The sun & INR

[Jan]

Hi
I also have a question regarding INR

The Dr at the Warfarin Clinic wants my INR to be 3.5

Three weeks ago I was on holiday in Spain, I ate and drank as normal (one or two drinks a night )

The day before I came home I developed a large bruise on my thigh, I went for a blood test and my INR had shot to 7.0

My Warfarin was stopped for two days and then retested and was 2.7
I was then put on 4mg daily and tested 7days later at 1.9
I am now back on 5mg and at my last test was 3.1

Could sunbathing have had any effect?

before the holiday i was taking 5mg one day and 6 mg the next
and was usually around 3.1 to 3.5

Thanks

Jan

 

[Guest]

There have been no studies showing that this happens. However, you will probably get quite a few replies as people look at this. We had a big discussion about 6 months ago on this topic. You will find plenty of backers for your theory. I'm surprised that 43 people looked at this and nobody had gotten into the fracas.

FYI - when warfarin is held for two days the INR will often drop by about half, so 7.0 to 2.7 is about what would be expected to happen.

 

[Zipper]

From all I've read here..it does seem like INR's go nuts when vacationing..it would seem to me that it's a combination of eating out/drinks prepared differently/excercise altered, and Maybe more sun exposure and just overall changes in routine. Gee...lucky me..haven't been away since surgery (4 years...yikes..I'm soooo overdue)...but my common sense tells me all of the above and then over-correction of dosage..hmmm?? Just MHO (my humble opinion)

Zipper

 

[Guest]

Yeahbut - you live where people try to get away to go to.

 

[Granbonny]

Me and the sun

Me and the sun

I'll add my 2 cents worth..I have a very good tan..Sit by pool..cover the scar and NO side effects...Was down for 7 hours yesterday (Not all time in sun)..Feel good today. Bonnie

 

[Zipper]

Coastal Paradise

Coastal Paradise

LOL! So true...I do love the Ca. coast..the weather where I am is generally on the cool side..rarely over 75 degrees. I prefer it to the heat!

Janie...YES...come see me...I'd love your company...I'm only a couple blocks from the beach and a mile from the harbor! It's no wonder my boys are 'water dogs'...LOL! Can't keep them out of the surf! Not me tho...those days are over..but love walking the beach. Bring warm clothes..lol!

Zipper

 

[Rain]

If we only had a beach in Colorado.........

If we only had a beach in Colorado.........

Well, Mr. Al...

At one time I would have sworn that being in the sun effected my INR. But I have since convinced myself that it?s probably what I drink and don?t eat when I?m in the sun that effects it.... along with what I?m doing. It?s amazing what a person can learn by keeping a diary of what they do and eat!! I did that for a month or so.

I still believe that when I miss my exercise class a couple of times it messes with my INR... but other than that, I think it?s mostly what I put in my mouth that causes the swings.

But you know what, Al? Since it?s become summer, I have started taking a 1/4mg more per week! lol I still think its what I?m eating and that I?m more active in the summer though.

Rain

 

[Sunshine susan]

Hence, my VR.com handle.....

Hence, my VR.com handle.....

Oh how I do love the sunshine and light breeze we get right off the gulf and Tampa Bay. Even drive a little convertible...however, while I can't say sun has ever affected my INR, since I have been on coumadin (3 years now), I have noticed a distinct propensity towards photosensitivity. So much so that I now avoid direct rays if at all possible. I wear hats, plenty of lotion, sit in the shade & under umbrellas; and stay out of it altogether from 10 to 2. I used to bake as a teenager, and my husband survived a malignant melanoma 20 years ago. Now I enjoy it only as long as it is not directed directly on my skin. But can't say the frolicking has affected the INR---like Rain, I think it's much more what I put in my mouth and my overall stress level. Anyone else find a photosensitivity problem? Thanks! Susan

 

[Rain]

Susan,

The other thing that has happened to me since I've been taking medication is that my eyes have 'squigglies' in them sometimes. And also, they just really hurt sometimes (my eyes) .. when I'm in the bright outdoors. You may say thats normal.. but it never happened to me before?! The first weekend after I started taking medication we were driving, in January after a snow storm to my son's wrestling match... it was VERY bright outdoors and a long drive.......my eyes started hurting so bad I couldn't keep them open! That, or nothing like it had ever happened to me before. It continues to happen to this day. I take toprol, lanoxin and coumadin. I know it's one of them, or maybe all of them combined...... I donno. I just know nothing like that ever happened to me before. Now it happens all to often.

But then again........ I found a broken blood vien in my leg after the surgery. I was totally freaked!! I asked my cardiologist.. what is doing this?! He said, "Lorraine.. you are aging" LOL "these things happen".

Well, dad gum it... it's a pretty wierd coincidence!! lol

 

[Guest]

Can't get much sun around here lately. We had the most destructive ($$) forest fire in Colorado history last weekend. But the record only stood for one week. My son says that he can't see where his golf drives stop for all the smoke.

I agree with the diaries and the INRs going down from activity.

Sunshine Susan, it seems like so many other things that it is change that affects people. Jan is from un-sunny Liverpool, England and went to sunny Spain. If you are in sun consistently, it appears that nothing happens.

I'm not convinced that sun raises the INR but lots of others are.

Rain, if that thing happens with your eyes again call your doctor and ask for an order to have a digoxin level & a serum albumin done at the lab. Visual disturbances are a sign of digoxin toxicity. As one (I did not say you) ages the dose of digoxin often needs to be lowered. This may also happen more frequently to people who eat little meat because the serum albumin may be low. Digoxin is highly bound to albumin. The bound part is inactive. If your albumin is low, then there is more free drug to cause toxicity. There is a formula to calculate this but I do not remember it exactly. I'm a specialist, you know -- I know more and more about less and less. Soemday I will know everything about nothing - then I will retire.

 

[LUVMyBirman]

Hi Rain

Hope all has been well with you.

Send my your number again......I will give you a call so we can catch up.

And, have some info about the optical migraines. I was diagnosed with the same symptoms you are describing. Too long to go into detail. It's really a wonder I could find the computer and get online. My time is scarce these days. I can work and chat at the same time

Take care
Gina,
Email. [email protected]

 

[cookie]

Hello!
I went on a cruise last year to the Carribean and my INR jumped way high. Watched my diet, rarely had a drink, but was in the sun a lot. My ankles swelled and I broke out in these little red dots on my feet. What was that? Have also been diagnosed with optical migraines. Really strange. Had migraines going through menopause but they went away after I was done. The opticals started after surgery. Had my eyes thoroughly checked by an opthomologist and nothing had changed. So what causes these? Many unanswered questions. Age? Well, maybe!

 

[Sunshine susan]

We are ageless-especially us bionic ones!

We are ageless-especially us bionic ones!

Rain, I have had optical migraines since I was 19, and am now well--let's just say I have gotten my first AARP package--so it's not just age. A few years ago I went through the MRI via a neurologist and the whole medical testing deal scam--nada. So I have learned to deal with it. Have had everything from squigglies to complete gray out. It can also be food induced. I have a slight problem with hypoglycemia and have pretty much learned when to avoid what or will get the swuiggly eye and shakes. All of this started long before the heart surgery, and I only take coumadin. However, I did have for just about all of my life an undiagnosed congenital bi-leaflet aortic valve. Caused a murmur no one paid any attention to until....anyway, those eye things can be both an annoyance and a fright! Susan

 

[Zipper]

Me too!

Me too!

Susan and Rain...

I've had migraines since early 20's/squiggles, etc...also have mild hypoglycemia..also had bi-leaflet valve...also have my AARP mailings..LOL.

Lots of similarities here..never have figured out what food triggers the migraines, but do know which ones keep my hypoglycemia in check. These were with me long before my heart surgery, so I agree with the notion that age and or surgery are not causes. I am also sensitive to bright lights and that in itself can trigger a migraine. These similarities make me wonder what the connection might be...Valve/migraine/blood sugar...Hmmmm...????

Zipper

 

[Rain]

WOW!

WOW!

Al,

Thank you!!

I?m thrilled to be armed with this information, especially since it looks like I will be taking it for the rest of my life. I know I should take the time to really study these drugs. But I kinda got sick and tired of worrying about my heart for a while there. I was so freaked about everything for the first few months after the surgery. Just the clicking of the valve freaked me out! Because you could really hear the inconsistent beat of my heart.

Anyway... I will certainly ask my cardio for the test. Thank you for taking the time to explain it to me. You?ve inspired me to study up on it! I kinda thought it was just something I had to learn to live with.

I?m about 45 miles from the fire burning in Durango. We pray for rain, but all we get is lightening. You should see the responses from people when they see my license plate. I could deal with people doing ?thumbs up? and stuff like that.... just figured it was my cool Colorado buds sayin, ?hey? But, for the longest time I couldn?t figure out why people were putting their hands together like they were praying when they drove past me?! What?s up with that?? Finally one guy did it and pointed at my license plate!! lol Hilarious! My plate is Colorado ?RAIN? lol


Thanks again,
Rain

 

[Rain]

Hey Girlfriend!!

Nice to see you. Are you all moved? I?ve lived in the same house forever... I cannot imagine trying to move all the stuff I?ve collected over the years. lol I?d probably get irritated and throw 90% of it away. Second thought.... maybe I DO need to move! lol

My world is fine, just been really busy. Seems summer is always busy, but I love it. My favorite time of year.

I?ll send you an e-mail.

Cookie, Susan & Zipper --

When I was pregnant with my now nine year old daughter they sent me to a specialist to have my eyes checked in relation to Marfan?s syndrome....... The guy told me ?there are people who would kill for eyes like yours, they are absolutely perfect? I never had problems with my eyes until I started taking medication... read Al?s post to me above.

And those ?little red dots? I have them around my ankles all the time. That?s one way of gauging my INR! lol If I have no spots.......... Low INR. If they are all the way to my knees.... High INR. lol It?s true! Al told me the name of them one time, but I forget what it was.

I used to have horrible head aches. But they were caused from a truck wreck I was in a long time ago... my head cracked the windshield of a Mack truck! I only have them now when I do something to irritate my neck. Other than that I seldom have a head ache.

The thing with my eyes started the weekend after I started taking the medication. Up to that point I had hardly even taken an aspirin in my whole life. I?m really a healthy person... if I just didn?t have a screwed up heart! lol

 

[Guest]

petechiae

 

[Guest]

I'm consulting on a murder case right now. Talk about having to be right. It could mean the difference between freedom and life in prison for the defendent. I'm advising the attorney on how to challenge the autopsy report. You guys keep me on my toes.

 

[arlice]

question about optical migraines

question about optical migraines

It has been a long time since I stuck my head up out of my prairie dog hole but today I have a question about optical migraines. I do not have a valve replacement but my husband does so I check this site from time to time. I do, however, have atrial fibrillation and some of the information on this site applies to me anyway.

About 1 1/2 to 2 years ago I was on coumadin for the afib. I had to stop taking it as I developed a side effect known as "purple toes syndrome". That is apparently caused by microembolii of cholesterol that is loosened by the coumadin. Since then I have only been on one regular aspirin daily for anticoagulation.

About 10 days ago (just after eating a half piece of toast with jelly) I had some sort of "spell" where I felt like I was backing out of my body and my vision narrowed into a tunnel. It only lasted a few seconds. That was followed by a trip to the bathroom as my bowels didn't like what happened. I went to the physician's assistant that same day. They did blood work and it all came back normal. Four days after the first spell, I had another just after eating ice cream about 9:30 pm. It was even shorter, but also necessitated a trip to the bathroom. Then I felt fine both times. The next morning I went to see my primary physician. He mentioned the optical migraines, sent me for a carotid scan since I had also complained of achy pains in my neck. That was also normal. Tomorrow I am going for an echocardiogram. He said depending on what that shows they might want to do a transesophogeal echo.

Does anyone think it possible that the two could be related even though I am no longer on the coumadin? Someone mentioned that food seems to be involved in their optical migraines. Food is always involved in our lives isn't it? It has even set off my afib at times.

Any help you can give would be appreciated.

Thanks
arlice

 

[Guest]

Warfarin is cleared from your body within 5 days after you stop it, so there is absolutely no chance that it is causing this problem this long after you stopped.

I am also a little curious why the warfarin was stopped for the purple toes syndrome. I have successfully managed two people with this by continuing their warfarin.

If you have atrial fibrillation and take aspirin instead of warfarin you may be giving up as much as 80% of your stroke protection. The trade off for purple toes does not seem big enough to give up the stroke protection.