Put on lovinex today, INR 1.4

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halleyg

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My INR has been steady for about 6 weeks now. WAsn't supposed to get checked again until a week from tomorrow.. but I've been having some stomach "issues" over the past few (4-5) days so I knew I should get checked. Went to the coum. clinic today and knew something was wrong when there was no blood from the finger stick site. My INR is 1.4 so the coumadin mgr. consulted with one of the cardio's and they put me on the shots. I just had one (could not do myself, made my poor hubby who had a vasectomy this morning do it!) and will give myself another in 12 hrs.. also she doubled my warfarin dose for tonight, and I get checked again tomorrow morning. I really got scared when she told me how low it was.. I like her because she is very matter-of-fact about the risk of haivng a mech. MV, but she also reassured me by showing me some study which said if you were on nothing for 4-5 days that the chance of a clot forming is so slim. Of course I am still a little freaked out about the whole thing. She said usually w/digestive issues you see a rise in INR but my warfarin must not be absorbing at all. Just wondering if anyone else had to do anything like this at some point and how quickly does it take INR to rise with the shots?
 

Ross

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Depends on whats going on with thy tummy. It should fall, not rise. If Lovenox is what you must do, then do it until your therapeutic again. Home testing would be great for you.
 

ALCapshaw2

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Sorry to hear about your difficulties Halley.

I *assume* the shots you are receiving are Lovenox which acts on a different part of the Coagulation/anticoagulation mechanism and does NOT show up in the INR measurement.

The usual protocol is to use Lovenox shots every 12 hours until your INR comes back into range from your pills.

Modern thinking has shyed away from using a "Loading Dose" and instead just resumes your normal dosing schedule until you are back in range.

Can you get the Title and Source for the Study that reported a Low Risk of Clotting for 4-5 days after your INR drops below theraputic range? That jives with the protocol used by some surgeons but I'm sure many of our fellow Coumadin/Warfarin patients would be interested in reading the study (including myself).

Hope you return to your normal range soon.

'AL Capshaw'
 
K

Karlynn

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I have never had to use Lovenox - yet, but my INR was low for a time, I'm taking around 2 week, the lowest was 1.6, but I was hovering around 1.8. It was scary, but I had no issues. Breathe easy now, the Lovenox is helping you out while your INR gets in range.

Did you have stomach flu or something that caused the Coumadin to flush out more quickly?
 

Blanche

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Halley:

Sorry you have this concern now. The Lovenox will not cause your INR to increase, but it will keep you safe until your INR does increase. I know it is a pain in the stomach (and probably other places too, but it will keep you safe until you are able to metabolize the Coumadin and achieve a therapeutic INR.

I wish you the very best. I just know that this will pass soon and it will be a smooth process for you soon.

Kindest regards,
Blanche
 
G

Guest

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Hi Halley,

Those shots are no fun but we do what we must to stay clot free. My abdomen is still a little tan and it's been 3 or 4 weeks since the last shot, and my INR finally was in range. 3.0 yesterday, I hope that means I'm stable now.

The experts here at VR.com have said that it takes 48 to 72 hours for coumadin to kick in so if you are retesting tomorrow, tonights double dose won't be there yet. :(
 

Magic8Ball

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halleyg said:
knew something was wrong when there was no blood from the finger stick site. My INR is 1.4 so the coumadin mgr. consulted with one of the cardio's and they put me on the shots.
Lack of blood on finger stick is not an indication that there are problems, just that you need a different finger, a bigger needle or a harder stab.

Did they not do a needle draw to double check this?, did they not test you twice with finger stick?

If the blood is slow comming out or if you have to squeeze the finger too much to get blood out i'm under the impression you will get a less accurate result.

I'm not saying you are in range just that it doesn't sound like they made that good a job of the apparently single finger stick.

I used the same finger for some time and then it got a little light on the flow so switched to another....i also got some new needles which although the same size on the box have a thinner physical needle tip and it gets less blood out.

When home testing i take off any rings/watches, shake my hand like i'm shaking off water and then do some light finger stroking and continue shaking hands until the machine tells me to stick.

I have on two occasions put my hands in warm water to get the blood flowing after a test fail.

Anyway, good news that they put you on the shots until they are sure you are within range.

Regards.
 

Blanche

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Magic is absolutely right. Just think of this, people who do not take Coumadin are able to produce blood for a finger stick site. There must be something else that is afoot here. Study his Magic's post. I suspect the answer is there. And, don't worry in the meantime. THis will be sorted out.
Blanche
 

halleyg

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Thanks all for your replies and support. I know my INR won't show an increase today, but she wants to check me just to track since Sat. I won't be able to test.

I didn't have trouble producing blood from the stick.. I said the site did not keep bleeding afterwards, which it usually does for me. The finger stick itself was trouble-free and normal, no squeezing or anything.

I"m off to get tested again.. Al, will ask for the study info.
 
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