How Much and When should I?

[Blake777]

Yes, well I am nervous, but all I can do is try to get it back up and pray nothing happens. I will call my warfarin doc (heart surgeouns assistant) tomorrow and let him know I have been off and back on but it is still low. He said to be off of warfarin 3 days before and 3 days after procedure. Which I did get back on 3 days after but it's just low and I am trying to get it back up. I usually use the warfarin calculator to get back straight, it usually works. And yes I tried my regular dose and it was still low so I went up just 1mg tonight, so we'll see what happens.

 

[Ross]

Your testing too soon and changing your dose to frequently. I can see that plain and simple. No bridge is leaving wide open to stroke. Doctors don't care about that, they worry you'll bleed which if they'd start reading their medical journals instead of playing golf or whatever it is they do in their off time, they'd know this is not true.

You have two choices. Listen to the doctors and continue on the yo yo or stop the silliness of it all, take 1 single dose for 7 days straight and adjust it from there. I'm sorry if I sound gruff. I've been there, I've watched others play the same game and there is no reason for any of it. You have to start somewhere and obviously your doctors don't get it.

 

[ALCapshaw2]

Uh-Oh..... did you Wait 3 Days after your procedure to Start your Coumadin?

If so, it's NO Wonder your INR is so low. It takes 3 or 4 days for Coumadin to become fully metabolized.

It is my understanding that Most Docs who do NOT use Lovenox re-start their patients on Coumadin that night, a few to several hours after whatever procedure they performed, knowing that it will not become fully effective for 3 or 4 more days (and that they may need a few more days to reach their theraputic level / target zone.

I would recommend that you test your INR either tonight or again first thing Monday Morning.
If is is still below 2.5 (minimum recommended range for a Mechanical Valve in the Mitral Position),
I would definitely ask any and all of your Doctors for a prescription for Lovenox Injections
because 8 Days Below Range, especially for a Mitral Valve Replacement, presents a High Risk of Clot Formation and possible Stroke.

'AL Capshaw'

 

[Jkm7]

You mentioned you have just started eating again, the heat is bothering you and you are on pain pills. All of this is certainly understandable but all can contribute to your INR level. Even if you go back to the dose that kept you in range prior to your dental work, if these three variables continue, the previous dose may need to be changed.

As you start eating your usual diet again, cease the pain pills and get relief from the heat, you more than likely will go back to your pre-dental coumadin dosage.

Good luck. I can feel you angyst in your post. Hope you stabalilze quickly.

 

[lance]

Hi Blake,
I know some people will drop complete doses to lower INR and it works for them. I've always been more comfortable taking a 1/2 dose for for 2 days days because there is always warfarin in my system.
Sandra