Warfarin Woes

[MNmom]

I put this as a reply to my last post, but meant to add a new thread. So sorry for the duplicity, but here I am again:
I was on 6MGs all weekend, to find out my INR went down to 1.6. now i have to continue the shots, and take 8MG today and Wednesday, and 6 MGs again Tues/Thurs. Why wouldnt they just increase me to 8 for the week? I know it is low because i have come from being in bed for a week to moving around my house, target, grocery store, as well as eating more vegetables! So should I be pushing to go up to 8 for the week? Or do I just know too little at this point to know what I am talking about. I am just frustrated, and want to be done with shots!

 

[Duff Man]

I have no clue about INR but I think 1 is normal value without thinner, and the higher the thinner. Also vegtables have vitamin K which would make that value lower, not higher as is desirable. How much I don't know.

I hope I'm not wrong and definitely don't take my word for it.

 

[Bina]

I replied with my calculations on the other thread....I would take 8 mg every day until the test on Friday.
They are pussy footing around with you when you are almost at zero!!

 

[Karlynn]

Sounds like they are being way too conservative, most likely because they worry about you going too high. Those of us that take Coumadin would rather be too high than too low. An INR up to 5.0 is nothing to get excited about.

 

[Ross]

I concur with Bina, take 8mg everyday and see where your at. Personally, they should only test once a week, not every 3 days.

 

[AgilityDog]

Do what Bina said. 8 mg/day.

Go purchase the algorithm chart ASAP, and learn how this works. You'll be much more comfortable when you understand (i) what is the usual guidance v. (ii) what guidance you are being given. Sometimes they are not the same, and if not, you can ask why not. I LOVE my chart, since I'm an "unstable" type, and taking control makes me feel better.

 

[ALCapshaw2]

You can purchase Al Lodwick's "Dosing Guide" for $5 from his website www.warfarinfo.com

It will be the Best $5 investment you could make in your 'new life on Warfarin' !

 

[MNmom]

Thanks! I got my doc to agree

Thanks! I got my doc to agree

I told the nurse "the messanger" on the phone that I would feel better taking 8 every day then 8/6/8/6. I told her my aunt is only here another week, and i will not give myself the shots. . She got back to me that 8 mgs per day would be fine, but then reminded me of the side effects of high INRs.
Now here is a silly question- is INR only a measurement of Warafin, not Lovenox or Heprin in the blood? Because it seems like all those shots should have been affecting the blood too, right? I am so new at this....
Also, I do realize that vegetables and activity level will lower the INR, but i really dont want to give them up, as I am a pretty active and healthy eater, which I thought was supposed to be a good thing in general. I am going to have to let the coumadin respond to my eating, rather than vise versa, right? But in the meantime, I would love to just give up vegetables - but I know that would just make stabilization more difficult later. Ugh. Sorry to vent

 

[aussigal]

You are right....Dont go swapping your diet around to suit the Warfarin...its much easier and better to change your warfarin until it matches your lifestyle.

I'm pretty sure that your INR isnt affected by Lovenox or Heparin , I think they work differently although do similar jobs.

Checking the INR level every 3 days will give you an idea of where your level is heading but you have to remember that it takes around 3 days for the warfarin to get to its full effect...thats why most of us wont change our doses every few days or you are setting yourself up for the yo-yo effect. You need to settle into a new dose for a week before you get an accurate idea of the INR it gives you. INR is not something that stays at exactly the same level always, what we aim for is an INR that hovers around your correct range.

 

[ALCapshaw2]

Lovenox and Heparin work on a different part of the coagulation process and DO NOT show up in the INR measurement.

INR only reflects the level of W a r f a r i n (correct spelling) in your blood.

One the the favorite sayings on VR.com is
"Dose the Diet, Don't Diet the Dose"
which means adjust your Warfarin Dose based on your
Diet (assuming you consume a nominal level of vitamin K containing vegetables / foods every day).

Consistency is the KEY.

There is a GREAT Analogy:

Think of being in a Dark Room (i.e. NO light = NO vitamin K)
Turn on a 50 watt light (HUGE increase in light ...or vitamin K).

Think of being in a room with a 50 watt light. (some light, some vitamin K)
Switch to a 100 watt light. (SMALL difference in light - small difference in vitamin K).

Studies have confirmed that patients who injest a consistent level of vitamin K (either by diet or supplements) have MUCH LESS variation in INR than patients who try to avoid vitamin K entirely.

Variations in Physical Activity / Metabolism show up as small to moderate changes in INR depending on activity level and can be adjusted for.

Personally, I would prefer to wait 4 to 7 days to test INR, especially if changing doses. This allows the 'full effect' of the change to be seen better than testing too often (3 days or less).

'AL Capshaw'