GeorgeM
Well-known member
In a previous thread I raised the problem of getting lower than expected INR values (such as 1.9 when I should be nearer 3.5).
I had some great and wise advice from several members here, including this from Ross...
Whatever that dose was, is your sweet spot, I'll bet on it! Let me guess, they got 3.1 and lowered your dose and then you ended up at 1.9, now they want to increase it again?
...Well Ross you should have placed a bet !
But I was still puzzled, after all I'm sure my clinic would not deliberately set out to under-dose me and put me at risk. And the doses I'd received had not varied that much (typically around 3 mg daily).
So I decided to use the Al Lodwick monitoring chart and review the doses I'd been given over the last month.
Holy Smoke - now I see the problem !!
Over a two week period my INR had fallen from 3.1 (inside my target) down to a dangerously low 1.9 !!
The chart showed me that when my target INR was reached the clinic had in fact reduced my weekly dose by 17%. This had been achieved by reducing my daily dose by just 0.5 mg !!
So the reality is that until you look at the weekly trends these changes may not be visible either to clinic or patient.
So now I am charting my weekly doses and looking for trend changes.
My latest INR is now 2.1 - still not in range but I know the dose I'm now taking will get me there soon.
Thanks again all you VR experts !
Best Wishes
George
I had some great and wise advice from several members here, including this from Ross...
Whatever that dose was, is your sweet spot, I'll bet on it! Let me guess, they got 3.1 and lowered your dose and then you ended up at 1.9, now they want to increase it again?
...Well Ross you should have placed a bet !
But I was still puzzled, after all I'm sure my clinic would not deliberately set out to under-dose me and put me at risk. And the doses I'd received had not varied that much (typically around 3 mg daily).
So I decided to use the Al Lodwick monitoring chart and review the doses I'd been given over the last month.
Holy Smoke - now I see the problem !!
Over a two week period my INR had fallen from 3.1 (inside my target) down to a dangerously low 1.9 !!
The chart showed me that when my target INR was reached the clinic had in fact reduced my weekly dose by 17%. This had been achieved by reducing my daily dose by just 0.5 mg !!
So the reality is that until you look at the weekly trends these changes may not be visible either to clinic or patient.
So now I am charting my weekly doses and looking for trend changes.
My latest INR is now 2.1 - still not in range but I know the dose I'm now taking will get me there soon.
Thanks again all you VR experts !
Best Wishes
George
One thing though, don't believe that tiny window they gave you. It's near impossible to maintain it. Be happy with anything between 2.0 and 4.0, but if you must have it closer 2.5 to 3.5. 3.0 to 3.5 will have you chasing your tail and you'll never get stable.
