A Day at the Coumadin Lab

[MarkU]

I went to the lab today for my PT/INR. The nurse was visibly upset about a patient that she had tested earlier in the day.
The 91 year old woman had been told to "take 5 per day", which she had interpreted as "5 pills per day". So she had actually been taking 25 mg per day!!! Needless to say they took her straight to the hospital. The nurse was thankful that the woman hadn't had any small mishap which could easily caused her to bleed to death.

 

[McCln]

I hope that they found out who told the poor woman about taking five and not explaining to her about the 5 dosage and number of pills. There are some so called professionals that forget that older people have a harder time comprehending things at an older age. Thank goodness that she is alright. I hope the person who did not do his/her job correctly got a stiff lecture about how to explain medications to the elderly. Thanks for sharing this with us. It is a reminder that when we do get older, er can lose comprehension skills as we age. Maybe some professional will learn something from this terrible mistake.

Caroline
09-13-01
Aortic valve replacement
St, Jude's valve

 

[Jan]

Warfarin

Warfarin

I live in the UK and my warfarin is managed by the local hospital

You are given a book with your details and range in it,
you must hand this in when your sample is taken.
the results are ready later in the day
if your dose needs altering the hospita lwill telephone you that afternoon,
If you are to remain the same your book is posted back with a printed slip with all your details INR and the dosage and your next appointment

For example if you need to take 5mg per day it will say

Monday 5mg Take one pink tablet

and it lists it like that until your next test

It must be very time consuming for the people who do the tests
but it sure avoids mistakes being made by our senior citizens

We often criticise our NHS but i feel I am getting a good service with my warfarin management at the hospital.
There is also a sticker on the front of the book to tell you if you are on antibiotics you need to go for a test on the 3rd or 4th day of taking them,

When you are stable you go on 4 weekly tests

I intend to buy a home test kit when stable, just for my own peace of mind as I have read many good reports on home testing
on the site.

Well tomorrow I am off across the big pond to Florida for Daytona Bike Week so I am hoping for some sunshine

See yo all in two weeks

Jan

 

[hensylee]

The motorcycle week? Wow that's great. Went there once when the bikers were in town and you couldn't move for bikes. Thousands of them. Daytona Beach is soooo beautiful. Maybe they still let you ride on the beach (thought they had cut that out because of sand erosion, but maybe not). Anyway, enjoy Florida. It's a great place.

 

[Guest]

For those of you having trouble getting doctors/insurance to approve self testing, here is the reference to a new article. I only have the abstract. If you want the entire article you can print the reference and take it to a librarian and request that a copy be sent to you. Perhaps Mike Visnich has it and can send it to you.

Reference: Rosengart TK. Anticoagulation self-testing after heart valve replacement. J Heart Valve Dis 2002 Jan;11 Suppl 1;S61-5

The author states ..."A growing body of data suggests that the ability to monitor the INR at home results in a greater maintenance of 'in-range' values... this will translate into a lower frequence of bleeding and thrombotic complications."

 

[Marty]

Coumadin Self Testing- self dosing?

Coumadin Self Testing- self dosing?

Al, this "body of evidence" in regard to self testing keeps growing and growing till there should be no doubt at this time. What about self management of the dose? A couple of years ago I discussed this with some folks at the International Thrombosis and Hemostasis meeting and they told me about a Dupont study in North Carolina that found only 15-20% of patients had enough smarts to self dose successfully. What do you think in view of your experience?

 

[Guest]

For the most part, people who are able to take their own medication every day should be able to make their own dosage adjustments.

Many of the people I see are not able to do either. The hospital where I work was founded as part of a steel mill. (On the old papers it says COLORADO FUEL AND IRON - Corwin Hospital) Most of the people are elderly and spent thie lives taking orders, not taking initiative. Mostly they could not. But they are not typical of the nation as a whole.

 

[Marty]

Self Dosing?

Self Dosing?

Very interesting. Not surprised.

 

[LUVMyBirman]

Agree, when the day arrives that I start questioning my judgment....will turn my anticoagulation management over to the professionals.

Have to add, " I have never been more stable on my own, self dosing and testing"!

 

[Guest]

I was caught saying, "take 5 ..." today.
The lady said, NO!!!! I'm not taking 5 pills"
OOPS!!

 

[Zipper]

Ooops!

Ooops!

LOL! Well Al...just shows you're human..we all goof! Good for that lady tho!!

Zipper *~*

 

[Guest]

My mother-in law once crossed up nobody's perfect and everybody's human and came up with the classic

Well, nobody's human.

 

[LA_Cruiser]

"It is said that communication.....

"It is said that communication.....

...is the cause of MOST problems."

Somewhere I also read "That you should write, NOT in a way to be understood, --though in a way, not to be MISUNDERSTOOD."

Problem is that we most always ASSUME that others can read our minds or that we 'know what we're saying.'

 

[Zipper]

I may have said this before...CRS...u-no???

I am amazed at the elderly people who do not pay a bit of attention to their INR. My mom lives in a senior building...as I discuss my strategies for food and coumadin intake and monitoring she is puzzled....says..."Oh many here take coumadin and never even think about those things".....YIKES....very scary and I wonder about their Doc's and how often they test. It almost seems like they think of it as 'just another pill'....I wish I could think of a way to educate these wonderful elderly people. Believe me...I have brought Al's book over and spoke to many....no impact.

I think this is an area of major concern. How to help?????

Zipper

 

[Guest]

That is a very tough problem. The people are there because they can no longer take care of all of their needs. However, they do not need total care. They are probably unwilling/unable to learn. Until you want to learn, you will not. They grew up when what you didn't know wouldn't hurt you.