Warfarin Newbie

[DavidMac]

Hi
I am new to this amazing website and am so thankful I found it!

I am 3 weeks post op and things are going well. As a newbie to Warfarin (I am on Coumadin) I am slowly distilling what I should be aware of, what I shouldn't worry about and what I should act on.
So far the advice I have been given has been pretty general which can be summed up as: JUST BE CONSISTENT.

My INR levels are still leveling out. When I left hospital it was at 2.6, then fell to 2.5 a few days later and now its at 2.0 since Monday. My cardio wants it up at the 3.0 region. I realise it can take a while to work out the right dosage, right? So this is normal.

So my question to all you Warfarin Veterans! What advice would you give a newbie about to embark on this lifetsyle adjustment.

Cheers and hello from sunny Sydney, Australia!
David

 

[Ross]

JUST BE CONSISTENT!

Seriously David, eat as you normally would. The best way, at least for me, is to stay with what you like and let the dosing fall into place with what you like to eat. If your going to deviate, watch the High Vit K content things. If you need a link or two for foods high in Vit K, just yell. I'm in no way saying stop eating High Vit K things but rather, use common sense.

What dose are you taking currently?
How often are they checking your INR?
What other medications are you on?

I ask because it's unbelievable at how many places do not know how to manage coumadin patients properly. Sometimes it's the manager that has you bouncing all over the place because of making dosage adjustments when there isn't really any need too.

 

[Nancy]

Hi David-

My husband has been on Coumadin (warfarin) for 25 years. It goes up and down all the time. That is it's nature. It is affected by so many things in daily life, exercise, foods that are eaten, medications, illness and some even say the weather. It is almost impossible to tell what is affecting it, but when there are wide swings, sometimes it is the person who is monitoring it making huge adjustments when just small adjustments are what is needed. I guess the key to keeping things as much on an even keel as is possible is to take it at the same time everyday, eat a healthful and consistent diet, and have someone monitoring you who knows what they are doing. It will still fluctuate quite a bit.

Also do a search on this board for hidden sources of Vitamin K. There are some things that you would never think of that contain it, like nutritional drinks, such as Ensure, Boost, SlimFast or other diet drinks, soybean products, some cooking oils, vitamins and some other things.

 

[carbomedic]

Hello there!
This is what I was told, "Don't change anything. Eat as usual, play as usual, just don't hit your head, We will adjust the dose." So far, that is what I did, and I do not have any issues.
But I must admit there are times where the whole coumadin thing feels overwhelming, lifetime time and all. But, read some of the posts here and, voila, I feel one in a group of many who have something in common.
Good luck in your recovery. It all gets better!

carbo

 

[Rich]

Hi David,
As you can see some people prefer to maintain the same lifestyle as they did before surgery and that's OK.
It does however make keeping your INR in range a little more difficult.
Personally I have been on Coumadin for about seven years.
After the initial period following my surgery I have not changed my dosage in all that time.
The key is just like the others said- Be Consistent.
I gave up the things that are high in vit K although I do have a few salads a week or cole slaw for instance.
I also gave up alcohol for life.
People kid me about that but I tell them hey I havn't had a hangover in almost seven years
There are other things that can throw your INR out of whack such as anti-biotics.

 

[Simon Gee]

Hi David,

welcome to the wonderful world of warfarin!

As the other guys have said, consistency is the key, with moderation and common sense also important. I've only been on warfarin for 2½ years, but have had no problems that I'm aware of. I watch my Vit K intake but continue to enjoy salads and green vegeatbles. My main concern beforehand was the ability to enjoy a drink, but I was advised by my surgeon to continue drinking if I wanted, but a consistent amount every day. Music to my ears, so I savour a couple of beers or glasses of red wine every day.

My biggest problem was realising there are no some activities I can no longer participate in - rugby being the most obvious for me. I'm a (reasonably) fit 42 year old with three sons, and as they get older and try new activities, I realise that there are things I'm well advised to steer clear of. However, it's a small price to pay for the chance of seeing those boys grow up!

Good luck with your warfarin management - I hope it's as simple as mine.

Simon

 

[Guest]

You can also look at my website www.warfarinfo.com

 

[DavidMac]

Thanks for all your advice guys.

So far my levels still haven't stabilised. I am down at an INR of 2.0 which my Cardio wants up to 3.0. My doctor is alternating dosage at 6 and 7mg every other day. I have another blood test tomorrow and hope it has worked out. However, I ate two brocoli heads tonight and got all paranoid that it will blow out the result.

So. My question is: what does it mean to be consistent? Does it mean avoid binge eating / drinking things? Can you give me some examples of what consistent means? Everyone I have spoken to has said the same thing, but nobody has specifically defined what that means.

My philoshphy so far is eat as I did before: a healthy varied diet of all the major food groups.

Cheers everyone!
David

 

[Ross]

To be consistent=To eat about the same amount of Vit K per day and try not to binge on items like BROCCOLI hehe. Yes, that may bring your INR down too low too quick. I'll send you those links as soon as I can here. When you get into these charts, you'll have a much better understanding of the Vit K contents and what consistent really is.

2 heads of Broccoli?
Your as bad as me and brussel sprouts!

 

[ccrawford]

Welcome David

Welcome David

Hi David - You didn't specify, but I assume you got a mechanical valve during your surgery. If so, then I believe your target INR should be between 2.5 and 3.5. Coumadin has a pretty long half life-if you understand how that works, then you'll understand that making daily adjustments to dosages simply won't work. Typically, once you find your optimum dosage level, your INR will typically hang about where it is supposed to--unless........ Try to get into the habit of reading the labels on food containers, and especially be careful when you take any new drug. Many drugs will interact with Coumadin and cause the INR to go up or down. If you'll browse thru all the old posts, you find many links to other sites which will help with drug interactions, herbal interactions, food interactions, etc. Re the normal veggie portions, rather than pig out on your favorite green stuff, try and keep it to a cup or so of vegetables X times a week. Whatever X is, keep it pretty constant, and you'll do ok. Whenever I get a high INR reading, I usually use that as an excuse to indulge in a big spinach salad. Its ok to do this because you're trying to bring the INR down, and the greens simply hurry up the process. I own several books that relate to coumadin management. One of them is "The Pill Book" and you can find it in most drug stores.Hope this helps.Chris