Introduction

[kismet]

I am one week post op from aorta and aortic valve replacement. I am 56/female (my b'day was second day post op- oh well,) On the advice of my cardio guy and surgeon, I went with a mechanical due to longevity and both think that a better drug than coumiden is well on the way . So far so good. I came home last Wednesday and have had two home nurse visits and she says I am doing great. Coumiden was stopped yesterday based on results and I will be retested Monday. How long did it take for them to get yours right?

I found this site only about a week before my surgery and found it to be very helpful. I look forward to learing more and hope that I might join your "family".

 

[Cooker]

Hello and welcome. It took about 4 weeks for me to get stable . Hope you continue to do well, this is a great place too make friends and get the information and support you will need.

Take care,

Cooker

 

[Ross]

The biggest thing we see here in the forums is Coumadin managers that do not understand the drug therefore, mismanage your dosing. Most of us here are self dosers and self testers, so we have a really good grasp of how things work. Would you mind posting the dosage you take over the week, what your last INR was and how often they test you along with any other medications? I'm asking only to determine if they are doing the job right. You'd be surprised at how many don't.

If your INR was less then 5, they probably should not have had you hold a dose. Cutting it in half for one day usually puts you back in range. Just trying to get a feel for what they're doing to you.

You've come to the best possible place for these types of problems. Al Lodwick, a resident member and certified anticoagulation expert has tons of information you could use. Visit his site at http://www.warfarinfo.com/warfarinfo.com2.htm

If all goes well, you should be stable within 4 weeks. As your activity levels increase, so will your dose. Please tell me that they haven't given you the old "Don't eat greens" story.

 

[geebee]

Welcome to our family, Kismet.

Glad you made it to this side of the mountain.

I am concerned that they have stopped your coumadin for 3 days. This will most likely remove any coumadin from your system which can be dangerous. Post-sugery can be a time when your ACT should be correct and they are leaving you unprotected.

I know I am scaring you but you need to contact your doctor to express concerns about being off coumadin. Unless your INR was over 10, this is way too long to go without coumadin.

Please try and address this so you don't get into trouble.

 

[Ross]

Good catch Gina! Don't know why I was thinking they were having her hold just one dose. It's absolutely wrong to have you off the drug that long.

 

[Karlynn]

Yes, please tell us what your INR was that caused them to hold it for three days and then test. As Gina said, that's basically wiping from your system.

Please be sure you read the Stickies at the top of the Anticoagulation forum here. There is important information there.

Coumadin is a good drug, the problems that arise with it most often come because people in the medical field don't know how to manage it.

I'm glad you found us!

 

[kismet]

Hello all and thanks for the warm welcome. My dosage is 5mg per day plus 325mg aspirin. Seemed odd to me as well to be told to go off for three days. All the nurse said was "you are a bit thin" so based on whart most of you have said perhaps I should call someone

 

[Ross]

Never accept an answer like that. You need to know exactly what your INR is and you need to know the same day it's tested. Come Monday now, your INR is likely going to 1.0 or the same as having no Coumadin in your system and at risk for stroking. I'm never going to understand why it's so hard for these people to get it right. It's not rocket science. Another give away that they are clueless, saying "your a bit thin", Coumadin does not change the viscosity of the blood. It is an anticoagulant, not a thinner as so many misguided people seem to think.

In order to take better care of yourself, since these people don't seem to know how too, take a look at the link below and educate yourself on how the drug works, dosing, what to do for a high INR or Low INR, drug interactions etc. It takes 3 days for a dose of the drug to show in a test. If you've had none for 3 days, your not anticoagulated any longer.

http://www.aafp.org/afp/990201ap/635.html

 

[Karlynn]

If she didn't tell you your INR # that's clue #2 that they aren't going to manage you correctly. Clue #1 is that she told you to hold 3 days, that's a biggie. If you were so high that you were told to hold 3 days, chances are you would have been bleeding from somewhere and possibly required an ER trip. I have been on Coumadin for almost 16 years and have had an INR as high as 7.6. I didn't hold for 3 days with that. (Nor was I bleeding.)

Please read this link http://valvereplacement.com/forums/showthread.php?t=17116 and pay particular attention to the first item. It really is in your best interest to learn how to dose yourself. Start by keeping track of your weekly dose total (which is how they should be making changes) and your INR with each test. You will begin to see how your body works with Coumadin.

 

[RCB]

Ditto

Ditto

Welcome to our family, Kismet.

Glad you made it to this side of the mountain.

I am concerned that they have stopped your coumadin for 3 days. This will most likely remove any coumadin from your system which can be dangerous. Post-sugery can be a time when your ACT should be correct and they are leaving you unprotected.

I know I am scaring you but you need to contact your doctor to express concerns about being off coumadin. Unless your INR was over 10, this is way too long to go without coumadin.

Please try and address this so you don't get into trouble.

kismet,
Did the nurse give you written orders, because you may have misunderstood the nurse. They more likey meant hold for one day only, then retest on Monday (meaning you would resume you normal dose today, Sunday and Monday, it is very important to be precise!) . While I wouldn't agree with that method, it makes more sense than to hold for three days for being a "bit thin". I would place a call to the on-call service right away to confirm this order! Call now!

 

[WayneGM]

Welcome to the VR family. Thanks for joining us.

 

[Bina]

Hi Kismet, welcome to the group.
Good thing you found us, ACT needs to be managed properly.
It took me about 5 weeks to be really stable and I have stayed that way. Thanks to this group, I am now home testing

 

[Ross]

Hi Kismet, welcome to the group.
Good thing you found us, ACT needs to be managed properly.
It took me about 5 weeks to be really stable and I have stayed that way. Thanks to this group, I am now home testing

Yeah and I remember just how apprehensive you were. Now we've created a monster.

 

[ALCapshaw2]

I would NEVER Hold even ONE dose for a reading that was "a bit thin". I would also NEVER let the Coumadin manager get away without telling me my EXACT INR reading.

Holding for 3 days GUARANTEES that you will have NO anticoagulation in your system by Monday (or nearly so) and puts your at RISK of a STROKE.

Call your Doctor ASAP, tell him what is going on, and ask if you should be placed on Lovenox (a fast but short acting anticoagulant that is injected into the 'belly fat' twice a day) immediately to protect you until Monday. (Surely some Doctor will be "on Call" over the weekend for urgent situations such as this).

Out of curiosity, WHO is managing your Coumadin?
Either they are incompetent or simply do not communicate clearly.

Sorry to be so blunt, but holding Coumadin for 3 days is DANGEROUS.

'AL Capshaw'

 

[ALCapshaw2]

Hello Kismet,

Were you able to contact your Doctor Saturday?

If not, I strongly suggest you try again or go to your local ER and tell them your situation.

I am concerned because one of our members (Deana, screen name denobobeno) DID have a STROKE when her INR plummeted shortly after her surgery.

'AL Capshaw'