belongs to (part of my HMO) had a coumadin clinic - with a wonderful nurse who knows her stuff. So I made arrangements to meet her & get into the program but she was going to be gone for a few days & my PCP wanted me to get tested while she was gone. I did, & then talked to his nurse. By now my INR had dropped to 1.9. She said, "Dr. wants to keep your dosage the same." I thought I had lost my hearing... my INR drops and they want to keep my dosage the same? I said, because I had learned so much from everyone here , that I wasn't comfortable with that. I told her that my range was 2.5-3.5 and that keeping the same dosage would probably drop my INR even further, and also that I had only been off amiodarone for 1 1/2 weeks which had an effect on the level too. She said she'd call me back. When she did it was with a rather interesting adjustment. Double doses for 2 days and then an 2.5 mg every day instead of alternating 2.5 & 2. (Based on her comments I think she made the first decision & dr. made the second.)
That raised me to 3.4, on the high side but I'd rather be there than where I was. I was terrified of having another stroke (I had one after an a-fib episode 1 week after surgery)
At any rate, I've learned a lot here... especially the "real world" stuff and I would like to offer my thanks. I know I will continue to absorb information and hope that, from time to time, I can make a contribution. Knowledge is power! (not to mention potentially life-saving). Thanks again everyone
Cris
Once I went back to work (part-time at first), I wasn't by the phone when she called and, for what ever reason, she would not call me at work. Then came the day that she called & left the message to call her. I, of course, got the message when I got home from work (around 4:45) and the office was closed. After cussing for a few minutes and then crying for a few more, my husband told me to call back & talk to the on call dr. I was too upset so he made the call, talked to the on call dr. (not my regular cardio), who said he would have his nurse call. She called back a few minutes later, accessed my medical info on the computer and told me my INR had dropped to 1.8 - she adjusted the dosage. I was really ticked... my cardio's nurse really left me hanging. (She did a similar thing a week later when I gave her my blood pressure info & asked about some medication to lower it... I wrote my work number on the sheet I gave her & told her I would be at work & to call me there. Again, she left a message on my answering machine - while I was still at work - and I waited over the weekend to get the prescription - what a ditz!)
Anyway, I saw my PCP recently and he asked who was managing my warfarin. I told him the cardio and he said the group he belongs to (part of my HMO) had a coumadin clinic - with a wonderful nurse who knows her stuff. So I made arrangements to meet her & get into the program but she was going to be gone for a few days & my PCP wanted me to get tested while she was gone. I did, & then talked to his nurse. By now my INR had dropped to 1.9. She said, "Dr. wants to keep your dosage the same." I thought I had lost my hearing... my INR drops and they want to keep my dosage the same? I said, because I had learned so much from everyone here , that I wasn't comfortable with that. I told her that my range was 2.5-3.5 and that keeping the same dosage would probably drop my INR even further, and also that I had only been off amiodarone for 1 1/2 weeks which had an effect on the level too. She said she'd call me back. When she did it was with a rather interesting adjustment. Double doses for 2 days and then an 2.5 mg every day instead of alternating 2.5 & 2. (Based on her comments I think she made the first decision & dr. made the second.)
That raised me to 3.4, on the high side but I'd rather be there than where I was. I was terrified of having another stroke (I had one after an a-fib episode 1 week after surgery)
At any rate, I've learned a lot here... especially the "real world" stuff and I would like to offer my thanks. I know I will continue to absorb information and hope that, from time to time, I can make a contribution. Knowledge is power! (not to mention potentially life-saving). Thanks again everyone
Cris
