On my way with home testing

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Patrick7651

Active member
Joined
Nov 15, 2016
Messages
28
Location
New York
So about three weeks ago I obtained my own monitor to start self testing to get a better handle on my levels. The first month or so out of the hospital my INR was all over the place from 3.7 to 2.1 with testing every week. Prior to getting my meter I was reluctant to eat any salads or drink any alcohol for fear of having an unknown change in my INR. Now with the self testing I feel much more confident and in control. I have been testing every other day (picked up a 48 test strip pack) and tracking my diet as it affects INR and adjusting accordingly. My doctor wants me to test weekly and call in my results to get my dosing guidelines, which is fine for me. The problem is my INR was fluctuating too much. Last week it dropped to 2.1 which was a little to low for my liking at this point. My doctor recommended dose was 6 mg which I had been taking through the week. Well I bumped up to 6.75 and got my reading to 2.4. Over the past five days I have stuck to the new dose and have had a stable INR at 2.4. I know when I test in two days for my call in I will have to confess that I upped my dose. I hope They don't read me the riot act, but I feel much more comfortable managing my own dose as I can react more quickly and effectively to changes. Now I am back to eating salads and having a relaxing drink after work.
 
Patrick7651;n875847 said:
So about three weeks ago I obtained my own monitor to start self testing to get a better handle on my levels. The first month or so out of the hospital my INR was all over the place from 3.7 to 2.1 with testing every week. Prior to getting my meter I was reluctant to eat any salads or drink any alcohol for fear of having an unknown change in my INR. Now with the self testing I feel much more confident and in control. I have been testing every other day (picked up a 48 test strip pack) and tracking my diet as it affects INR and adjusting accordingly. My doctor wants me to test weekly and call in my results to get my dosing guidelines, which is fine for me. The problem is my INR was fluctuating too much. Last week it dropped to 2.1 which was a little to low for my liking at this point. My doctor recommended dose was 6 mg which I had been taking through the week. Well I bumped up to 6.75 and got my reading to 2.4. Over the past five days I have stuck to the new dose and have had a stable INR at 2.4. I know when I test in two days for my call in I will have to confess that I upped my dose. I hope They don't read me the riot act, but I feel much more comfortable managing my own dose as I can react more quickly and effectively to changes. Now I am back to eating salads and having a relaxing drink after work.

It's great that it's working out!

I guess all you can do is tell them you made the change and why, it's not like they can take your birthday away, can't see they will have an issue your not a 5 year old

When I started self testing and then dosing I felt the same benefits as you, it's a good feeling. Test myself weekly.
I only go for a test that the doctor see's every few months lately, and I'm normally in range from the adjustments that I make so theres nothing he needs to change :)
 
Hey Patrick

Patrick7651;n875847 said:
So about three weeks ago I obtained my own monitor to start self testing to get a better handle on my levels

way to go!

The first month or so out of the hospital my INR was all over the place from 3.7 to 2.1 with testing every week.
that's not uncommon ... I was just reading an old paper on this (it was dated 1999 ) and it seems to follow exactly what I experienced ... basically its about blood serum albumin levels post surgery. Short answer is that it leads to lower doses just prior to surgery and leveling out to higher doses after 3 to 6 months ... which fits what happened to me. Let me know if you want the paper

I have been testing every other day (picked up a 48 test strip pack) and tracking my diet as it affects INR and adjusting accordingly.

dedication! I hope you've written (spreadsheeted) it all

The problem is my INR was fluctuating too much. Last week it dropped to 2.1 which was a little to low for my liking at this point.

I understand ... but 2.1 isn't really horror show and to be honest as long as its only down that end for a few days its not biggie, but (and it appears you are) stay on top of it and make adjustments to dose.

Don't make the adjustments big and test again (normally I'd suggest testing in 3 days but you're nailing it). Be careful of "oversteering it" ... keep the adjustments to 10% (your reported amounts seem good to my eyes too)

Well I bumped up to 6.75 and got my reading to 2.4.

that's good what it needs now is to monitor over the following week and see where it trends. Myself I look for trends in the INR and find (in Excel) the 3 period average trend line helpful

Over the past five days I have stuck to the new dose and have had a stable INR at 2.4. I know when I test in two days for my call in I will have to confess that I upped my dose.

which supports that you made a good call. Its always important to keep them in the loop so that they know whats going on (well, while they are involved).

All sounds good, In case you missed my post on my 2016 data here is what I found last year in retrospect. Maybe that helps you too

http://cjeastwd.blogspot.com/2017/01/2016-inr-data.html


Keep it up, you seem to be doing great!

Best Wishes
 
The sooner you tell them you made a change the better. I ran into trouble with this when my clinic was three weeks behind me and wanted to change based on what they thought I was taking. Learned it's better to get their thoughts, then tell them what I'm thinking. To their credit, they seem to have become okay with my input and updating their chart accordingly. Bottom line for them is just to know where I'm at, regardless of how I got there.
 
Well I did my weekly INR call in to my Dr today. INR was at 2.4, steady for the last week over 4 tests. On the return call I had to confess that I tweeted my dose. The nurse was not happy and said she would talk to the Dr and call back. A few hours later she called back and scolded me for upping my dose without the Dr's knowledge. I explained that I had a an INR that was trending down from 2.3 to 2.0 and adjusted mid testing period. I further told her that when I called in last time mid testing period I was told not to test so frequently. She then told me that the Dr recommended continuing on the dose I had set.
 
Patrick7651;n875949 said:
Well I did my weekly INR call in to my Dr today. ... She then told me that the Dr recommended continuing on the dose I had set.

Well based on what you've said I agree with your choice.

But I'd like to clarify a thing or two. Daily testing needs the tester to be aware that you can't see trends day by day. Due to the buffering of things in the system.

Of course when my line moves under my minimum I keep an eye on it with a mid week test.

Daily testing can help you to understand how slow things actually move (such as a missed dose) but without a research question in mind are of limited value..

Be aware that being over reactive to variations will cause the variations to be amplified, like a mid learning to sail is tempted to move the rudder every time the bow bobs one way or the other. Keep a steady hand on the tiller.

I think it's important if you are experimenting to see what happens without intervention. Don't over steer the boat.

I recommend you read this post carefully. Happy to talk you through more details if you wish, and that article does not holistically cover all scenarios.

http://cjeastwd.blogspot.com/2015/10...r-example.html
 

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