1st Anti-coag question (i think)

[Magic8Ball]

Day 8 post surgery....

day 1 was 5mg with an inr of 1.1
day 2 was 5mg with an inr of 1.1
day 3 was 5mg
day 4 was 5mg
day 5 was 6mg with an inr of 1.8
day 6 was 7mg
day 7 was 6mg with an inr of 2.4 DISCHARGED
day 8 was 6mg with an inr of 2.2 (first test at local GP with recco to stay with 6mg)

Now i won't be getting tested for 3 days staying on 6mg per day but as i'm at the low end of my 2-3 range i'm a little worried waiting 3 days incase i drop below 2....

Do you guys think im justified in insisting on getting tested again in two days rather than 3 especially being so early on we have no idea how i'm going to take to it along with adjusting to the normal home diet rather than the hospital one....

 

[lance]

Testing too often

Testing too often

Warfarin has a half life of 4 days. So you are testing too often.

Testing on Day 5 is better.

Assuming a veinous draw is being used your veins will be scared.

Otheres will soon be here to help.

 

[Karlynn]

The INR test isn't an exact test. The variance can be .5. So the 2.4 and 2.2 are basically the same result. I'm guessing that you are going to end up on more than 6, simply because as your body recovers, your metabolism will increase and and you'll require more to stay in range.

3 days is as close as you want to test. I know they test daily in the hospital. Not sure why they had you on 7 mg for 1 day and then dropped you back down. What size tablets do you have?

If 6 turns out to be not enough, I somewhat doubt that it will drop you too much below 2, so try not to worry. And then you'll just raise your dose and in a few days you'll be in range again. If they had told you to retest in a week, then I'd advise to go back in. But 3 days in acceptable.

 

[Ross]

That's 39mg for the week to get you to 2.2, so I'm going out on a limb and saying that you'll be like me and need 42.5 to keep you in range. I do that with 5mg everyday except Mon,Wed and Fri, then I take 7.5 for those three days.

 

[Marty]

Another point to think about is- the INR is never static. Its always on its way up or down. Trying to keep your INR at one number is just like trying to keep the gas in your tank always half full while you are on a long trip.

 

[Magic8Ball]

Cheers guys, i guess i'll sit tight until Friday..wasn't keen on getting stuck again but didn't want to drop too low.

With my range being 2-3 i'd prefer to hover around 2.4-2.7.

But as someone somewhere said, getting a clot in the aorta is like trying to stick toilet paper to the side of a flushing toilet so i'll just keep chillin.

Regards.

 

[aussigal]

Looking ahead in my crystal ball I can see that you will spend the next few weeks adjusting to the new tubing in your system. As you get stronger and hungrier and more active your dose will need to be adjusted upwards until you reach a point of relative stability.

If I were you I would try keep the adjustments smallish at around 5-10% of your weekly dose in an effort to avoid the yo-yo effect (inr going up & down) which seems to happen when the dose is adjusted often.

Do as you have been, and keep a record of your dose and inr and you will soon get a good idea of how ratsak works for you. If you just remember it takes a few days to get into your system and that dose changes dont show up straight away you will do fine.

 

[Magic8Ball]

Been taking 6mg a day since my first worried post and had my INR tested today and its 2.5 so i guess 6mg a day is ok for me at this stage.

I was just worried it was going to plumet back down again so now thats not happened (did everyone go through that?) i've lined up an ice cold low alcohol beer for later tonight (still don't want to go too mad early days )

Cheers guys n gals

 

[Ross]

Just realize that it's going to bounce around as you recover and become more active. I'll bet anything, soon you'll be doing 7.5 two or three days a week and 5 the rest.

 

[Magic8Ball]

Just tested this morning and i', 2.8 for the second time in a row so i'm to continue on 6mg a day.

As long as i test at around 2.8 for 3 or 4 tests in a row i may actually have a beer

Obviously beer will up the INR so do you guys reduce your dosage if you are having a drink, i.e if i was to have a beer would you recommend taking 5mg that day? or should i just wait for the next test to see the affect and then decide from then.

I'm not yet at the stage were i'd feel comfortable having a drink every day but wouldn't mind a beer or a glass of wine over the weekend....

 

[Guest]

If you don't have more than 2 beers daily, there should be no effect on the INR.

 

[Karlynn]

I've never found alcohol - in moderate consumption - had any affect on my INR. I wish it were true, as it would be a fun way to raise a low INR.

 

[Magic8Ball]

If you don't have more than 2 beers daily, there should be no effect on the INR.

Really? wow, i thought even thinking about the stuff would raise the inr

Can you define what you mean by '2 Beers' as that is a vague term that means different things to different people.....

i.e. in the uk it would mean 2 Pints of beer of 4.0-5.0% strength.

Here in Auz it probably means 2 bottles (about 330ml) of 4.0-5.0% strength.

I was intending to drink low alcohol 2-3% strength and be able to have 3-4 bottles rather than two bottles of the stronger stuff.

Similarly, a 'glass' of wine depends on the size of glass, should we discuss it in ml or am i just being too sensitive to the issue being new to warafin....

 

[Karlynn]

In the US a can or bottle of beer is 12 oz. So whatever that equates to when converted is what Al is most likely referring to.

 

[aussigal]

I have worked my way thru a bottle of red wine over the course of 3 or 4 evenings and found it had no effect whatsoever on my INR. Its not something I make a habit of but I now know it didnt wreck my stable INR.

 

[Ross]

My bloody mary's don't affect it either. This may not hold true for all people, but it doesn't bother mine.

 

[Guest]

It means that a small to moderate amount of alcohol is unlikely to have any effect on the INR. The exact amount is not important - 330 ml vs 473 ml (1 pint) even at 5% is not likely to be a factor.

When you want to set exact boundaries, that tells me that you are trying to find ways to violate the rule.

 

[bvdr]

It means that a small to moderate amount of alcohol is unlikely to have any effect on the INR. The exact amount is not important - 330 ml vs 473 ml (1 pint) even at 5% is not likely to be a factor.

When you want to set exact boundaries, that tells me that you are trying to find ways to violate the rule.

Al, that's me you are talking about! I can gain weight on any diet from doing exactly that.

Magic8Ball, It won't be long before taking warfarin is just part of your normal routine. I generally don't give it a thought from the moment I fill up my week's Medicine containers until I test again right before filling them again for the next week. You are still in the period that everything seems new and strange but it won't always be like that so try not to stress. I think you are actually doing fantasticly well with your INR at this stage!

 

[Guest]

Betty,
I hear that. It is a good thing I never really got into drinking, because I have enough trouble with eating.

 

[Magic8Ball]

When you want to set exact boundaries, that tells me that you are trying to find ways to violate the rule.

Not true Al, just trying to understand the general 'limit' and what it means for me.

If you are saying two pints of 5% beer is fine to drink then i'd rather drink 4 1/2 pint bottles of 2.5% alcohol, its that simple.

If i can find a decent tasting non-alcoholic beer my problems will be solved.

It's the 'cold' drink in the summer affect and the 'being sociable' aspect that i want to maximize not the alcohol content.

I havent had a single drink in over 3 weeks and that will continue probably until christmas week when i will only dabble slightly if my inr is stable at that time.