Inr 6.5

[LUVMyBirman]

Back from Hawaii with an INR of 6.5, yikes!!! Just had lunch and added a nice big bowl of Broccoli! I will cut my dose in half today and test again in 48 hours. It has been proven that If I hold my dose for a full day I will bottom out completely.

It is soooo difficult to remain consistent while traveling. Especially when the Mia Tias are flowing :-).

Well,live and learn. Last year I did that same and was fine, go figure.

[Christina]

Hi Gina.. Isn't that awful? You just can't win huh? It is seldom right. But like I was saying in another forum, I have been on my own now for the past two weeks and my numbers are better than ever. Last Friday It was 3.4 and today 3.0, and that's where I want to be. Around the 3 mark.
The last time my doc wanted me to go to the lab the results came back at 4.9, and my protime results were 3.2, but of course that doctor did not want to accept my results. He wanted me to skip the Coumadin for 48 hours. That would have brought me down to 1 I am certain, so I did not listen, because thinking back how they collected the blood at the lab that day, I knew a mistake was made.
I am in the process of getting another doctor, so keep your fingers crossed for me and hope he has better "bedside" manners than the previous one.

Be well my friend.

Christina
Mechanical St. Jude's.
Coumadin

[Hank]

Isn't it nice to have your machine so you can test anytime? Did you re-test to confirm the high number?

[LUVMyBirman]

Hi Christina

Hang in there. You will find a new doc.

Have you considered consulting a hematologist? They are not spread as thin in the regard they are focussing on one and only one issue. Blood disorders. I hade a wonderful one, though he was too conservative to the point where he would not prescribe my home test unit. I needed it so badly. Travel, young child that I would have to drag across town to my appointments. We are talking almost two hours by the time I returned home. Did this for almost two years. Not fun. I will have no problem calling in the hematologist if I have any major concerns. He will just have to except the fact that I am self sufficient now.

Take care and please keep us posted. What is going on with the other tests you mentioned? Email me when you have time.

[Perrster]

Gina,

What do you think it is about travel that causes Coumadiners to have so many problems? Official Coumadin literature even mentions possible affects due to travel.

I'm not a jet-setter by any means, however I am planning a trip to Florida between the holidays this year.

Is it primarily because we goof up our systems with exotic food intake? Is it becasue we forget to take our Coumadin at a normal time or forget entirely? Are we having too much fun?!

PerryA

[Herb M]

Janie, I think you are right about the time of day effects the INR. I had always taken my INR tests in the morning before my coumadin dose. Last month I took my coumadin about an hour or two before the INR test and the reading was higher than normal. So now, I take my coumadin at night which should minimize fluctuations.

[LUVMyBirman]

Hey Hank....you know I should have retested to confirm but since the sample was practically like water and did not clot fast accompanied by a few bruises and bleeding gums I left it at that. Your correct though, should have. Will test in the AM.

As for the time adjustment. Took my meds at the same time I would at home 1:00PM Hawaii time = 6:00PM at home so that should not have played a role. Have experienced an elevated INR from prolonged exposure to the sun in the past. This would be the case. Have also had a decrease in INR do to the sun exposure. Both happened while traveling. Luckily I have the option to self test. Will let you know how it turns out.

[LUVMyBirman]

Back to normal today. 3.0. Would like to see it a little higer.

Halfed my dose for one day. Included a small salad and brocolli. From 6.5 to 3.0 in 48 hours.

Big differance!

[strayze]

I don't think well enough about details to figure out the times of the day when travelling. I just take the Coumadin and other medications first thing in the morning. That's about all the concentration I'm capable of. The biggest effect on my INR are in changes of medications. I'll be on interferon gamma 1b three injections per week (ouch, expensive) soon, so I'm glad I have the Protime home monitor to keep my INR straight. The second week of the interferon will be done in travel mode.

[hensylee]

I see that all of you are taking your Coumadin in the morning. Wonder why my brother's dr switched his from morning to night? The dr's nurse was rather startled the first time she called me to adjust his medicine, when she found he was taking it in the am!

[RobThatsMe]

Hi,

WOOOO.... I take mine at night and so do others on here. In fact, my doctor told me that evening is best, in the event that you need to make corrections/adjustments to the dosage.
If you have already taken your dose in the morning, then find that you needed to lower it, it's too late to take immediate action.

Anyway.. I have always taken mine in the evening.. and will continue to do so.

Rob

[Nancy]

Joe always takes his coumadin in the PM. He has for many, many years, 24 to be exact. That's what his doctors told him to do also.

[hensylee]

Tks for your answers. After re-reading above posts, notice that only two (Strayze, listen up) are taking in the am. Sorry, but thanks for the info - I need all I can get re this med because my brother gets so confused about it and all his other meds that I have to oversee.:confused:

[Christina]

I take my Coumadin always at night at 6PM. In the hospital they gave it to me at 4PM, but I changed that to 6PM. Too difficult to remember it at 4, because I often am not home yet, so would have to take it with me. I also wear an alarm watch to remind me that it is time. I have forgotten it once. Not a good thing to do.

Christina:)

[hensylee]

Christina, what a great idea - the watch. My bro has to take one of his pills at 9 and 3 - a watch would be such a help. He lives alone and needs all the reminders he can get. Bet he'd forget or never learn to set it! Or worse yet, wonder what was buzzing! But will suggest to him. Thank you, thank you.

[strayze]

I need at least 2 watches and 3 pairs of glasses in order to be able to find just 1, and that is with placing them in the same place ( thought)! Is there any hope for us?

[Christina]

Hi Hensylee, So glad I could be of help!
It was my dear husband who thought of it. He's terrified I end up in the hospital again with a blood clot or worse. He's so helpful and caring! Every night he'll ask me if I've taken my Coumadin, or when I am already in bed, he'll check my pill box just to make sure.
It has happened that I've taken the watch off (I don't like wearing jewelry) and did not hear the alarm go off and forgotten to take my Coumadin. YIKES!! I hate to think what could have happened if it weren't for him. I am much better about it now, and try my hardest not to forget the 6PM Coumadin time.

Hope it'll work for your brother.

Christina
mechanical St. Jude's
one year post-op.

[allodwick]

Some of you know that I run a Coumadin clinic and am not a heart valve recipient. I have seen about 12,000 patient visits. It seems to me that the two biggest reasons for INRs out of range are going on vacation and having company. Both of these throw off your routines - eating drinking and the time you take the medications.

[Christina]

Allodwick,
I sure appreciate your input on this forum. I developed a blood clot underneath my new machanical valve after 11 days, and the AV surgery had to be redone.
As of January of this year I bought my own Protime Microcoagulation machine, but have experienced a lot of opposition and unwillingness to accept the results. I am still searching for a doctor who wants to work with me, so I won't have to have all those vein draws from the arm.
I have been without a doctor for the past 3 weeks and have been doing fine on my own testing once or twice a week, but I am a bit scared to do this totally on my own.
Any input?

Christina
St.Jude's mechanical
Coumadin

[strayze]

The inability to get INR monitoring locally after a year's searching, prompted me to get the Protime, my handy INR machine. I'm on my own and doing fine. Occasionaly a check at the closest Coumadin clinic which is far away, and I got into that only after a 6 mo wait list. There is no coordination with my Protime, but at least there is that backup. I do not feel uncomfortable with no medical backup for the Protime, I'm glad I have it, and certainly feel safer (after I threw a clot to brain earlier when my INR was abnormal and stayed abnormal till I was informed in writing by local physician 1 wk after blood draw, without instructions).

[Jeff Summers]

I take my rat poison, first thing in the morning, and I always have, and I have only missed 2 doses since June 12, 2000. I have not had to change my dose for about 4 months. I am currently in the appellate stage with my HMO, to try to get one of the Pro Time machines. I was denied because the machine is considered a "convenience item" I agree, its a convenience that I am tired of living without. I'm jealous of y'all that have the machine. If I do win the appeal, I'll let you all know.

[strayze]

I had my INR checked at the Coumadin clinic and it matched well what the Protime measured. I've kept my INR within bounds even though I'm changing medication right now- - medication known to affect INR. I won't go back to Coumadin clinic for a couple of months since I've kept my INR so stable. This Clinic does NOT support home monitoring, but is a useful check for me. The nurse there told me that since I was so forgetful and distracted that taking Coumadin first thing in the AM is OK for me, since it was more important to get Coumadin every day than to risk missing it as I surely do and have done for years with any medication that needs additional daily doses.

I wish success to those of you waiting to hear from your insurance. Since there is no local INR measurement, the Protime for me is not a convenience but a necessity. That of course is not a winning argument for insurance coverage.

[Gisele]

Before my winter vacation I usually go tanning so that I don't burn. I normally see an increase in my INR. Also when on vacation my INR goes up due to alcohol intake (best rumrunners in Florida) and due to hot weather and exposure to sun. I worked for a group of cardiologists for four years as a certified medical assistant before I changed careers. Part of my duties was to work with Coumadin patients one day per week. On my day, one of my patients was a woman my age who was an RN. We compared notes a lot, and she encountered the same changes in INR as I did when exposed to sun, alcohol, and heat. I find that this medication is affected by absolutely everything under the sun! LOL