Thrown up 2nd dose of warfarin tonight.......

[gijanet]

so now what? Thought we had been there before.................argh!

Katie has the stomach bug..............yes, again! 2nd verse, a little bit nastier, a little bit worse.............

She threw up, so we thought we would give her her coumadin a little early on an empty stomach, so it would be absorbed quickly, but nooooooooooo....

she threw up thirty minutes after we gave it - I'll spare you the gory details, but definitely light shades of pink. I thought, okay, we have done this before. Gave her another dose, usually 2.5, so I gave her 2. Then, twenty minutes later, she pukes again, poor thing. STill pale pink. She's running at both ends, so now what? I'm afraid to give her anymore................don't want her INR shooting through the roof, but I don't want it too low either. Last INR check was last Wednesday. 2.6 from lab draw; 3.4 on INRatio. Will draw again in a couple of days to check it, but that doesn't tell me what to do now....................sigh! LIfe's always an adventure around here. Any input? P.S. Since Katie developed Heparin-induced thrombocytopenia after her last surgery, we can't do heparin if her INR gets too low; we'd have to do argatroban, I guess..............dunno! Dazed and confused. Janet

 

[cocoalab]

Hi JANET SORRY TO HEAR Katies sick again! poor thing. Well I am with you with not trying to give it again tonight. Who knows if any has been absorbed and she will probably just throw it up again anyway.

It seems like from what I read here the home testers are more likely to be acurate than a lab draw so I would feel more confident that the 3.4 is closer to where she is at. Missing some of today will probably not bring her down too far, and wht can you do at this point? We will just pray that tomorrow her tummy can tolerate it.

You two have sure been through it. Keep us informed on how it goes.

 

[gijanet]

Thanks, Wendy.

Thanks, Wendy.

I reallly appreciate the sympathy and your input...............geez! Just when I start feeling the slightest bit comfortable about this stuff, she throws me a curve ball. Just likes to keep me on my toes, I guess...................sigh! Ya know, last bug, she threw up in bed and then the sink (cuz we happened to be in the bathroom). Boy, I had forgotten how little kids never run for the trash can or the toilet or any type of container..............they just stand where they are and puke everywhere - all over themselves, the carpet, and whatever else is in the spew zone..........................oh, the joys of motherhood........... Many hugs and thanks again. Janet

 

[geebee]

Janet,

Your life just gets more and more interesting - yeah, right. I agree with Wendy that you should just wait until tomorrow and try again. There is a chance Katie got some small bits of the coumadin in her system and her INR shouldn't drop too fast. Just test in a few days to make sure.

I hope her tummy is better tomorrow and your carpets survive.

Try to hold onto your sanity, there's only about 15 years left before you can throw her out.

 

[gijanet]

Thanks, Gina.............

Thanks, Gina.............

as always! That's what I'm banking on - that at least some of that got absorbed between the two doses. Al said normally you would expect it to be absorbed within a half hour or so, but he also said that would be under normal stomach conditions, not one about to erupt in a Mount Vomitus fashion, so to speak...............

Yes, let's hope her tummy is better tomorrow............got to get her well before it makes its course through the rest of the family......................... and as far as the "carpet" is concerned, it has already met its untimely demise, thanks to Kaite..............sigh! Just waiting until she's a tad bit tamer to replace it. 15 years? Yeah, but I'll be in nursing home or my grave by then at the rate she's aging me. Many hugs. Janet P.S. HOpe YOU'RE feeling better, too.

 

[WendyD]

Hi Janet, so sorry to hear that Katie is sick,
hope that everything settles down really soon for you all.
Sending you love and best wishes
Ernie Wendy & Fam

 

[gijanet]

Oh, Wendy, thank you............

Oh, Wendy, thank you............

and not to hijack my own thread, but I was just checking to see if there was an update from you on Ernie............any decisions yet? You guys are STILL in our nightly prayers until I hear otherwise. Hugs. Janet

 

[Phyllis]

Oh, Janet so sorry to hear that Katie is sick again- hope it doesn't spread like wild fire through the house and that she is feeling better today. You "deserve a break today"- and not Mickie D's- maybe a tall martini! By the way- loved the "butt" pictures and so glad you all got to have such a great visit before the mean old stomach flu made a visit.

 

[Guest]

Texas Southestern Medical School in Dallas has a service called Difficult Hematology. Dr. Rodger Bick is the director. I think that Katie should be referred to him.

 

[Emma]

Awww Janet, why do our girls not like to make life easy for us?!

Chloes done this exact thing to me before (twice in one night giving back her warfarin) and strangely her INR wasnt affected by it a couple of days later.

My theory on it is 'cos throwing up tends to raise the INR anyway (something to do with vit K in the stomach being thrown out of the system at the same time or some such thing?!), even though Chloe hadnt taken any of her warfarin in, her INR still stayed up due to the puking.

Hope Katie feels better soon and her INr isnt too badly affected.

Love and hugs to you all
Emma
xxx

 

[gijanet]

Just to let y'all know ...........

Just to let y'all know ...........

how this turned out as I have been puterless for a week or so, Katie's INR was 4.3 when we checked a few days after that..........not too bad, but it was good I didn't attempt a third dose............dunno if the coumadin did get partially absorbed or it was all the vomiting and diarrhea or the combination..............anyway. She's alive and kicking and being a holy terror since Santa is coming soon. THanks for all of the good wishes. Hugs. J. P.S. Al, were you joking?

 

[Guest]

No. He is in your area. She qualifies, I would think. At least you would be in contact with people who are prepared to deal with the rare cases. You already know more than the average doctor and so you have few places to turn for answers.

 

[gijanet]

No. He is in your area. She qualifies, I would think. At least you would be in contact with people who are prepared to deal with the rare cases. You already know more than the average doctor and so you have few places to turn for answers.

That's a dangerous thought. So who would refer her, her PC or PCP? and on what basis now? Just a stop and get to know ya visit, just in case anything crops up? The HIT is what scares me the most, especially if she does end up having to have the intestinal malrotation addressed. Anyway, thanks for your insight. Hugs. J.

 

[Guest]

Why don't you call the Difficult Hematology Clinic and see what they want in the way of a referral. Also check with your insurance's customer service.

There are alternatives to heparin and Lovenox, but again you would need someone who has some experience with their use in children.

Dr. Rodger Bick, the clinic head, is the author of a small medical jorunal devoted to blood disorders. He invited me to write an article several years ago. He may still remember my name. I have never met him personally but we have talked on the phone and exchanged e-mails.

 

[gijanet]

Thanks, Al.

Thanks, Al.

Why don't you call the Difficult Hematology Clinic and see what they want in the way of a referral. Also check with your insurance's customer service.

There are alternatives to heparin and Lovenox, but again you would need someone who has some experience with their use in children.

Dr. Rodger Bick, the clinic head, is the author of a small medical jorunal devoted to blood disorders. He invited me to write an article several years ago. He may still remember my name. I have never met him personally but we have talked on the phone and exchanged e-mails.

I would be willing to bet he remembers you (there are certainly enough of us on here who think you walk on water), but I won't bandy your name around. Will definitely check into it. Thanks again as always for your taking the time to give me your input. Hugs. J.