"high" INR

[Gnusgal]

My last surgery

My last surgery

I got my St. Jude's mechanical valve three months ago. June 24th. I also had surgery on April 18th to replace my pacemaker (battery went into backup mode). And I was in the hospital the first week of August to have an EP study to find out if I needed a defibrilator because before the VR surgery I had a stress test that picked up a run of v-tach. Fortunately the EP study showed I did NOT need an ICD, but I had to sit in the hospital for a week because of the coumadin.

For me, when it rains, it pours. I seem to have some years where the "fun" doesn't stop, but then I can go several years with not much happening (as far as medical stuff goes). Before the whole thing with my valve came up I'd been surgery free for four years. But that year I had three surgeries, an angiogram, and a catherization. Insurance just loves me...

Sorry I didn't reply to the first request. Lot on my mind lately...

 

[Gail in Ca]

I agree that 3.6 is not a high inr.
My cardiologist would prefer mine to be closer to 3.5 than to 3.0 or below.
But, I already take 73 1/2 mg per week and my inr seems to go 2.7 to 3.0. I don't want to take more coumadin to get it higher so I just hope my inr's are fine in the long run.
Gail

 

[persianlady]

hello my name is chris I am concerned about my level i dont understand what it means it has never been explained to me i had my aortic valve replaced two yrs ago im 48 female right now the dr said my level was too high becasue she raised it from 2 to 4 mil i started to bleed in my urine so she took me off it said i should be off for ten days today is the 4 day i stoped the bleeding but i have a headache for 4 days now just a slight one in ten days she will check the level i know if it goes too low its dangerous its better if its high but isnt there a time limit when we can only stay off coumadin its very confusing she doesnt tell me to get a check on the valve she said if it gets too low im to get v-k with a IV please help me to understand this level i many timmes my left arm goes numb and when i walk sometimes it it feels like cold air is going into my chest and i havce to stop it hurts she said it was nothing write me ok

 

[JimL]

Chris,
I think you need to get this all explained to you by someone who knows how to manage coumadin, preferably by your cardiologist. I found very soon that I couldn't trust my surgeon's associate to manage my coumadin, and started doing it myself. I'm glad for whatever advice I get, but I make the final decision on what to take.
The important number is your INR. Normal people have an INR of 1 or less. Since we have a mechanical valve which forms clots much more easily than a normal valve, we need a higher INR, definitely over 2.0, usually 2.5 up to perhaps 3.5. The higher the number, the slower clots are formed.
My INR has gone as high as 5.0 without any side effects -- but everyone is different. Just for that reason, the coumadin dosage is irrelevant, that varies from person to person, depending on how quickly your body metabolizes the coumadin.
I have a friend who was put on coumadin last spring because of a blood clot, no mechanical valve, and she's still on it. She said yesterday she was told not to take any coumadin from last Wednesday to this Wednesday because her INR last Friday was a little high. But the coumadin she took last Wednesday was gone by yesterday. I encouraged her to take at least half a pill (5mg cut in half) yesterday and today, in order to maintain her INR at an acceptable level.
As far as coumadin dosage goes, it works best to calculate the weekly dosage, and then divide it out as evenly as possible among the seven days. My weekly dosage fluctuates around 39-41, so I am aiming at taking 6mg and 5mg tablets to reach that goal.
I hope this helps, but please get this explained by someone you trust, PCP, cardiologist, the person who does your INR test.

 

[Gnusgal]

Find another doctor now! If your doctor has told you to stop coumadin for TEN DAYS, I would say that she doesn't know what she's talking about at all! Also, if you are asking questions and she is not giving you answers, that is another reason to find someone else. Remember, she works for YOU, not the other way around. If you have another of these headaches, or your arm going numb, I suggest you go into the ER. If you read my post about my "Big Oops" you'll see why it is important to listen to your body's warning signals. Please seek a doctor who will listen to your concerns, and even if it is "nothing" at least explore the situation rather than blowing you off.

You've found a wonderful site, and you will learn A LOT from the threads about coumadin. I know I did. Welcome to the family.

 

[Guest]

You must run (figuratively) not walk to another doctor before this one kills you (literally).
When you hold warfarin, the INR drops by half every 2 days (approximately). To hold it for a week and then be at 3.0, it would have to have been about 25 to start with.
Your doctor does not understand how warfarin works. You might want to see if there is a warfarin clinic in your area. To do so, look at www.acforum.org and click on clinic locations. If there is one, they might be able to help you find a doctor who will work with them to manage your warfarin.
The danger of holding warfarin for one week without checking the INR in the meantime cannot be overemphasized. YOUR LIFE IS IN DANGER.