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Thread: stabilizing inr/pt levels post surgery

  1. #1
    Join Date
    Sep 2001
    Location
    Westchester, NY
    Posts
    2,236

    Default stabilizing inr/pt levels post surgery

    hi all,
    my dad is having quite the time getting his coumadin levels stabilized. one day they're too high and they tell him to refrain for a day, the next few days they're too low and he loads with coumadin.

    i remember there being a thread where someone (al?) listed percentages, and based on those percentages, the amount of coumadin to be calculated.

    can anyone recall this thread? i can't seem to find it and i'm not happy with the way my dad's coumadin is being handled.... by his cardio, not an anticoag. specialist. he normally takes 5 mg 3 days and 7.5 four days a week. his levels were 3.7 yesterday after taking 10 mg on sunday. he took another 10mg on monday, but was told to withhold coumdin yesterday. now back on 5 mg as of today and the 7.5 as well. i don't know what to tell him, since it seems to be seesawing up and down (was 1.3 for days before the 10 mg addition)... i'm learning even though joey doesn't take this, but should they not have kept him on atleast 2.5 on what they called his "day off"?
    help, please?
    thanks so much...
    still pray for all who are not well and think of all who are...
    stay well,
    sylvia
    sylvia
    my husband, Joey, had Ross Procedure 9/20/01
    Beth Israel Med. Ctr., N.Y.- Dr. Paul Stelzer

  2. #2
    Join Date
    Dec 2001
    Location
    On The Hot Seat
    Posts
    25,981

    Default

    They should never have adjusted for a 3.7! That is perfectly acceptable even if only slighly out of range.

    What was he taking for the week to get that 3.7? I would go back to that dose and if still a little high after ONE FULL WEEK, reduce the weekly dose by 10% and retest in ONE MORE WEEK. Now as he regains strength and excercises more, his INR will fall and require a little higher dose of Coumadin.

    He is see sawing because of whoever is managing his care. They don't know what their doing.

  3. #3
    Join Date
    Jul 2001
    Location
    Pueblo, Colorado
    Posts
    3,677

    Default

    Testing and making dosage changes more often than once per week is the main reason that INRs jump up and down.

    It is like driving a car by slamming the gas pedal down and then when you get going too fast in half a block slamming the brakes on then jamming the gas pedal down again over and over and over. You will be in range once in a while but the warfarin manager will have no idea what it was that caused the INR to be in range.
    Al Lodwick, R.Ph.
    Certified Anticoagulation Care Provider
    [URL=http://www.warfarinfo.com]Go to my website for warfarin information[/URL]

  4. #4
    Join Date
    Mar 2003
    Location
    North Alabama
    Posts
    6,910

    Default

    Whoever is managing his Coumadin dosing is an CLUELESS !

    Can he get referred to a REAL Coumadin Clinic?
    They do a MUCH BETTER job of regulating INR than most Doctors who only handle a few patients.

    I like Al Lodwick's analogy of FULL GAS, FULL BRAKE, FULL GAS.

    The SAFE RANGE for INR is 2.0 to 5.0

    Making drastic changes (i.e. Holding a Dose) for a 3.7 is ridiculous and will lead to WILD SWINGS in INR just as he is experiencing.

    Dosing Guides have been posted in the AntiCoagulation Forum several times. (Keyword "Dosing Guide").

    Al Lodwick sells a nice foldout Dosing Guide for $5.
    See his website www.warfarinfo.com Well worth the cost.

    'AL Capshaw'

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