Very low INR

[Robbyn]

What do they do for a low INR of 1.3? Anything other than increase the Coumadin?

 

[Ross]

Increase the Coumadin and find out what kind of diet and medications you are on, also if you've been sick recently, so that they can see if anything if affecting your INR. They may want to put you on Lovenox or a Heprin drip until your INR is in range. It's very dangerous to be running around with a Mitral and INR that low.

 

[ALCapshaw2]

WHO did the INR test that gave you such a low result?

If you had the test done at a Coumadin Clinic or Doctor's Office, THEY should have given you a dosing plan for the coming week at least.

In any event, with an INR that low, you should call your Cardiologist ASAP (Friday morning at the latest) and see if he wants to put you on Bridging Therapy (Lovenox or Heparin) until you get back in range. Note that it may take several days for your INR to come back up to the desired range. Without Bridging Therapy, this could place you at High RISK for a Stroke.

'AL Capshaw'

 

[Guest]

Giving you the results without giving you a treatment plan is definitely substandard care.

 

[Robbyn]

I agree

I agree

I agree, it is substandard care. I live in Ontario and we don't have Coumadin Clinics. I have a card that enables me to go the lab whenever I want to have my INR done. My doctor will not be back in the office until Monday. I usually adjust the dose myself but when it is at unusually high or low levels I don't know what to do. My alternative is to go the hospital. Thanks for your help.

 

[Ross]

Being a Mitral valve, I'd feel a whole lot more comfortable in you were on a bridge therapy until your INR is in range again. No sense risking a stroke.

 

[Guest]

Here is the information for Coumadin Clinics in Ontario

HAMILTON CIVIC HOSPITAL RESEARCH CENTER
Phone: (905)527-2299
711 CONCESSION STREET, HAMILTON, L8V 1C3

SUNNYBROOK HEALTH SCIENCE CENTER
Phone: (416)480-4497
2075 BAYVIEW AVENUE, TORONTO, M4N 3M5

ORTHO-CLINICAL
Phone: (416)755-1238
6675 MILLCREEK DRIVE, MISSISSAUGA, L5N 5M4

OTTAWA HOSPITAL - CIVIC CAMPUS- THROMBOSIS ASSESSMENT & TREATMENT UNIT
Phone: (613)761-4127
737 PARKDALE AVENUE, OTTAWA, K1Y 1J8

THE HOSPITAL FOR SICK CHILDREN
Phone: (416)813-5426
555 UNIVERSITY AVENUE, TORONTO, M5G 1X8

UNIVERSITY HOSPITAL
Phone: (5419)685-8300
339 WINDEMERRE AVENUE, LONDON, N6A 5A5

MCMASTER UNIVERSITY - DEPARTMENT OF MEDICINE
Phone: (905)521-2100
1200 MAIN STREET WEST , HAMILTON, L8N 3Z5

TORONTO GENERAL HOSPITAL ANTICOAGULATION CLINIC
Phone: (416)340-4175
200 ELIZABETH STREET, TORONTO, M5G 2C4

GROUP HEALTH CENTRE ANTICOAGULATION CLINIC
Phone: (705)541-2240
240 MCNABB STREET, SAULT STE. MARIE, P6B 1Y5

OTTAWA HOSPITAL -GENERAL CAMPUS - THROMBOSIS ASSESSMENT & TREAT. UNIT
Phone: (613)737-8768
501 SMYTHE ROAD, OTTAWA, K1H 8L6

Med-I-Well Services
Phone: 705-671-7356
1730 Regent Street, Sudbury, P3E 3Z8

HOSPITAL FOR SICK CHILDREN
Phone: (416)813-6459
555 UNIVERSITY AVENUE, TORONTO, M5G 1X8

MCMASTER CLINIC
Phone: (905)527-1710
237 BARTON STREET EAST, HAMILTON, L8L 2X2

KINGSTON GENERAL HOSPITAL
Phone: (613)545-6342
STUART STREET, KINGSTON, K7L 2V7
%0

 

[Robbyn]

Thanks very much

Thanks very much

Al,

Thank you very much for the information you so graciously typed out for me. As you know I have been having trouble with my INR for some time. I had my surgery Feb. 2004 and have yet been able to go more than a week without INR testing. I do believe that the meds and other medical problems I have contributes to the INR's that are so out of range. But I see on the list that there is a clinic at Toronto General Hospital. That is where I had my surgery and I have now called them. It is time to get this under control.

Thanks again,
Robbyn

P.S. Ross i think you are right Iwill go the walk-in clinic tonight

 

[Guest]

Thanks for the recognition. I should probably let you think that I typed all that out but it was actually cut and paste.

For any of you others wondering if there is a Coumadin (Anticoagulation) clinic near you look at www.acforum.org and click on clinic locations. The list is a little outdated so call any that interest you.

 

[JimL]

I've gone to acforum often for their listing, but it is definitely out-of-date. My clinic isn't listed. I used the list to find a place to get tested when I was in Wisconsin for three weeks of school this summer, and ended up at a stone-age level clinic in Mequon. Not only did I have to have a veinous draw, but they kindly called to let me know my INR one week after I had the test -- as if that would be of any help.
I sent them an email encouraging them to update the site..

 

[Guest]

Most likely the reason that you clinic isn't listed is that they have never requested listing.

They know that there are many clinics that have closed or moved and are trying to get it cleaned up.

The previous administrator retired and they have hired a new one.

With Coumadin being overtaken by generics and Exanta not getting approved, the two main funding sources have dried up.

People who use that site should call ahead to make sure the clinic is still at the site listed and find out what techniques they use.

 

[JimL]

Thanks, Al, it helps to understand what is or isn't going on behind the scenes.

 

[lance]

Toronto General Hospital/INR clinic

Toronto General Hospital/INR clinic

Hello Robbyn,

The clinic run by Dr. E. Yeo at TGH is excellent.

Staff there trained me to self-test with the Coaguchek S monitor earlier this year and are unfailingly helpful, knowledgeable and an absolute pleasure to deal with. I can't recommend them enough.

Cheers

 

[Robbyn]

Thanks

Thanks

Hi Lance,

Thanks for the recommendation. I called them on Friday and the nurse there, Sue, told me what to take for the next 3 days. To do my INR today and page her with the results. I am sooooo glad that Al posted the numbers of the Coagulation clinics. That is the best care I've had since my surgery last year. I have an appointment to go and see them next week. I don't know why I didn't go there before, as that is where i had my surgery. Did you have surgery there?

Thanks everybody for the help and replies,
Robbyn

 

[JimL]

I received a very nice email today from acforums: "Thank you for your feedback. I am in the process of updating the clinic locations section of the website." That's good news.

 

[lance]

Toronto General Hospital/INR clinic

Toronto General Hospital/INR clinic

Hello again Robbyn,

I'm really glad for you that you have made the connection with Sue in the anti-coag. clinic.

My surgery was done in Hamilton. When I was sourcing a home testing device Hamilton was very unhelpful so I found my way to TGH where I received all the training I needed.

If you are talking with Sue tell her Sandra says hello.

I know you will be more than happy dealing with that clinic.

Cheers

 

[Cris N]

I don't know why I didn't go there before, as that is where i had my surgery.

Robbyn,

I think it's a conspiracy. After my surgery the cardio set me up to be tested at the hospital lab and then he (or his "unable to understand the implications of INR testing" nurse) would adjust my dosage. I had no idea that there was a Coumadin Clinic associated with the hospital. I'm doing my testing there and am so much happier! The nurse there seems to know what she's doing.

Good luck with getting & staying therapeutic.

Cris

 

[loretta]

Inr

Inr

Hi, I thought the coagucheck S was for Professionals only? Do you have one that you use at home? loretta

Hello Robbyn,

The clinic run by Dr. E. Yeo at TGH is excellent.

Staff there trained me to self-test with the Coaguchek S monitor earlier this year and are unfailingly helpful, knowledgeable and an absolute pleasure to deal with. I can't recommend them enough.

Cheers

 

[Guest]

Whether or not the CoaguChek S is for professionals only depends upon which country you reside in.

Actually there is little difference other than size and the S gives results a little faster (if they are in range). They use the same test strips. I kept the old one as a backup in my clinic.

 

[lance]

Coag.S monitor

Coag.S monitor

Hi, I thought the coagucheck S was for Professionals only? Do you have one that you use at home? loretta

Good morning Loretta,

As far as I know the Coag S is the only one available in Canada. Al is right about "professional use" in the US--it has not been approved for general use by the FDA yet. When a Coag S is sold here the user must attend training from a professional (nurse, doctor, coag clinic).

A Roche technician told me the original Coag monitor screen gave written instructions to the user, the Coag S has pictographs instead--not much of a change.

Cheers