Hi
Since my health insurance covers 100% of my INR testing I’ve not looked into home testing but I’m up for anything to help me get through this.
so you go to a lab? How often? (its important).
My knees are the worst but I have it in the joints of my hands too.
so ibuprofen comes to mind (but you mentioned Tylenol doesn't cut it) I'm sure there are some other arthritis sufferers here who are also mech valvers, but to be honest your title may not see them reading this and finding what you wrote is actually about "how can I get relief from arthritis pain when I'm on warfarin".
NHS has this and all are possible if you are managing your INR properly as far as I know (and if your going through a lab properly is up for debate):
https://www.nhs.uk/conditions/osteoarthritis/treatment/
Pain relief medicines
Your doctor will talk to you about medicines to relieve pain from osteoarthritis.
Sometimes a combination of therapies, such as painkillers, exercise and assistive devices or surgery, may be needed to help control your pain.
The type of painkiller a GP may recommend for you will depend on the severity of your pain and other conditions or health problems you have. The main medications used are below.
Paracetamol
If you have pain caused by osteroarthritis, your GP might suggest you consider taking paracetamol for short-term pain relief. You can buy paracetamol at supermarkets or pharmacies.
However, many people find that it doesn't work very well, and it is only normally tried if you can't take other medicines.
When taking paracetamol, always use the dose a GP recommends and do not exceed the maximum dose stated on the pack.
Non-steroidal anti-inflammatory drugs (NSAIDs)
Some NSAIDs are available as creams (topical NSAIDs) that you apply directly to the affected joints. Some topical NSAIDs are available without a prescription. They can be particularly effective if you have osteoarthritis in your knees or hands. As well as helping to ease pain, they can also help reduce any swelling in your joints.
Your doctor will discuss with you the type of NSAID you should take and the benefits and risks associated with it.
NSAID tablets may be needed if topical NSAIDs are not easing the pain. They may not be suitable for people with certain conditions, such as asthma, a stomach ulcer or angina, or if you have had a heart attack or stroke. If you're taking low-dose aspirin, ask your GP whether you should use a NSAID.
note: the above says "certain conditions" and the next part goes on to say "can break down" ... it does not say "will break down" and there are always ways to mitigate it. Your rheumatologist sounds like they are lazy, so you may want to change (depends how you feel about putting up with pain..
If your GP recommends or prescribes an NSAID to be taken by mouth, they'll usually also prescribe a medicine called a proton pump inhibitor (PPI) to take at the same time. NSAIDs can break down the lining in your stomach that protects it against stomach acid. PPIs reduce the amount of acid produced by the stomach, reducing the risk of damage to your stomach lining.
Opioids
Opioids, such as codeine, are another type of painkiller that may help relieve severe pain.
GPs will only usually prescribe opioids on a short-term basis because of side effects such as drowsiness, nausea and constipation.
You may be prescribed a laxative to take alongside it to prevent constipation.
Capsaicin cream
You may be prescribed capsaicin cream if you have osteoarthritis in your hands or knees and topical NSAIDs have not been effective in easing your pain.
Capsaicin cream works by blocking the nerves that send pain messages in the treated area. You may have to use it for a while before it has an effect. You should experience some pain relief within the first 2 weeks of using the cream, but it may take up to a month for the treatment to be fully effective.
Apply a pea-size amount of capsaicin cream to your affected joints up to 4 times a day, but not more often than every 4 hours. Do not use capsaicin cream on broken or inflamed skin and always wash your hands after applying it.
Be careful not to get any capsaicin cream on delicate areas, such as your eyes, mouth, nose and genitals. Capsaicin is made from chillies, so if you get it on sensitive areas of your body, it's likely to be very painful for a few hours. However, it will not cause any damage.
You may notice a burning sensation on your skin after applying capsaicin cream. This is nothing to worry about, and the more you use it, the less it should happen. But avoid using too much cream or having a hot bath or shower before or after applying it, because it can make the burning sensation worse.
