Very high INR test at home, questions/concerns

[worktheday]

Hello all,

Not sure how quickly someone may reply, but I just took my INR at home (have been on warfarin for 8 years - AVR with mechanical, so very familiar with testing, ranges, etc) and I got a reading of 5.9. In my eight years of having blood tests and doing home tests for my INR, I only remember twice being higher, in the 6's. Both times without incident. To my question, because it is 1:30 am here right now I of course have no doctor to call. However, wondering how concerned I should be? Some may thing after mentioning I am not new to INR testing that I should have a grasp, However as I said it has been rare I've ever been this high. I know enough to skip my dose tonight, and most likely tomorrow (I will be receiving instructions from my clinic with the high report tomorrow anyway), but in the meantime, meaning this evening and until I speak with someone tomorrow, how worried should I be and should I go to the ER? Again it's been higher in the past and I have just rode it out for the two days following without issue and gotten back on track, but still wondering?

I know a lot of this is per the individual also. Just as a note, I have no noticeable issues...no bleeding, no bruising, no headaches, etc. I am pretty sure I can attribute this to being foolish the last week and having a few nights where I have drank more than I should, and more than is normal for me. Also I started taking a multivitamin and another vitamin recently. These may have added to it? As I said I'll be discussing with my clinician tomorrow. But in the meantime any input would be greatly appreciated! Should I do anything besides skipping my dose tonight (which I've already done) like gobbling down a bowl of broccoli, or just skip the dose and wait to talk to the doc tomorrow?

Thank you and hope you all are well

J

 

[Freddie]

Everyone reacts differently when skipping a dose or two. Some people drop really fast others may take a couple days.
I have my own practice when I've been at 5.0 a couple of times. I don't skip a dose but cut my dosage in half for two days and eat lots of greens. After two days I go back to my regular dose and retest after 3 or 4 days to see if where I'm at (I also home test).

I believe that's its better to keep some warfarin in the blood stream rather illuminating completely for one or two days and avoid the possibly on getting on a 'roller coaster ride' in order to get back within range.

 

[pellicle]

Hi

I wouldn't be too concerned, but all the same would examine all the obvious things to work out why its 6. Some tings to look at will be medications and foods. For instance have you started drinking (or increased volume of grapefruit juice)?
Eg

Well I had a similar experience this week. I had a blood test for something totally unrelated to warfarin and just because they had a needle in me they decided to test my INR, which I said would be 3.0 +/- 0.1. Imagine my shock when it came back and was 9.0!

then I would wish to double check the INR reading, take a second one..

What machine did you use?
Do you have a history with that machine?
Are you confident there was no user error in technique?
(just as an aside I guess that you knew of problems with Alere strips)

With respect to the dose I would half my next dose and then reduce the following one by 5 or 10%

What is your daily dose? Does it vary day to day? By how much?

Some reading from my blog may be of interest.

http://cjeastwd.blogspot.com/2014/09...ng-my-inr.html

 

[Protimenow]

I'm with Pellicle -- and by the time you see my response, you would already have gotten advice from your clinician. Before I had testing available, I was very lax in my testing -- and at one point had a 7.1 or 7.2. The doctor told me to be careful for a couple days (don't bang into things, etc.) and may have cut my dose for a couple days, but it wasn't that big a deal.

Some clinics will repeat a test if the result is 4 or higher.

It certainly wouldn't hurt to eat greens, or even to get a Vitamin K supplement (use it only once -- you don't need to get on the merry-go-round), and by all means, test a few times this week to see that you're back under control.