Who, What to believe? Confused - HELP

[njean]

My doc is very organized, but laid back.
I give him results about every 3 months or when I remember.
He has it all on file, and so do I. Works perfect.

The same goes w/my cardio of which I am so glad. I guess he figures that since I've been on coumadin for so many years, he trusts my judgement & he knows I know, where my range should be!

 

[catwoman]

Do some or all of you that have home monitors, report your INR results to your drs??

Just curious because I have never reported my results to anyone in the two years that I've had my monitor. Whenever I have a checkup w/the cardio dr. he will ask me what the number was on my last INR check & that's it.

Ditto with my PCP and my cardio.

 

[Herb M]

I get tested in a lab, and they call in the results to my doctor. Within a day, I get a call from one of the doctor's assistants and she telsl me if the Doctor recommended an adjustment to my dose. I listen and then I do what is correct and it is often not what the doctor recommended.

There are some people who will only do what the doctor recommends on any health issue. I know better.

 

[Ross]

I get tested in a lab, and they call in the results to my doctor. Within a day, I get a call from one of the doctor's assistants and she telsl me if the Doctor recommended an adjustment to my dose. I listen and then I do what is correct and it is often not what the doctor recommended.

There are some people who will only do what the doctor recommends on any health issue. I know better.

Unfortunately there are a lot of us that had to do it this way or we'd of been in some real trouble.

 

[bvdr]

Ditto with my PCP and my cardio.

Ditto here too. Basically it is "call me if you don't know what to do."
When I go on Lovenox he always in involved because it usually involves a third doc and surgery or procedure.

 

[lance]

How long

How long

has your INR been in low fours? Are you trending up or down.

 

[zipper2]

Freddie i agree with some posts here so to say(dont follow the instruction of your doc)
I spent 17 years before i found vr and i tell you talk frustration cus i had no choice of knowing this place exsisted and things are easier.
Ive been very consistant since 2nd surgery and am on amoxicillin regulary on and off for a on going problem and it never turns my inr rollercoaster.
I pray for day when you find understanding docs they are difficult to find
when comes to coumadin management but they exsist i have two....i thank god for daily and far as my lab i donot go often but today was a mega of vampire day and they know me well and said what the heck you doing here when you have your own machine and explained how many come in weekly for inr's and too bad everyone couldnot offord these coagucheck machines especially harder for the elderly in wheelchairs,that have to transit back and fourth and so difficult for them,they luv the idea and do know i have my machine and know in over a year im still kicking not at the lab and somehow i must be doing things right and credit to vr rather they like to hear it or not the 2 combined work.....im proof after 16 years following docs on rollercoaster
management i prayed for something better from the frustration of docs managing and found vr,my family doc was hesitant at first and i just quit the lab as soon as i got my machine and didnot follow his lead management but turned here for help and now hes turned over a leaf and says you've been in that body 17 years you know what to do better than me.
Seems they need proof though and of course we have it .
It's frustarating,been there as well and it only gets better....CHIN UP

 

[Freddie]

has your INR been in low fours? Are you trending up or down.

Yep, been trending up and down all summer. Two weeks ago I was 2.7 (3.0 on the monitor) and this past Thursday, Aug. 27 I was 4.1 (4.3 on the monitor), but now I'm sick with bronchitis and haven't been eating a whole lot this past week.

 

[lance]

Trending up and down ......................

Trending up and down ......................

all summer. I should have been more specific. How often do you test?

Just an example. My spouse's three previous test results were: 2.5, 2.3 and 2.1. Following the 2.3 result I decided to wait and see what the following week would bring. Trend very obvious. Sometimes it's not that simple or clear cut. Doctor's nurse, not knowing the "trend" advised staying on same dose. Uh,uh, I put it up 2 mg. and he was in mid-range the following week. He has a stent and his range is 2-3.
Had he continued the original low trend dose his INR could have 1. stayed the same, 2. gone down, 3 gone up. The increased 2 mg could have done the same. Because of the downward trend over three weeks my hunch was it would go lower, but warfarin being warfarin you can't be absolutely certain. Dosing is an art not a science. A patient will just get the feel for it hopefully sooner than later.Also I suggest for dosing trust your meter.
It's interesting that my latest lab draw was 3.3 and my monitor 3.6. Dosing was based on the monitor result

 

[Freddie]

I've been testing every week since May 21st, when the lab results came back as 3.8 I was taking 6mg daily.
June 4 - INR 4.3 - started on 5mg for a week
June 11 - INR 3.7 - continued with 5mg
June 18 - INR 3.6 - Started to alternate 4 & 5mg
June 25 - INR 2.1 - back to 5mg for a week
July 2nd - INR 2.0 - 6mg for the week
July 9 - INR 4.9 - took 3mg for 2 days then alternate 5 & 6mg
July 11 - INR 2.5 - alternate 5 & 6mg
July 16 - INR 2.0 - back to 6mg/wk
July 24 - INR 2.7 (monitor-2.9) stayed on 6mg
July 30 - INR 3.4 (monitor got hot in the sun and read 4.1 - got the same reading twice)
** took 5mg on Thurs & Sat. and 6mg on Fri, Sun, Mon,Tues, Wed.
Aug. 6 - INR 3.3 (monitor - 3.5) continued with the above dosing
Aug 14 - INR 2.7 (monitor - 3.0) dosing did not change/ but getting a cold
Aug. 27 - INR 4.1 (monitor 4.3) dosing is now 5mg along with new this new drug with me having bronchitis.

 

[Bina]

Freddie, I'm glad that you are keeping good records.
Usually checking the last 4 tests is enough info to determine a trend.
Don't let the 4.3 bother you. I don't even blink an eye at that number.
Use your monitor and see where you go this week. No big deal.

 

[Freddie]

Freddie, I'm glad that you are keeping good records.
Usually checking the last 4 tests is enough info to determine a trend.
Don't let the 4.3 bother you. I don't even blink an eye at that number.
Use your monitor and see where you go this week. No big deal.

Thanks Bina, it was because of this forum that taught me to keep track - heck this forum has taught me many things - too bad it won't sink in

To a point, I have to be concerned about the 4.3 or I'm going to loose my doctor, and trust me I have looked for a new one, but no one is excepting new patients.
Pure and simple she wants me below 3.5.
I'm thinking that I should test myself this morning to see where I'm at. Good idea yes?

 

[Bina]

is the doc testing you again on Thursday?

 

[Freddie]

No, she wants me to test on Tuesday. But I'm wondering if I should check myself to see if this new drug is effecting my INR and being on 5mg is doing the trick.

 

[Bina]

It is such a shame that your doc is causing you all this stress....
If you will feel more comfortable testing before Tuesday, then do it,
but please don't fiddle with your dosing for the sake of a couple of points.

 

[Freddie]

CRAP!
Just did it.
It's 4.4
Now What?
1/2 dose today and tomorrow, yes?

 

[Bina]

Hee hee.....4.4 means you better run for the hills.....just joking.
DON"T start big changes. Do you have any 4mg pills?

 

[Freddie]

I've 1's and 5's
Yes I can take 4 - 1mg

 

[Bina]

Maybe a 4mg dose is where you need to be for a few days...add a bit of broc soup.
when do the antibs finish?

 

[Freddie]

Hey, A couple of V8's and a couple of days of 4mg might do the trick