INR 5.8 after one week

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Juliemoon

Active member
Joined
Nov 25, 2016
Messages
37
Location
Lafayette, LA
Hi. I had surgery Feb 17. When I got home from hospital, they were checking INR every 2 days. It was 2.6 last check. Today they came after 6 days, and my INR is 5.8. I haven't changed any medicines. No idea why it shot up in a weeks time. Other than eating greens, is there anything I can do to bring it down? ( I just had a red leaf lettuce salad from my garden.) Have any of you had symptoms accompanying a high INR? Been feeling weak and light-headed past 2 days, but figured it was the Lopressor. The home health nurse told me that the potassium supplements could be the culprit? Not too sure about that.
 
Hi, I had some wild readings in the months following surgery as well. I'm sure someone else will give you technical information. Here's what I did: I tried desperately to keep my diet somewhat consistent, but the recovery period was fickle - some days I ate a lot, and some days I ate almost nothing. I took about 6 months to settle in to a routine. To this day, if I happen to have a high reading at the clinic (which is rare), the RN suggests a dark green salad, or Brussels sprouts for breakfast. Similarly, if I have a low reading (rare) then maybe a glass of wine. Regardless, it takes time to settle down, and a change in dose is going to take 2-3 days to register on a test.
 
When I was first put on warfarin, my INR was all over the place until they figured out the dose that worked for me. It bounced around (got as high as 5.9) for about 2 months before it settled down. Now I've taken the same dose and been stable (INR always measures between 2.0-2.2) for the past 5 months. hang in there!
 
Hi

INR variability after surgery is common ... so the only answer is to test weekly. 5.8 isn't a "worry" level but I'd be steering it down.

your theory on greens is the exact opposite of the effect of greens ... greens will reduce your INR ... but you'll need to eat about 1Kg of lettuce to make a dent in it. So that's not it anyway.

To bring it down I'd say to reduce your next dose by about 30% then reduce the remainder of the days dose you're taking by about 5~10% Test again in a few days to keep an eye on it.

Let me know by PM if you want me to help (as is even possible from the other side of the planet), but I can call and talk you through things
 
The guide that I've used for years says....If no bleeding "hold warfarin and recheck INR in 24-48 hours. When therapeutic, restart warfarin at 15-20% less than previously. Recheck in 3-7 days"......If bleeding "go to ER". When I've had unusual numbers the first thing I do is retest and/or draw a sample for lab testing. Sometimes it happens for no apparent reason.....and sometimes it is a meter/strip error.
 
Dick

dick0236;n873879 said:
The guide that I've used for years says....If no bleeding "hold warfarin and recheck ...


I love these old guides ... its like "if limb is black and smells like cheese amputate, otherwise redress wound and examine in a week"

I'm personally glad you didn't come to harm and are still with us!

Best Wishes
 
My INR was all over the place for a month after surgery. Keep having it checked and take your medicine according to what the medical team you have advises. Personally, I would not skip taking meds without them telling me.
 
pellicle;n873880 said:
Dick




I love these old guides ... its like "if limb is black and smells like cheese amputate, otherwise redress wound and examine in a week"

I'm personally glad you didn't come to harm and are still with us!

Best Wishes

Ah jeepers thats classic... hahahahahaha nearly fell off my chair... haha
 
as said it seems to be common for it to wonkle around after surgery, I kinda thought it takes a while for all the crap to clear right out of your body and your liver to get back to whatever normal is, mine kept going down every few weeks to start with and I had to keep increasing the dose to get to the happy place

as said the thing to do is reduce the dose so hopefully your INR manager is onto it, now when it does go a bit high I find that a specific dose reduction (I take 9 mgs a day but drop down a couple of mgs over 48 hours when needed) over a few days is enough to get it back in range nicely and I just continue the same previous dose

I was taking paracetamol 2 weeks ago a couple of times a day over 3 days for the worst tooth filling I've ever had (I think they used a masonary drill) and that was enough to bump my INR up over 3
 
Hi

Warrick;n873899 said:
Ah jeepers thats classic... hahahahahaha nearly fell off my chair... haha

Ha! Happy to entertain ;-)

When I was doing Microbiology at Uni back in the 80's we learned that the treatment for gunshot wound in the old black powder days was to tip boiling oil on it to cauterise the wound. Something like 80% of the soldiers treated this way then developed gangrene and had to have the limb amputated ... despite mounting evidence that the treatment was causing the gangrene the old army surgeons kept doing it for centuries after other treatments were proven ... surgeons have always resisted "evidence based practice", but in the army the needs of the Generals outranked the surgeons.

Fun reading: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2706344/

The treatment of war wounds is an ancient art, constantly refined to reflect improvements in weapons technology, transportation, antiseptic practices, and surgical techniques. Throughout most of the history of warfare, more soldiers died from disease than combat wounds, and misconceptions regarding the best timing and mode of treatment for injuries often resulted in more harm than good. Since the 19th century, mortality from war wounds steadily decreased as surgeons on all sides of conflicts developed systems for rapidly moving the wounded from the battlefield to frontline hospitals where surgical care is delivered....

The development of firearms made cautery a universally accepted treatment for gunshot wounds throughout the 16th century. Gunshot wounds resulted in gross tissue destruction that was an excellent medium for infection. However, because surgeons of the era had no knowledge of bacteria, they concluded infection was the result of poisonous gunpowder, and sought to destroy the poison by pouring boiling oil into the wound [116]. The precise origin of this practice is uncertain, but it was widely popularized through medical texts written by an Italian surgeon, Giovanni da Vigo (1460–1525) [41]. During the siege of Turin in 1536, Ambroise Paré (1510–1590), a surgeon with the French Army, ran out of boiling oil and substituted a salve of egg yolk, oil of rose, and turpentine, which, to his astonishment, reduced inflammation and enhanced patient comfort, at least compared with “seething oil” [7]. He concluded conventional wisdom was incorrect and published his observations in his Treatise on Gunshot Wounds in 1545.

:)
 
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