trying to help sis with INR's getting higher

[SisHeidi]

My Sister is having trouble getting her INR to stablize. She had surgery in April and has been having trouble with it ever since. She was put on Predizone about a month ago, and her INR went down. Now that she is off the predizone, her levels keep going higher. she says she eats lots of greens trying to balance it out, is this the thing to do? or could the greens be making it raise higher? I know the Via K is suppose to be an anti cogagulant to the coumindian, but her body seems to be acting different. does anyone have any thoughts on this?
I'd like to get her interested in this forum, but for the time being, will try for answers myself.
Thank you for any thoughts on this.
Heidi

 

[geebee]

Welcome Heidi.

What a great sister you are to be helping like this. Supporting loved ones is a gift that not everyone has.

First off, your sister should not be eating to regulate her INR. She should eat like she wants to and adjust the INR accordingly. She will drive herself crazy trying to eat this and that in enough quantities to matter.

Greens will lower INR but, again, unless she decides to eat nothing but spinach every day for a week, it is unlikely it will cause that much of a difference.

The trick to a stable INR - for most people - is consistency. Similar amounts of exercise each day/week, diets without extremes - eat what you want but try not to pig out on any one thing for days on end, and watching out for changes due to new meds like prednisone.

Please ask other questions and be sure to visit Al Lodwick's website. Al is our "resident" pharmacist/coumadin expert/help we couldn't live without.

http://www.warfarinfo.com/

 

[Ross]

Most often, if the INR hasn't stabilized within 60 days tops, it's not the patient but the care providers fault. Many of them do not understand Coumadin and really shouldn't be managing their care.

Can you post the dosing schedule your sisters on? How often is she tested? How many milligrams each day for all 7 days of the week? Any other meds? Give us as much information as possible.

 

[SisHeidi]

thank you

thank you

Thank you for your quick replies. I will talk to my sis and ask her what her dosage is right now and post again as soon as I find out. I am in NC and she is in CA, but when she had the surgery, I flew out there and stayed with her for 2 weeks the day she got out of the hospital. but now am having to go on what she tells me. again, I'm hoping to get her to post, this forum is very informative.
thank you again
Heidi

 

[Karlynn]

Welcome! Did your sister receive a valve replacement? If so, I would encourage her to join us here too because there is so much support and information.

A few of us that are have been on Coumadin for a longer time have put this thread together http://valvereplacement.com/forums/showthread.php?t=17116 as a quick touch on some of the most often asked questions.

Please note that the founder and administrator of www.warfarinfo.com, Al Lodwick, is a member here and a fabulous resource of information.

Al's interaction page on his website mentions that Prednisone has shown to both lower and raise INR.

 

[Jackie]

Helping Sis with INR

Helping Sis with INR

Hi Heidi, This is your sis. I will answer the question's asked by Ross.

I take 5.0 on Sun, Mon ,Fri, Sat. 2.5 on Tue, Wed, and Thursday. I am tested every week Everytime it is two low or to high my dosage is changes and a few days are added or subtracted to the time in between. This week it was 2.7 so I have 12 days before my next test.Yes I did have an Aortic Valve Replacement and my reading should be 2.5 to 3.5. I am also the Jackie who started the thread on Home testing. The greivance starts when ever the objecting Cardio gets a letter off of his denial. In the mean time I am getting info ready to submit.

Jackie

 

[Ross]

Jackie not that it's a big deal, it isn't, but what I would do is Do 5mg on Sun, Tue, Thurs, Sat and 2.5 Mon, Wed, Fri. It just gives a more uniform dosing through the week. At 2.7, they shouldn't be changing anything at all. In fact, if it's 4 on down to 2.5, they should not monkey with it. Now why they are stretching your test dates out makes little sense to me. One week is long enough.

 

[Jackie]

helping sis with INR

helping sis with INR

Hi Ross, I was thinking the same thing. Thats what one girl had me doing awhile back. I have talked to three people from the Anticoagulation clinic. They seen to have differant ways of handling the dosage. Is there a formula for the amount they prescribe? This is one reason that I really want to get the Self Testing Monitor. Last week I went in to the lab on Thursday morning iand I did not receive the results until Friday afternoon. If I had my own monitor I would know within seconds. I did tell the girl that but I don't think it made her very happy. Her reply was I don't have any control what the lab does. The tech that took my blood on Thurs. told me that the Clinic is the one who deternads if the test is done stat or sent out. I wish I could afford to go outside of Kaiser.

Jackie

 

[Karlynn]

Jackie, all INR lab tests should be done STAT. A clinic that doesn't subscribe to that is operating in the dark ages. Your tube of blood just sitting around will cause the INR to be suspect.

Now that you're on Coumadin, there really isn't a formula that says If the INR is 1.5 give 5 mg, or some such thing. It is based on your current dose, and whether you need to get your INR up, or to bring it down. This is done by reducing or increasing your dose by percentages.

Take a look at this. http://www.aafp.org/afp/990201ap/635.html About a third of the way down you'll find 2 dosing charts. One for 2-3 range and one for 2.5 - 3.5 range.

 

[Sagebrush]

dosing!!

dosing!!

Just another thought to ponder. When the clinic had me dosing 2.5 one day and 5 the next day my inr was always wacko.....then when I got my own machine at home I decided that the jump from 2.5 to 5 was just too much so I would leval it out to 4mg a day and see how that goes and it worked...my inr became more consitant. I take 6 mg 6 days a week and 5mg on Wednesday. My inr has been much more consistant to now 3.00 two weeks ago to 2.7 last week. GOOD LUCK!!

 

[Ross]

As Karlyn has pointed out, there is no formula persay, but if your INR is low, take a look at your total dose over the week and increase that by 10% and retest in a week. If it's too high, subtract 10% for the week and retest in week. That's basically all there is to it.

 

[Jackie]

Trying to help sis with PT INR

Trying to help sis with PT INR

Ross, can I demand that I am tested in a week when I am told to come back on a certain day. Also if I change the dose should I tell them when I am called with the results. They always confirm what I have to been taking. If I don't follow their instructions am I going to be in trouble? With the grieveance that I am filling against the Cardio, trying to obtain the HemoSense, my name is being spread all over Kaiser.

Jackie

 

[RandyL]

I am not sure why you take different doses. Your current dose equals 27.5 per week, Why not just take 4 a day which equals 28 and see what happens.

 

[Sagebrush]

thinking alike

thinking alike

RandyL,
I was thinking the exact same thing!!!

 

[Jackie]

rying to help sis with PT/INR

rying to help sis with PT/INR

What size pills to you have? Mine are 5m, how would I cut it into 4m. Guess I am pretty dense

 

[Blanche]

Albert takes an even dose everyday and has for years. Before that he seemed to have more fluctuations. The link that I am leaving might be helpful for you because it does show the different strengths of Coumadin.
Albert has 2mgs, 3mgs, and 5mgs. Right now he is taking 6mgs per day, which is one 5mg and 1/2 of a 2mg tablet.

http://members.aol.com/AMAmail/Coumadin.html

Blanche

 

[RandyL]

What size pills to you have? Mine are 5m, how would I cut it into 4m. Guess I am pretty dense

That makes it a little tough, you would have to get some other sizes if not just get the 4mg pill if your INR is stable using 4mg /day

 

[Sagebrush]

I have....

I have....

Jackie,
I have two prescriptions of warfin, 2mg and 5mg. So you could do 2-2mg and then if you have to decrease or increase just split the 2mg in half and you have 1mg. Hope this helps!!!