Whoops!

[Harpoon]

It figures... After getting all the crap settled out so I can do my protimes (that's what they call it, PT/INR, coumadin levels, I guess are becoming interchangeble even though they all mean different things) at my doctor's office instead of going to the phlebotomy clinic for blood draws. I go through all the crap over flow sheets and lab results and who exactly IS monitoring my levels and who gets records and all the other BS associate with such things.

By the way, they're still sorting some of that out!

So anyways, today I go out and get my first finger stick. Whoohoo!



Scored a 5.0.


WHOO HOO!!!! That's better than a perfect GPA!!!!

Right?


Yeah... I know.


One of the doctors at the practice recommended I drop from the usual 8mg a day at dinner to 7mg. I can do that...

Go back and get tested in a week.

Funny thing, I was kinda "educating" the nurse a little on what not to eat and such. She gave me the generic, "don't eat so many leafy green vegetables..." line...

Ok, for lunch I had about half a tablespoon of guacamole (see Quentlin's recipes in the Recipe section) in a pita with some refried beans (again, se said recipes) and a homemade salsa (AHA heart healthy cookbook) and a few slices of cheddar... How high is the vK in avocados?

Anyways. There I am. No biggie... Would be nice though if I don't have to take 8mg anymore, if 6mg or less would do for me. Easier on the wallet at least. =)


For the record, they use CoaguChek (or however it's spelled) Pretty slick.

 

[Ross]

Curiouisly, if you had a 5.0 at the fingerstick clinic, what was your most recent at the vein stick clinic? I'm thinking you should be around the 6.5mg per day dose, but I haven't tracked you long enough nor do I know how your really eat, but I think your going to end up around there.

 

[Harpoon]

I can only assume my last blood draw was "within specified parameters" because no one made any noise over it. if the protime was off, I'm certain I would have heard from my cardiologist at the least.

I did start two other medication since that last blood draw, Prilosec OTC and some kind of asthma inhaler (I can't recall the name off hand) however all of my doctors, including y cardiologist) cleared me for it and the coumadin...


Hmmmm...

It might be a diet thing, however I haven't made any real drastic changes since my last protime.

We'll see in a week what the new test says.

I'm assuming it's not really possible to get a different protime result between Coagochek and a lab blood draw... Right?

At least not THAT different.

 

[Ross]

If you did the coaguchek and draw at the same time, there shouldn't be but perhaps a .1 to .4 spread in the two.

 

[Nan]

999 foods highest in Vitamin K site

999 foods highest in Vitamin K site

Katie, thank you so much for posting that site! I hadn't run across it before. it is tremendously helpful.


Harpoon, that INR seems a bit high to me.....our resident expert (Al Lodwick) has a chart which will tell you how to increase or decrease your dosage to to reach the desired INR level. When I was 4.4 at one point they had me hold the Warfarin alltogether ( for too long,actually, it went too low, but you don't have to hold it for days like I did).

You might want to ask Al his opinion....

Good luck.

 

[JimChicago]

Thanks for those links Quentlin - they is definitely a comprehensive list of vit k in food.

 

[Harpoon]

Ummmm... Yeah, a 5.0 is high. I'm on a lower dose of coumadin until I get tested next week. I'm NOT making any kind of changes in my diet though. One change at a time. If I'm Ok for a lower dose of coumadin given my lifestyle and eating habits, then changing my lifestyle and or eating habits AND changing my coumadin dose isn't going to get anywhere.

Besides, for someone with no drug coverage, a lower dose of coumadin saves money. =)

 

[Rush20]

I appreciate your frustration. I tested at 2.0 two weeks ago at an intake rate of 6mg M-W-F and 4 mg SU-T-TH-SA. My cardio upped me to 6mg every day and my INR tested at 3.6 today. Wow! Powerful stuff.

I am now supposed to take 6mg M-F and 4mg SA-SU (weekends) and test again in 7-10 days. I can't believe an extra 8mg per week caused that much of a spike. The new intake rate is an increase of 4mg from the original schedule.

I guess he's trying to get me into the 2.5 - 3.0 range. My question, is there a specific guideline of INR level/intake based on sex, weight, height, age, etc.? For example, is a 6.2, 215 lb man similar to a 5.5, 120 lb woman in intake amounts?

 

[Ross]

At 3.6 they should have left your dose alone for another week and see. I guess if they wanted you at 3.0 instead of 3.5, the dose change makes sense.

What size tablets do you have? I'm trying to figure out why they don't have you take 5.5 mg everday instead of what they are doing.

It doesn't matter as far as height and weight etc. It depends on the individuals metabolic rate and what the liver can process. This is why people are all over with various amounts of the drug to maintain the therapeutic INR range. Some people are fine with 2 to 4 mg per day and some as high as 20 per day. It's just what's right for them.

 

[Rush20]

Thanks for the response Ross. I have 2mg tablets so its either 2 or 3 tablets per day. I too wish I could stick to the same dosage every day, however I'm only the patient here.

 

[Ross]

If it works out on this next check, ask the Doctor for a prescription for 5's and 1's and take the same amount each day. It's not that big a deal, but I think it would save you some money and we can all use some of that can't we?

The other thing I might do instead of what they are telling you is to take your 6's on Su, Mo, Wed,Fri, Sat and your 4's on Tu and Th. It would be a little better balanced that way and if you eat like I do on the weekends, the higher dose should be on those days.

 

[Harpoon]

I'm at a 2.5 now (I think that's like a B average in high school) with an appointment to go back in a week to see if it's stable at that or "rollercoastering..."


Last week they charged me a $15 co-pay for the test... I called my insurance and they said there shouldn't be a co-pay for lab work so I didn't pay 'em this time. They'll either send me a refund or a nasty letter.... Hmmmm...


When I got the blood draws for pt/inr there was no fee involved.