Low INR

[INRtest]

I just tested as I do once a month on my INRatio. Range should be 2.5 - 3.5. My INR was as low as I've ever seen it 0.8 !

I wonder if the fact that the drop of blood wasn't big enough to cover the entire circle on the test strip could have affected the result. There was, however, enough blood for a result and I actually stuck myself again to add to it while the machine was calculating.

It would cost me several thousand dollars to go to an emergency room right now and get a shot of heparin. Guess I'll up my dosage tonight to 10 (2.5 above the 7.5 that I take) and test again in 2 days.

Any advice?

 

[Bill B]

Repeat the test.

 

[Protimenow]

0.8 is really strange -- without warfarin, normal would be 1.0. It sounds like a testing error.

The protocol used by Duke Clinic is to increase your dose to 1.5 times normal daily dose, then to recheck.

I'm curious -- because you already have a meter, and presumably have a good supply of strips, why aren't you testing more often than once a month? Until I got low on strips, I was testing every week.

I'm with Bill -- repeat the test. Make sure that you have enough blood to run a good test.

Even if your INR is low, you probably don't need an emergency dose of Lovenox - again, the Duke clinic doesn't go overboard with requirements for Lovenox in people who are more than 3 months post-op. You're probably okay with an increase in the dose of warfarin (but, again, confirm the value -- you may want to call Alere and ask them about this, too -- they may help you to resolve any possible problems with your meter). You'll probably want to test every two or three days to see when you're back in range, then reduce the excess warfarin.

Again, if I had enough strips, I would be testing weekly -- at the price of the strips, it's rather foolish NOT to test every week or, at most, every two weeks. (Back in the days when getting an INR meant driving to a lab, paying through the nose for a blood draw, etc., there may have been a rationale for not testing more frequently, but with convenient, relatively inexpensive in home testing, the reason for waiting a month between tests is really not there).

It'll be interesting to see what your retest shows, and how you resolve this.

 

[dick0236]

I just tested as I do once a month on my INRatio. Range should be 2.5 - 3.5. My INR was as low as I've ever seen it 0.8 !

It would cost me several thousand dollars to go to an emergency room right now and get a shot of heparin. Gu my

Any advice?

I would test again....now. As you are on 7.5/day?...there should be no way you could be at .8, as that is below the normal number of 1.0 for a person not on warfarin. I would suspect a test error.....but you'll never know, without validating that test. BTW, a stroke will cost you much more than several thousand dollars.....

 

[sarahsunshine]

Yep... Retest. Update us too. Seems very odd.

 

[Eva]

If the blood was not enough, the machine would give a 'error message'. I agree with the others. Test again and let us know.

 

[bradvo]

Ya might consider testing sooner then a month apart until your certain you are in the recommended target range.

 

[Protimenow]

Whether or not he is in the target range, there is no logical reason for testing once a month. If I had more strips, I'd be testing weekly.

(As stated earlier - there may have been a bit of a rationale for waiting a month between tests when you had to go to a lab, have a blood draw, and wait for results -- the whole thing was a bother and could have been expensive. Today, with meters and quick results, with a low cost per test, there's not as much reason to have to hope that your INR stays stable between monthly tests.)

 

[Bill B]

So, what was the follow-up?

 

[denobobeno]

Curious what you found out?

Curious what you found out?

I tested at .08 because my Surgeon hadn't sent me home on a large enough dose of Coumadin. I had a stroke after receiving a shot of Lovenox 5 years ago. That is in a major danger zone for an artificicial valve patient! Scary! I wished my Doctor had put me in the hospital and monitored me while trying to anti-coagulate me properly.