Going back home

[extraordinary]

so It's been 1 months and half on my surgery and it was time to go home, My INR STILL isn't stable and not in range, In my home country we are 7 hours ahead ( i was in celevland cline for the heart replacement surgery ) In America i used to take the warfarin everyday at 5 PM, now that I'm home and with the time difference even day I'm taking it an hour earlier than the other day til i reach 5 PM in our time zone
any one been through thaT? how did you deal with it ?did it effect you're INR ?

 

[dick0236]

An exact daily time is not a big deal for me. I normally take mine, along with my other pills, in the AM shortly after I wake up, but anytime between getting out of bed and noon is OK for me. Your method of transitioning to late afternoon sounds OK. It is a good idea to establish a daily time that is convenient for you and that will help prevent forgetting a dose.......but warfarin dosing is not "time critical". After all, it takes a couple of DAYS for a dose to fully metabolize. A seven day pill box is a fantastic way to prevent forgetting, or doubling, a daily dose.

 

[pellicle]

Hi

so It's been 1 months and half on my surgery and it was time to go home, My INR STILL isn't stable and not in range,

What is it? What range does it move through?

My INR did not fall into line for a few months after surgery (many here have reported similar, the massive metabolic issues of drugs and body repair from such a injury as breaking and entering your body takes time to settle).

My dose gradually increased (in small increments) for months after surgery and I (not having anyone to ask) despaired at this.

I know now it was just what happens.

In my home country we are 7 hours ahead ( i was in celevland cline for the heart replacement surgery ) In America i used to take the warfarin everyday at 5 PM, now that I'm home and with the time difference even day I'm taking it an hour earlier than the other day til i reach 5 PM in our time zone
any one been through thaT? how did you deal with it ?did it effect you're INR ?

I flew from Australia to Finland (about 8 hours difference) ... I didn't change my taking time and I noted no difference in INR (and I measured twice weekly during that period to gather data).

I reckon you'll be right.

Let us know what your INR is and stuff and we can perhaps assist more...

Best Wishes

 

[extraordinary]

An exact daily time is not a big deal for me. I normally take mine, along with my other pills, in the AM shortly after I wake up, but anytime between getting out of bed and noon is OK for me. Your method of transitioning to late afternoon sounds OK. It is a good idea to establish a daily time that is convenient for you and that will help prevent forgetting a dose.......but warfarin dosing is not "time critical". After all, it takes a couple of DAYS for a dose to fully metabolize. A seven day pill box is a fantastic way to prevent forgetting, or doubling, a daily dose.

thanks
but the hospital told me it's very important to take it everyday at the same time ..

 

[extraordinary]

Hi



What is it? What range does it move through?

My INR did not fall into line for a few months after surgery (many here have reported similar, the massive metabolic issues of drugs and body repair from such a injury as breaking and entering your body takes time to settle).

My dose gradually increased (in small increments) for months after surgery and I (not having anyone to ask) despaired at this.

I know now it was just what happens.



I flew from Australia to Finland (about 8 hours difference) ... I didn't change my taking time and I noted no difference in INR (and I measured twice weekly during that period to gather data).

I reckon you'll be right.

Let us know what your INR is and stuff and we can perhaps assist more...


Best Wishes

my INR haven't stable yet and so is my dose, they are adjusting my dose til i reach what they desire, when they lower the dose my INR came to low and when they gave me higher dose it went too high, so now they are trying in between dose, I'll check my INR again in my country this Monday and I'll let you know

I had to adjust my pill to my country timing because 5 PM IN USA is 12:00 AM IN Kuwait so this time isn't right or good for me had to adjust to 5 PM TO our timing and I'm taking it day by day 1 hour earlier tomorrow I'll take at 8 PM so 3 more days to get it

 

[pellicle]

Hi

my INR haven't stable yet and so is my dose, they are adjusting my dose til i reach what they desire, when they lower the dose my INR came to low and when they gave me higher dose it went too high

classic micro management (and attendant failure if you ask me).

To make any real observations I would really need to know exactly what doses and by what alterations in responce to what. However in the absence of that I'd say that increasing doses and decreasing dose in larger amounts (say, more than 10%) is going to trigger enzyme responces which will cause instability in the amount of warfarin which is residual in your system. This will in turn cause your INR to be unstable.


I know that in the early stages of warfarin introduction there are some significant issues which need to be taken carefully, but that knowledge should not translate to a knee jerk reaction on the part of your team. Again I don't know specifics, so I can't say anything much.

I'll check my INR again in my country this Monday and I'll let you know

please also tell us (me?) what your dose is (in mg) and if it is regular (day to day) or varies (like 5mg M,W,F,Su and 7mg Tu,Th,Sa) ... I hope its regular because I believe there is nothing like regularity to promote regularity.

I had to adjust my pill to my country timing ... our timing and I'm taking it day by day 1 hour earlier tomorrow I'll take at 8 PM so 3 more days to get it

I can not imaging that shifting the dose time by 8 hours would make the slightest difference, but if you wish to do all that then it certainly won't make any harm. I would even think that you could shift by 12 hours and it will be almost impossible to tell by any measurements. I would not shift it by 12 hours on a day to day basis, but as a one off or even every few weeks ... should be fine.

Best Wishes