What's your magic number?

[Ross]

Thanks Marty. The Clinic nurse and I talked about what the new game plan would be. The doctor wants things the way they are, but obviously, the INR is too high at his dosing. Anywho, her and I think the 15% cut will be the route to go.

Mr. Lodwick: If you pass through here, I'd like your input too.

 

[Ross]

1.2 today, Yikes!

A two day hold for me is not a good thing. I took 5mg when I woke up and was told to take another 5mg and resume my normal schedule minus 10%. I'm now doing 7.5mg everyday except Monday-Monday is a 10mg day.

 

[Granbonny]

Normal schedule minus 10%..Is that a day or a week? I thought the 10% was over a week's worth of coumadin Bonnie

 

[Lorraine]

Being as I'm in examland at work, I wasn't able to get my protime done until this past Saturday at the outpatient clinic. I was amazed the technician found my vein on the first try and didn't even leave a bruise. I found out my INR today which was 2.2. Just before Thanksgiving it was 4.4 and the nurse in the cardiologist office told me to hold a day. I probably shouldn't have. In my own mind I knew it would plummet down the other direction. Now they want me to add 2.5mg to my dose and have another blood draw this weekend. I hate this. I can't take off during the week because of it being exam time ( I co-ordinate all exams for the Law School) so I have to go to the out-patient and get a blood draw versus getting my finger pricked at my clinic. I told the nurse today when i talked to her, if my INR goes up to 4.0-4.5 when I get my test done again this next Saturday, I will not hold a whold dose. I agree probably about a 10 percent decrease would be enough. Can't wait until I win my case for my own Protime!

 

[Christina]

Lorraine,

I was up to 4.7, and was told to hold the Coumadin for 48 hours. I did this only once but NEVER again. I also plummit to a low number and find that more dangerous. Now when I am up high and he tells me to hold the Coumadin I just agree with whatever he says and say, uh huh, yes, ok, but do what I think is best for me. I never hold the Coumadin, I just cut the dose in half. Worked again this week.

Hope you are doing well.

Christina
Tucson, AZ

 

[Ross]

Normal schedule minus 10%..Is that a day or a week? I thought the 10% was over a week's worth of coumadin Bonnie

It is a decrease of 10% over the week. I was taking 60mg a week and now, 55mg a week.

Christina, after the last hold producing low results, I should've just listened to you. Yesterday, my sinuses were still bleeding pretty good, but today clear. I guess I can't use my sinuses as an accurate gauge of any kind. I want to test at home, but I gotta find a Doc who will approve me.

 

[Marty]

Hold the warfarin?

Hold the warfarin?

In most cases the "hold" is ineffective and leads to the yo-yo. Al Lodwick says many physicians don't understand how warfarin works and I agree. And definitely...yes... the 10% dose reduction is spread as equally as possible over seven days.

 

[Les]

Hello All,
OK, I have a question about all this, especially for you Christina, since the "throwing a clot" statement got my attention! In almost ten years of ingesting D-Con I was only instructed once to not take it for one day, before my second AVR in '95. However, I have been scheduled for oral surgery the end of January and they told me to stop THREE days before. Now, I'm concerned and believe what Marty posted that these guys do NOT understand Warfarin. I thank you all for these posts, alerting me (and others). Should I even be so bold as to suggest to them they don't know what they're asking? Why is this always so complicated and will there ever be a time in our "career" when this is understood? Have my doubts. Christina, glad you came out of that OK! (I'm calling them now...)
_______
Les
AVR '93 / '95

 

[LUVMyBirman]

The 10% solution as Marty states. Works well for me.

Holding my Coumadin for just one day will put me at rock bottom. I had a very hard time convincing my doctor back south. Even after a few hospital visits for low INR's. Was just following orders. Though, my husband did not appreciate my lack of presence at home due to negligence in treating me under the guidelines of 'standard' protocol.

Those of us whom are fast metabolizes of Coumadin, i.e. anyone who takes more than 6mg a day I believe? Al? Anyway, the holding a dose scenario usually has adverse effects. Like Christina. Anything between a 4.0 - 6.5. I cut my dose in half for a day. Retest in two. That will return me to range of 3.0 -3.5. At that, I don't mess around with decreasing until I retest myself once more in 3-4 days. It usually levels out without making a dose change. The more you tweak it, the more you will ride it.

Les
You should have no problem staying on the Coumadin. Unless you are having an extraction. I also understand there are a few people here that did have an extraction on the Coumadin. Not sure I would be comfortable with that. Though, the risks of an adverse event with your heart may weigh higher than bleeding from an extraction? Keep us posted

 

[MarkU]

Got tested yesterday afternoon: 3.6. Normally I am pretty consistent at 3.2 -3.4.

Too much food & drink at Christmas parties is probably not helping!

Will get it checked again after the first of the year.

Mark

 

[Granbonny]

Drink V-8

Drink V-8

that will bring down your INR..might even but a little volka in it for Xmas. Bonnie

 

[Les]

Bonnie,
Mmmmm, Grey Goose screwdrivers...INR be damned!
Gina, and everyone, after consulting with the cardio, primary care doc and the oral surgeon, it is two to one against THREE days without Coumadin. ( Oral surgeon lost...) They recommend two days so, I'll go with that and then test after the yanking ceremony. Thanks to all for the warnings and advisement!
________________
Les
AVR '93 / '95

 

[Guest]

Please look at my web page http://www.warfarinfo.com/dental-procedures.htm


Does anyone know what you get if you mix vodka, orange juice and milk of magnesia?

 

[LUVMyBirman]

"Does anyone know what you get if you mix vodka, orange juice and milk of magnesia"?

NAUSEA

Recently I took a sip out of a drink a friend made, I never did like the hard stuff. Anyway, Vanilla vodka and pink lemonade. You can also try strawberry orange juice with that Vodka. Have to admit...it was very tasty. But.....I will stick to my Merlot. Right Perry Marilyn is still intact.

 

[Ross]

Does anyone know what you get if you mix vodka, orange juice and milk of magnesia?

 

[Blanche]

Al:
Is it a Pile Driver or a Phillips Screwdriver?

Barrett L:
After you have viewed Al Lodwick's material on dental practices, you might want to search the net for articles on the topic. I found the following:

Wahl, MJ, Myths of dental surgery in patients receiving anticoagulant therapy, Journal of the American Dental Association, 2000, Jan; 131 (1); 77-81.

Al mentioned this on his site. Conclusions of this study included:
" Serious embolic complications were three times more likely to occur in patients whose anticoagulant therapy was INTERRUPTED than were bleeding complications in patients whose anticoagulant therapy was CONTINUED (and those whose anticoagulation levels were within or below therapeutic levels). Interrupting therapeutic levels of continuous anticoagulation for dental surgery is not based on scientific fact, but seems to be based on its own mythology."

Alexander, Ricardo etal, Stop the nonsense not the anticoagulants: A matter of life and death - 11/02" New York State Dental Association. note: The three authors are dentists.

The conclusions are the same for this article. However, its strength is that it includes descriptions of procedures that can be done to protect the patient's health and safety.

There are numerous other articles and writings from dentists, dental associations, and doctors that maintain it is not necessary to interrupt anticoagulation for surgical removal of teeth. I strongly suggest that you copy these articles and send them to your doctors and dentist. My husband's dentist did not know of these until he was given a copy. I'd be glad to send you want I have. You can email me through this board, if you like.

 

[Guest]

Blanche got it right -- Phillips Screwdriver.

A little pharmacy joke. We should make her an honorary pharmacist!!