Doctor wants to adjust my dose.

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jax said:
well I didn't make an adjustment at all last week when i was sitting at 3.5. the doctor wanted to drop me by 6 mgs per week. I finally said i would be willing to do 2 mgs but never did because I really didn't feel that an adjustment should be made when i was still in range. Just got done doing my finger stick and my inr today was 3.2. So gald I didn't listen to the doctor. Especially with the 6 mg drop. I would have been way too low if I had listened to her.
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You've graduated the Anticoagulation management class. You shall be known as Dr. Jackie.
 
convincing the doctor to allow me to self dose is going to be the test. Even though she has no clue what she is doing i have a funny feeling she won't be willing to cut me loose. That is fine I'll just let her tell the doseage change and if i don't agree with her then i'll just do what I need to.
 
jax said:
got done doing my finger stick and my inr today was 3.2. So gald I didn't listen to the doctor. Especially with the 6 mg drop.
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Good going Jackie. Maybe you can make this doctor your "student" in correctly dosing warfarin. My "key" to dosing this stuff is to make smaaaaaall changes, or no change at all, once you have found the (sweet spot) dose that keeps you in, or around, you range. For whatever reason, INR blips do occur, and making large changes normally adds to the problem and causes the yo-yoing effect that can be a bitch to overcome.
 
I just go with my gut feeling when my doctor tries to go over the top with an adjustment. The last time i somewhat did what she told me to I was below range and if I had listened to her completely I probably would have been bridging with lovenox. And I have had my share of that in the last year and don't want to do it again any time soon. I prefer to sit somewhere around 3 for a little wiggle room. I haven't had to adjust my dose in 7 weeks. I would say i have hit my sweet spot. It took me a little while to become comfortable with following my gut and not listening to the doctor but I suppose that any of us would be like that for a while after surgery.
 
Did you tel your Doc that your 3.2 INR was the result of making NO CHANGE in your dose?

If not, she will be under the misconception that her recommendation was correct and she will NOT learn a thing.

Go ahead and tell her the truth. Hopefully she will 'see the light'.

If you have a Dosing Guide that you follow (such as the one from AL Lodwick for $5 from his website www.warfarinfo.com),
you might even want to give her a copy.

Good Luck Teach...
 
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