Totally Discouraged

[Freddie]

Gonna try to make a long story short.
On 6mg everyday and testings every two weeks - range is 2.5 - 3.5

May 14/08 - INR 3.4
May 21/08 - INR 3.4
June 2 - received a blackeye - INR 3.1
- Doctor asked to re-check in 10 days
June 13/08 (today) INR 2.4

Haven't done a darn thing different within those 10 days except taking Extra Strength Tylenol for the headache due to the mild concussion I gave myself with the blackeye.
Now I'm going to the dentist (re-do root canal) on Monday and will be taking antibiotics before I go.........Should I up my dose from 6mg to 7mg on Saturday and for Monday?
I have call into the Doctor, but I haven't heard from the Doc yet in regards of my headaches or my INR.
Any suggestions???
Any answers???

Its days like today I'm just ready to throw in the towel

 

[marie]

I can not answer any of your questions but I did want to ask you "hang in there". I'm thinking positive thoughts for you.
Earline

 

[Bina]

Fred why would an INR of 2.4 make you do anything? And what's with this "throw in the towel" crap?
Do I have to come over there and spank you......LOL
If you have been doing more exercise and stuffing in the spinach, you may be a little low for INR this week, no big deal.
Relax sweetie, all is fine.

 

[duncanjo]

Hey 2.4 is good, im at 2.4 myself and the Doc doesn't see any problem with that im on 5mg warfarin, but ran into the same problem as you.
i was on 3mg hovering at 2.4 inr, then for no reason went down to 1.7 in a week dont know why just dipped.. then they put me on 5mg, and now its around 2.4 hopefully it stays that way

joe-mech valve april4/08

 

[dick0236]

I would not change anything because of 2.4. I would recheck in a week. The 2.4 may have been a fluke. If the next test is low, I would then consider bumping the dose by +10%/wk and see what happens. Antibiotics for dental work usually have little effect on my INR...neither does Tylenol.

In the past month, I've gone 2.4 to 3.5 to 2.9(today) with no dosage or lifestyle changes. It just happens. My range is also 2.5-3.5, and I only try to stay SOMEWHERE in that range, so my numbers above are OK. I gave up trying to STAY at any particular INR number....a long time ago.

I only make changes when my INR numbers show a trend, either up or down, and then only in small amounts. "Knee Jerk"changes create a yoyoing effect which can be a nightmare to straighten out.

 

[Karlynn]

You'll be fine. Just retest in a week. If it's still low, increase the dose. No biggie. Early on I used to look at having to change dosing as a negative and get discouraged. Now it's just a non-issue, fact of life occurance. It's neither upsetting or something to celebrate - it just is.

 

[Freddie]

I've been always under the impression that antibiotics would lower ones INR. Keeping that in mind, is the reason I was asking about upping my dosage.

Bina - if I was "doing more exercise and stuffing in the spinach," I would totally understand the drop in my reading........but I haven't changed a damn thing.........if anything I've become lazy - given in to these headaches.
More promises about being spanked.............still waiting

Karlynn - if I test next Friday, the antibiotics would be out of system and I should get a 'so called proper reading'....correct?

 

[ALCapshaw2]

It has been MY understanding that (many) antibiotics INCREASE the INR.

Have you increased your activity level in the past 2 weeks?

I seem to recall several people reporting INR changes when SUMMER rolled around in past years. I'm not sure why, unless it had to do with greater activity.

'Al Capshaw'

 

[Freddie]

Sorry Al, I wish I could say that I have increased my activity level ......but I haven't. Been a bit of a couch potatoe nursing my headaches for the past 10 days.

 

[zipper2]

Freddie i really think its just friday the 13th and almost over
your inr seems like its doing what it should and why change
any dosage? my inr changed too in last 2 months from 56mg
to 46mg i dont know why or what changed it more fruit to eat
now,seasonal changes of eating habits,the weather, global warming
Please dont drive yourself into frustration over it,it only gets
better and we've all been here and still go here with these dam
inr's its an ongoing circle,dont beat youself up one black eyes enough
now



Zipper2

 

[JimL]

My INR dropped from 3.9 to 1.9 in a week, no explanation (maybe coming off nexium). So I've upped the dosage 2 mg, and I took the Coors tour yesterday.

For those who toured Coors as part of the 2004 Golden reunion, they have now dispensed with the tour guides, and give you little radios to listen to instead. I was not impressed, but my grandson liked the radio, even though his parents wouldn't let him sample the waters.

 

[Karlynn]

Antibiotics always seem to increase my INR.

 

[KristyW]

Gonna try to make a long story short.
On 6mg everyday and testings every two weeks - range is 2.5 - 3.5

Freddie,

You're thinking about your range in too tight of a range. Many of us consider 2.0 - 4.5 as a practical range. In other words, don't change anything and just wait and see what it does.

My experience with antibiotics is that they tend to slightly increase your INR. There's a good reason for this. Broad spectrum antibiotics like amoxicillin and clindamycin kill off not only harmful bacteria (like those that cause infection), but they also kill the beneficial bacteria (like those that live in our intestinal tract.) When they kill off the beneficial bacteria, the vitamin K that is naturally produced in our intestines is disrupted.

Relax. As far as I can see, you haven't been out of range. Watch the low INR, but don't panic.

 

[Freddie]

Thanks for the explaintion Kristy, I appreciate it.
But my Doctor pulled a small panic button when I was 3.4.
Can't imagine what she would do or say if my levels went to 4.0.

I'll try to relax now and continue with my 6mg, go to the dentist on Monday and test again on Friday......or screw that and test again in two weeks.
Thanks everyone for your input and knowledge.
freddie

 

[Bina]

I find that the one dose of antibiotics before the dentist does not cause a change. Now if I was taking them for a whole week, I would watch for some kind of change.
Fred, maybe your doc is making you more nervous about this whole INR thing. Don't let it get to you.
It really is a non issue to be at 2.4 and if the doc frowns at it, tell her where to go.....

 

[catwoman]

Thanks for the explaintion Kristy, I appreciate it.
But my Doctor pulled a small panic button when I was 3.4.
Can't imagine what she would do or say if my levels went to 4.0.

Doctors who go into panic mode when an INR is 3.4 for a mitral valver should know better.

See what your next test is and then decide whether to bump up your dosage.

 

[Karlynn]

This isn't surprising Freddie. Your doctor doesn't know warfarin management period. (Remembering your fight to home test.)

 

[bvdr]

Thanks for the explaintion Kristy, I appreciate it.
But my Doctor pulled a small panic button when I was 3.4.
Can't imagine what she would do or say if my levels went to 4.0.

I'll try to relax now and continue with my 6mg, go to the dentist on Monday and test again on Friday......or screw that and test again in two weeks.
Thanks everyone for your input and knowledge.
freddie

Freddie, I think it is the doctor here that is the problem and not your INR.
At 3.4 you were perfectly in range. My INR jumps around without any easily identifiable cause but if I'm from about 2.3 to 4.3 I don't change a thing. Remember that your INR is reflecting your status about 2-3 days prior to the test. I think you are doing fantastic. You will drive yourself crazy trying to micro manage it so relax and enjoy your success.

I just want to add that one of my doctors actually wanted my targeted range to be 3.0 - 4.0. So if 4.0 seems high to you then remind yourself that is right in range for many warfarin users.

 

[Blanche]

Be good to yourself

Be good to yourself

Fred:

If I may be so bold as to add on to Betty's last post...Albert's range has been 3.0 to 4.0 since 2001.

The only way you are going to stop the insanity of your doctor's competence of ignorance with anticoagulation is to do your own thing and make your own decisions. And, most important, get it out of your mind that you are doing something wrong everytime you have an variance in your INR.

Your doctor is the one who is causing this problem. If you can't work with her, and you can't replace her with a competent doctor, then you just have to work around her.

The main thing is don't take this out on yourself. INR variations happen. That's why you have the range in the first place.

Regrds,
Blanche

 

[Lisa in Katy]

Even though the range is 2.5 to 3.5, 2.4 is close enough. No test is that perfect. Antibiotics can raise or lower, but in my experience, they raise. Clindamycin is what my dentist used and it did nothing. Also keep in mind that hormonal changes in our bodies can cause variances as well, so even if you didn't do anything different, your body might have. Changes in weather can also affect metabolism. It's just not that easy, which is why I only get checked monthly (or less). I don't want to drive myself crazy with the normal variances.