marvsehn
Active member
I have a mechanical valve and self test weekly to stay between 2 and 3 with little problem. I have never taken baby aspirin and my Doc says not too.
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Hi Marv, do you have to test weekly? Do you know why? Thx, Tom
pellicle
Professional Dingbat, Guru and Merkintologist
hilarious ... and I agree, because for what its worth my review of the literature shows a divided result on "no effect" VS "possibly a small effect"
naturally you should confirm this with your own review of the literature ;-)
Adding to this revived thread. There are better scholarly articles and more accessible Maynard mainstream news pieces on use of aspirin, but here's a decent overview.
https://www.health.harvard.edu/heart-health/rethinking-low-dose-aspirin
https://www.health.harvard.edu/heart-health/rethinking-low-dose-aspirin
Taking baby aspirin with coumandin is usually a no no. Listen to the doctor on this.
rodmur
Member
Well, I take a daily baby aspirin. It's what my cardiologist and heart surgeon recommend. There was some push back once by my primary, but the surgeon said it wasn't enough to effect anything. So your mileage may vary. Have them chat with Girardi at NYP, I suppose... https://www.nyp.org/physician/lgirardi
marvsehn
Active member
My preference to know the INR. Rather than the typical monthly. I believe most home testing is suggested weekly. Takes me abt 5 minutes.
marvsehn
Active member
Tom
Let me add a bit more on why. INR is important to me because I don't want to be high. Higher mean more bleeding risk. I am quit active, ski the trees, hike, bike, travel to the family farm and help out for months. These all carry some risk of injury. A couple of years ago I cut myself cutting trees. I waited till the end of day to have it stitched, too long. It obviously had not coagulated. I now carry some medical supplies with me on these occasions.
Low is also bad due to the opposite reason and the medical communities concern. So I also watch that closely.
I would really like to be 2-2.5 but don't think that is likely for me. I am happy with 2-3 and in range about 95% of the time.
Let me add a bit more on why. INR is important to me because I don't want to be high. Higher mean more bleeding risk. I am quit active, ski the trees, hike, bike, travel to the family farm and help out for months. These all carry some risk of injury. A couple of years ago I cut myself cutting trees. I waited till the end of day to have it stitched, too long. It obviously had not coagulated. I now carry some medical supplies with me on these occasions.
Low is also bad due to the opposite reason and the medical communities concern. So I also watch that closely.
I would really like to be 2-2.5 but don't think that is likely for me. I am happy with 2-3 and in range about 95% of the time.
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JaneF
Active member
I hope you don’t mind if I jump into the conversation. I have been a long time reader, but rare commenter, and have found some very valuable information on this site. All that being said, my 2 year anniversary is coming up next week on May 23rd and I have been on the 81 mg aspirin and warfarin regimen since surgery. My target INR is 2.5 - 3.5 and I typically test approximately every 3 weeks, IF I am with in range. If not in range then I will test again in 7 - 10 days.
I would like to ask some of you if you are having the same problems that I am experiencing. My INR is like a roller coaster, as I might be in range at 3.0 and the next test be at 1.5 then the next test back at 2.5 and the next at 5.5.
My current dosage is 12 mg Tues & Sat and 8 mg all other days.
I have tried to control this via diet, as my diet varies very little since my surgery. My doctor has tried to be conservative in adjusting my warfarin dosage. I finally got frustrated and asked if there was a different blood thinner we could try and was told there was not another that was approved for mechanical heart valves. I will add that this has been going on since OHS.
Anyone else struggling with this problem? Is there a different thread for this topic, if so my apologies for hijacking this one!
I would like to ask some of you if you are having the same problems that I am experiencing. My INR is like a roller coaster, as I might be in range at 3.0 and the next test be at 1.5 then the next test back at 2.5 and the next at 5.5.
My current dosage is 12 mg Tues & Sat and 8 mg all other days.
I have tried to control this via diet, as my diet varies very little since my surgery. My doctor has tried to be conservative in adjusting my warfarin dosage. I finally got frustrated and asked if there was a different blood thinner we could try and was told there was not another that was approved for mechanical heart valves. I will add that this has been going on since OHS.
Anyone else struggling with this problem? Is there a different thread for this topic, if so my apologies for hijacking this one!
HI Jane, and welcome. I have been on Warfarin for almost 5 years now, and to me your Tuesday and Saturday "splurges" seem weird. Why not take 9mg every day? Then test weekly, and if your INR is drifting out of range, adjust slightly, even if only on a couple of days then? A more consistent dosing regime should lead to more consistent results.
user 16827
Premium Level User
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I agree with Andy, it's a good starting point
Consistency with the dose makes perfect sense
Consistency with the dose makes perfect sense
Warrick
Well-known member
My INR has had plenty of ups and downs in the last few months but I don’t stress I just adjust my dose accordingly. I was prescribed 100mcg daily asprin from the getgo by my surgeon and have certainly no reason not to take it .
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pellicle
Professional Dingbat, Guru and Merkintologist
Hi
never...
well right there you're missing out on data that misleads you ... you could easily have been in and out of range a few times.
well as you say that's quite a range. Here are a few of my years, and I ask you to note the subtle (but important dose alterations. Its also important to note that while my INR may be "all over the shop the range isn't what you've reported, well not real often)
In 2017 there are some strange readings because I had to undergo a small surgical procedure and needed to bring my INR down to less than 1.4 to satisfy the requirements.
Now these are all weekly readings, and you'll notice that if I didn't make some steering corrections in places (trace along the lines, check the dose changes) I could easily have been under 2 or over 3.5 a few times.
The key to my high time in range is simple:
personally I disagree with this sort of thing as it is essentially punching you up on the 12 (and if you were trending up then that would result in a higher INR again) or lagging you down.
I prefer to keep my dosage steady ... I mean the more steady we can make our dose the less effect that has on the already unsteady influences, which we know of but some.
I also disagree with this, there is too much variation of Vit K in foods to be sure of this. It is always better to make the changes needed with dose adjustments, not least becuase you are sure how many mg of warfarin is in each pill (the Kale on the other hand you just don't know).
myself I'd done months where I ate nothing other than oats, milk, plain meat and potatoes and then other months where it was rich in green vegetables. I was unable to identify which month was which by looking at my weekly INR readings in context of the year
not a bad thing (I call this "keeping a steady hand on the tiller"), but you do need to:
If you are willing to test weekly, and work with me on this with assurance that you are not accidentally missing doses (which like it or not is the biggest source of INR problems) I am confident we can get your INR to heel.
Unless there is some other medications you are taking which you haven't mentioned ... like ouh, I don'tk now ... say Voltarin or some antibiotics?
Best Wishes
never...
well right there you're missing out on data that misleads you ... you could easily have been in and out of range a few times.
well as you say that's quite a range. Here are a few of my years, and I ask you to note the subtle (but important dose alterations. Its also important to note that while my INR may be "all over the shop the range isn't what you've reported, well not real often)
In 2017 there are some strange readings because I had to undergo a small surgical procedure and needed to bring my INR down to less than 1.4 to satisfy the requirements.
Now these are all weekly readings, and you'll notice that if I didn't make some steering corrections in places (trace along the lines, check the dose changes) I could easily have been under 2 or over 3.5 a few times.
The key to my high time in range is simple:
- weekly testing
- understanding trends and adjusting for them.
personally I disagree with this sort of thing as it is essentially punching you up on the 12 (and if you were trending up then that would result in a higher INR again) or lagging you down.
I prefer to keep my dosage steady ... I mean the more steady we can make our dose the less effect that has on the already unsteady influences, which we know of but some.
I also disagree with this, there is too much variation of Vit K in foods to be sure of this. It is always better to make the changes needed with dose adjustments, not least becuase you are sure how many mg of warfarin is in each pill (the Kale on the other hand you just don't know).
myself I'd done months where I ate nothing other than oats, milk, plain meat and potatoes and then other months where it was rich in green vegetables. I was unable to identify which month was which by looking at my weekly INR readings in context of the year
not a bad thing (I call this "keeping a steady hand on the tiller"), but you do need to:
- have some basis for what you change in your dose and why
- keep firmly in mind that the only thing that determines dose is INR
If you are willing to test weekly, and work with me on this with assurance that you are not accidentally missing doses (which like it or not is the biggest source of INR problems) I am confident we can get your INR to heel.
Unless there is some other medications you are taking which you haven't mentioned ... like ouh, I don'tk now ... say Voltarin or some antibiotics?
Best Wishes
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To me it seems odd that you increase your dose by 50% on two days of the week. I have 4.5 for M, W, F, Sun and 5 for Tues, Thr and Sat. The only time I have a big change (e.g. like your 50%) is when I am out of range. My clinic have told me they like to keep the daily dose somewhat even if they can.
I use a coumadin clinic run by my Cardio group. Testing every 2-3 weeks unless out of range is pretty common and it's the frequency my group usually gives. When out of range, it depends upon how far out it is, not too much and they want a retest in 7-10 days; real low and it's more like 5-7 days.
Jmayer
James
I take 325 Mg's of aspirin with warfarin coupled with the addition of a statin and metoprol.
Wow that is a lot of aspirin, it also the dose that has been shown to help reduce risk of colon cancer.
Here is a new anti-daily aspirin story
https://www.cnn.com/2019/05/13/health/aspirin-head-bleed-study/
https://www.cnn.com/2019/05/13/health/aspirin-head-bleed-study/
Superman
Well-known member
Strikes me as a case of being dosed based on the pills you have rather than writing a new prescription. Guessing you have either 8 mg tablets or 4 mg. Should just ask for another prescription of 1 mg tablets.
I keep 5’s and 1’s on hand all the time. I can do a lot with those. 5, 6, 7, 7.5, 8, 8.5, 10. Sure, 8 would require 4 pills, but whatever.
I typically alternate 6mg and 7mg daily.
With 8’s and 1’s, you could do 9 mg daily going up or down 1 mg or even splitting the 1’s if needed.
We are the same in the UK: they issue 1mg, 3mg and 5mg Warfarin tablets and then THE PATIENT useS whatever combination is needed to make the required dose.
