Remember, they deal with the General Publicbecause it can “get very confusing very quickly.”
As per my blog post I advocate for consistent doses. Not just because it's easier but because I believe my INR is that little less volatile.taking say, three pills to equal a dose, like 4.5 (ex: 2.5, 1, 1) or 7.5 (5, 1.5, 1) each day, OR taking different doses each day, like 4 mg on Sunday, Tuesday, Thursday and Saturday, and 5 mg Monday, Wednesday and Friday.
Translation: "I don't understand basic math and you're confusing me."“What?? 4.5? There is no 4.5 mg pill! How would you do that??”
I said, “Just take a half a 5 mg one, and two 1 mg pills....”
She said she wouldn’t recommend “a whole bunch of different combinations” because it can “get very confusing very quickly.”
just wanted to add ... its a 1999 paper ... my blog is a more up-to-date and well referenced source. This is not to say that there is nothing in that paper, but that I believe I cover the perspective of a mech-valver on my blog with better simplicity.All I can find is a single sentence about it in this paper, in the caption for Figure 1:
Chuck -a year's worth of refills
I agree. You have to play the long game and have conversations, but avoid debates. Ask questions, and with your (Amy) team, I’m guessing you’ll have to find some sales tactics that make things seem like it’s your clinics idea. Watch old episodes of Columbo, “There’s just one more thing maybe you could help me understand?...”Repeated consistent adherence.
I was with a clinic for months, I built a case with my doctor
Sorry that they are making it so difficult to get your prescription. It is hard to understand their stubbornness. I'm sure eventually you will find a patient friendly PCP. If not, there is always the warfarin black market- just kidding don't do that- I can't imagine one even really exists.Chuck -
Yet another reason to move back to California. : ) God! I have had to fight and fight and make up INRs just to get a single month’s worth of 1 mg pills! (And even that came with protestations of “I don’t want to be responsible...” from the prescribing nurse!) I’ve spent days calling around, leaving my information at doctors offices, trying to not be denied by new PCPs, (which is apparently a thing) just to try to find someone willing to give me a prescription without stingily only giving out a few days’s worth at a time... I don’t get it. It’s not like this stuff is Valium, or Xanax, or whatever the hell the kids are taking nowadays... it has no palpable physical effect at all (to me) - I just need it to survive (assuming I’m not one of the lucky ones who’d be able to make it 27 or 37 years w/o warfarin).
this is at once a good plan and an interesting topic. In Australia (of course not related to the US situation) the cardiologist is actually not involved with this at all. The surgeon is the one who sets the INR guidelines (mine quite specifically directed me to keep it between 2.2 and 3 which given what I know about the ranges and "that graph" is quite sensible), the Cardiologist is uninvolved and my regular doctor (we call them GP for short) was responsible for my prescriptions for warfarin (I take Marevan brand) and initially I was assigned to Queensland Medical Laboratories (QML) to manage my dose. They are not responsbile for the prescription writing.There’s no law that it has to be your cardiologist’s office. PCP’s I find are more likely to work with and write for what you need. A lab can still make the draw and communicate the results to your primary, but any lab can draw for INR. Your primary can also write a prescription for a home tester, then it’s an issue of whether or not your insurance will cover as DME (durable medical equipment).