INR stroke level... Help!!!!

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C

CThrock

Well-known member
Joined
Jun 12, 2006
Messages
1,933
Location
Tucson Az.(warm country)
Hi all,
Sorry, its been so long since I've written. Ive been doing pretty good with rehab
and trying to get through that. Monday went and had my monthly INR check and yesterday the protime nurse called and said it was stroke level of 1.5. She asked if I've been feeling ok or missed a dose or doses. I told her I've been feeling tired
and sloggish but havent missed any doses. She told me to take it easy and to up my two days a week doses to what the other days were which is 10mg.
Wanted to know if any of you have had this problem and what you did if anything??? I'm almost 8 months post surgery and was doing really good.
Hopefully you guys can share alittle light on this subject.
Thanks for all your input its nothing like having input from people that know what's going on. Thanks, Crystal
 
Crystal, I can't help you , but suggest you post this in the anticoagulation forum, it will probably get more replies there, Lyn
 
Hi,

I am new also and don't know as much as most but did thye re-test? A few months ago mine was a bit low and they tested me three days later and it was fine. You might want to ask for a re-test.

Tom
 
(I'm sure Ross will move this to the Anticoagulation Forum.)

Crystal:

What is your INR range suppposed to be?
What is the dosage you've been taking (how much per day)?
What other Rxes are you on?
How often have you tested and what have the INR numbers been?
 
Crystal - take deep breaths. 1.5 isn't going to guarantee you a stroke. I've been low many times in 15 years and have not had any incidences. So relax a bit. The nurse's choice of words were frightening.

Answering Catwoman's (Marsha's) questions will give us a lot of information in order to see if we think the instructions you received were correct.
 
As you become more active following surgery, your metabolism will increase which lowers INR. It is not unusual to need to increase your Coumadin Dose to compensate. Getting a Re-Test is a GOOD PLAN.

'AL Capshaw'
 
Answering questions

Answering questions

Thanks for your input , heres alittle more detail...

INR from 2.8-3.0 been stable for at least 4 months
having it check once a month for the last 4 months
Before that was around 1 to 2 times a month.
After surgery for about a month every week.

The Rxs I am on are Lasix,potassium,warfarin,metoprolol

I'm on 10mg 5 times a week but now they up it to 10mg every day till its under control.

My diet has pretty much stayed the same, eating fruits and veggies.
During the holidays I ate a little more then I should of but don't we all.
Otherwise everything has stayed the same also exercising is at rehab.

Hope this helps answer some of your questions (catwomen)
Let me know!!! Thanks again
 
I agree that the nurses choice of words was unfortunate. And a retest is a really good idea. But in the meantime you are taking action by increasing your dosage.....hopefully to be tested (for the increased dosage) in a week?

I think there are many of us that have been at 1.5 at one time or another (I know I have been) and did not have a stroke!
 
Thanks Crystal.
What were you taking the 2 days you weren't taking 10? I'm hoping that they just didn't leave 2 days without Coumadin.

Taking 10 a day means that if you skip a day, your INR will drop pretty quickly. So if you tested your INR 2 or 3 days after a day where you didn't take any coumadin (if that's how they were dosing you) then it would be low. Maybe not 1.5, but still low.

Increased exercise and overall better physical health is going to cause a need for more Coumadin.
 
Hi ,
Thanks for more great input. On Tuesday & Thursday I was on 7.5 mg. But now everyday is 10mg. I've never had it that low before it was good to hear that, that happens. It really scared me when the protime nurse said the word stroke. I think they forget what people go through and I had double. I have not even met anyone in the cardio rehab thats had two values replaced the most was one. I'm sooo glad that I found this web sight before my surgery. Has been great to talk to all of you.
Let me know if theres anything I can do to help this situation. Thanks Crystal
 
Crystal:

Did I read that correctly -- that your intended INR range is 2.8 to 3.0? Surely that's not correct.
I assume you had both the mitral and aortic valves replaced. Most people with double valve replacements are told to stay in the 2.5-3.5 and sometimes even the 3.0-4.0 INR range.

Your public profile lists you as a teacher. Are you currently working? What about any outside activities, such as traveling on weekends, lots of chores around the house?
 
Your currently weekly dose (prior to the 1.5) was 65 mg. The nurse raised your weekly dose by ~6%. This probably isn't enough. 10 - 20% is the usual increase for an INR of less than 2.
 
This is no answer to your problem but I really encourage everybody to buy a Home Testing Unit, it's usually covered by insurance. It enables you to manage your Coumadin a lot better and it's way more convenient.

1.5 is low but it does't mean your going to have a stroke. Bad choice of words by the nurse.
 
Hi again,
I was a teacher for 25+ yrs. I am now on disablitily for other health issues.
I stay pretty active with traveling, home, excercise, church, drs appt. yard work, amoung many other things. It was hard in 2005 to not be working but I keep pretty busy along with my husband busy schedule.
I have another INR this coming Tuesday so maybe that will tell if the up on doses did help. I guess I just have to be a little more content dealing with the nurses and drs. Sometimes their choice of words freak me out a little. How much greeens do you think I should be eating ? I eat about a cup a day and thats what I've pretty much stayed at. I eat alot of fruit too. Have to be careful with that also. All of your input helps alot with just hearing others and checking out other options. My INR has been as low as 1.5 and as high as 3.5.
Thanks, Crystal
 
Crystal - what are they telling you your range is? With 2 valves replaced I'm guessing that it's at least 2.5-3.5, or maybe even 3-4.

I'm sure right now with an INR of 1.5 you are sensitive to eating greens. I know I would be. But when you get into range - don't spend a lot of time worrying about what you eat. Eat what you want and let your dose be adjusted accordingly. Most people have very routine eating habits. Yes, you'll have problems if you eat a large spinach salad each day for a week, adjust the dose to that, and then stop eating the spinach. Your INR will go up. But the reality is that most people don't have that type of wild eating routine.

Make sure that your Coumadin managers aren't afraid of you being in the higher end of your range. Just about everyone here will tell you that we are much more comfortable being on the higher side. Doctors do fear bleeding, but the reality is that most people will not have an issue of an INR of 5 or less. Even a little higher than that isn't something to be afraid of. If you have other health issues that make you suceptible to bleeding, then yes, you do want to be careful of going too high.

My range is 2.5 - 3.5. I don't make any adjustments for a 4.0 or below unless I test 4.0 2 tests in a row, then I tweak my dose.

What date did you have your valves replaced?
 
I agree with Karlynn that 6% increase may not be enough with 1.5 INR.
My wife has been below 2 a few times and we increased it by 15-20%.

Since you have been eating the consistent amount of greens, I do not think that was the reason for the low INR this time.
You might want to think about getting tested more than once a month. A good way to do it is getting a home testing machine.

With your high dose (10mg / day) if you skip a dose, INR will drop like a rock. Many people at high dose find 1 missed dose will drop it to a half and 2-3missed doses will get it to near 1.

Since you have been stable for quite a while, if you encounter a sudden unexplaiable drop in futue, I would get it re-tested right away to verify the low INR number is right....

EJ
 
doyo said:
With your high dose (10mg / day) if you skip a dose, INR will drop like a rock. Many people at high dose find 1 missed dose will drop it to a half and 2-3missed doses will get it to near 1.

Since you have been stable for quite a while, if you encounter a sudden unexplaiable drop in futue, I would get it re-tested right away to verify the low INR number is right....

EJ
Click to expand...

Good advice EJ.
 
Hi Crystal,

Please try not to worry too much. I was also at 1.5 for a while after I began taking Tegretol for complex partial seizures. My doctor ended up having to double my coumadin dosage because of the Tegretol but the 1.5 didn't cause me any problems.

Hope you're back in range soon!

Cheers,
Michelle
 
Up date on INR report!!!

Up date on INR report!!!

Well had my INR done yesterday and it was up a little but not much . From 1.5
to 1.8 so they added more doses to the daily 10mg to 12.5 mg. Then I will have another test done next Tuesday. Still feel about the same cold all the time,tired and light headed still. So don't move around to quickly these days. Will see what happens uping the doses. The nurse said they do it slowly till it comes back to normal. Thanks for all your input guys it really helps take off some of the stress. This is the BEST forum ever!!!!Crystal
 
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