what's you target INR ?

[slipkid]

based on that I agree, and think you need to change clinics or take charge of your dosing yourself. I guess though you being in the USA makes that harder.

Here's my conundrum (dilemma).

Yes, I can't just switch doctors, chose to go to a clinic (if I can even find one nearby), that easily. I do that and I piss off (& possibly lose) the only cardiologist I have, then I have to find another one (who?). Plus then my new GP (who is buds with my cardiologist) also gets pissed off at me, and probably doesn't want to see me anymore either. It's more than I can deal with. On top of that I will be in the middle of not knowing what my proper dosage is supposed to be, and trying to break in new doctors who will think I am some kind of troublemaker pain in the ass to have not listened to my other doctors...etc etc etc

And if I just up my dosage on my own gut feeling/uninformed decision (I am new to this after all) - I would suggest going to 7.5mg for at least the next 3-4 days then get retested, and say that goes well (and I get up to 2.5 and hold steady temporarily), then the cardio assistant will think just the one day of 7.5 was all I needed and go with that as a method moving forward, possibly not just for me but other people too, and that will be wrong.....or if I tell him I actually took it 3 days instead - then he'll probably get pissed at me for disobeying.....or worse if I have a problem while on my own regimen then it is my own fault....there's another type of mess.

Or if I just stick with what they are telling me now....if I suffer a stroke....then that's a mess.

At this point I will take mess #3 and pray nothing bad happens. Maybe just one 2.5mg up dose will inch me closer back up to 2 or above with no bad consequences. Get retested next Tuesday, I predict it will still be lower than we want but hopefully no ill effects...try to work with these people and find the right regimen after that.

It seems like 5mg every day does not keep me over 2.0, that much I do know.

And thanks for your comments, I do appreciate it.

 

[pellicle]

And thanks for your comments, I do appreciate it.

I do sometimes feel that despite wanting to help , that maybe it hasn't. So thanks for that.

I would consider carefully getting a second opinion. However I have read that patients with on-x valves gan go under coagulated for periods and the incidence of stroke is very low, so fingers crossed you won't have any issues.

Back to other reasons to be higher in INR is that there is an amount of platelet adhesion onto valves and this can cause functional issues in the long term. So my view is to keep knocking on their door and get a target more like 2.5

seems like 5mg every day does not keep me over 2.0, that much I do know.

Yeah, my dose is 7.5mg for that INR, but of course that really means nothing as we are all different.

Some interesting pictures here

http://media.corporate-ir.net/media_files/irol/64/64106/ATS_Forcefield.pdf

Anyway, keep a stiff upper lip and don't let the bastards wear you down. I know it can feel like you are at their mercy, but persist and it will pay off. In the last year I have felt like giving up many times. My approach now is to just keep presenting myself to t problem and a solution emerges.

 

[tom in MO]

In the summary conclusions, the paper cited above says 2.4-2.9 range or 3 as target is best for mechanical valves (unspecified position). That's the 2009 point of view for one study not specifically for valve disease. A survey paper on valve disease that came out last year says 2-3 is optimum for a AV. OnyX says that 1.5-2 will most likely work based upon current tests.

I wouldn't sweat being at 1.7, been there done that more than once no problem.

Testin every 2 weeks is somewhat normal as is small "bumps" up. I had the same problem after surgery. It takes awhile to stabilize. Once you begin to stabilize (i.e. not big swings), they "bump" you up assuming once you get there you will stay. I was out of my range more than in for the first month or so. My cardio said not to worry, my valve can withstand lower INRs, as can yours.

I want my INR in range, not over or under, but I don't sweat it if I am under/over, I just adjust as told and test in two weeks.

Many people want to keep their INR in range since there is not really any benefit to over coagulation unless you're a really old fart. Plus if you are active, the difference between a 2 and 3 INR can be a pain when trimming rose bushes, climbing, wrestling, an extra 10 minutes in the morning if you cut yourself shaving, and what about that car accident with head trauma

 

[slipkid]

Some interesting pictures here

http://media.corporate-ir.net/media_files/irol/64/64106/ATS_Forcefield.pdf

Anyway, keep a stiff upper lip and don't let the bastards wear you down. I know it can feel like you are at their mercy, but persist and it will pay off. In the last year I have felt like giving up many times. My approach now is to just keep presenting myself to t problem and a solution emerges.

Scary stuff (the photos, the operation ones that is). Quite amazing we all lived through any of that.

Thanks for all your input.

 

[slipkid]

In the summary conclusions, the paper cited above says 2.4-2.9 range or 3 as target is best for mechanical valves (unspecified position). That's the 2009 point of view for one study not specifically for valve disease. A survey paper on valve disease that came out last year says 2-3 is optimum for a AV. OnyX says that 1.5-2 will most likely work based upon current tests.

I wouldn't sweat being at 1.7, been there done that more than once no problem.

Testin every 2 weeks is somewhat normal as is small "bumps" up. I had the same problem after surgery. It takes awhile to stabilize. Once you begin to stabilize (i.e. not big swings), they "bump" you up assuming once you get there you will stay. I was out of my range more than in for the first month or so. My cardio said not to worry, my valve can withstand lower INRs, as can yours.

I want my INR in range, not over or under, but I don't sweat it if I am under/over, I just adjust as told and test in two weeks.

Many people want to keep their INR in range since there is not really any benefit to over coagulation unless you're a really old fart. Plus if you are active, the difference between a 2 and 3 INR can be a pain when trimming rose bushes, climbing, wrestling, an extra 10 minutes in the morning if you cut yourself shaving, and what about that car accident with head trauma

Thanks very much.

 

[babshappy]

t in yvr i am selftesting on a coaguchekxs and live in maple ridge would love to chat about self testing in the vancouver area. I go through london drugs anti coagulation program.. do you? who monitors your inr checks your family Dr. or cardiologist at St Pauls?

 

[mom2angel]

mine is 3.0-3.5