Hi Consuela,
I too have been see-sawing for the past few months (AVR 10/17/05). It's very frustrating, I'm either bruising myself or fearing a stroke, not a good way to be living a daily life that's for sure. Thank goodness for this site because I would be totally lost without it and it's where I go for all my questions, information, and just to check that I'm not going crazy (always debatable!
) I'm supposed to be in the 2.5-3.5 range. Most recently my INR was 4.7, my GP told me to skip 3 days!!! From the fine, intelligent, caring and very knowledgable people on this site, I knew that was very bad advice. What I ended up doing is skipping a dose for 1 day, then went back to my regular dose for the remainder of the week. My latest INR level? 2.2. I'm thinking that I'm very sensitive to skipping dosages and next time I would be more inclinded to reduce my dose by 1/2 rather than skipping. My GP then told me to up my dose to 8mg from my usual 6 1/2. I then went to the chart that I got off of this sight and figured out what to do with my dosage. My weekly dosage is 6.5 a day x 7 days=45.5mgs/week. According to the chart, with an INR in the 2.0-2.4 range I should increase the weekly dose by 5-15%. I chose 10% just because it was in the middle. So that would mean, 45.5 + 4.6 =50.1. 50.1 divided by 7 days=7.15 or 7.2 mgs/day. I'm going for my next INR around Wednesday of next week to give myself a chance to stabilize a bit.
I'm seeing my GP on monday and my cardio on Tuesday. I'm bringing the dosage chart with me to my GP and I'm going to talk with him, yet again, to support home monitoring, it may be a losing battle. I think the most important thing is for you to educate yourself, be your own best advocate, and constantly research this site for the answers to your questions, suggestions for your "next steps," and of course to participate in the fellowship that is available 24/7. Take care of yourself. Linda