What's up?

[csutherland]

Well, after all my bragging about how easily Jerry's INR is regulated he's having some bumps in this area. I posted last month that his INR was 4.3 or something like that. We and the clinic were confident it would straighten out so no one was alarmed. Then yesterday it was 5.3! Again, we had 100 degree weather last week, but it's been very nice this week. Can't think of anything different he's doing or eating. He was told to hold the dose last night and cut back several nights in the coming week then be re-checked next week. Hope we're not starting a rollercoaster on this; as I said, it has been easily managed and no big deal at all.

 

[Karlynn]

Take a look at what his total dosage will be for the next week, including the skipped dose day. Then figure out what % they dropped his dose.

i.e. If he had been taking 5/day, his total dose is 35/week. If they have him skip today and drop his dose to 4/day, that's 24/week and that's over a 30% drop in his dose. And you would be right to worry about starting a rollercoaster.

Although, since the clinic didn't make any changes with a 4.3, that does show that they don't freak out over above-range INR's, and that's a good thing.

One thing you might want to check is if he's ever been on this low of a weekly dose that he'll be getting this week.

 

[csutherland]

I'm actually pretty confident in the expertise of this coumadin clinic; they don't seem to freak too easily. His usual dosage is 47.5 mg per week and this next week it'll be 37.5. Last month when the INR was up they only lowered it by 2.5 mg for one day.

 

[Karlynn]

So if that includes the skipped dose day, they are lowering his weekly dose by a little over 20%. The charts do say 10 - 20%.

I don't like to make adjustments of 20% even for INR's over 5.5. But that's me. After almost 15 years I know that much of a decrease will send me the other way. But that's me. It doesn't mean this will happen to him.

Let us know what he's at next week.

 

[Ross]

It sounds right, just hope he doesnt' swing too low. All we can do is wait and see.