Hi
first yes it happens, but like has been suggested by the other guys its a personal thing. One of the other members here (
Warrick ) is like Dick and also has an INR that seldom varies much. I have a body which likes to make changes when it feels like it.
Thomas;n886605 said:
Hi,
I'm at a bit of a loss on this one. I've been on Warfarin for just over a year holding at my target INR between 2.5-3.5 without any issues. All of my testing has been at the same lab, same weekly day and time.I don't self-test yet.
thats good to hear that you're being super regular with your testing regime and also good to see the "yet"
Yesterday my regular test was done and my INR had dropped from 2.7 (2 weeks ago reading) to 1.5 . It had been steady with very minor fluctuations over the period I've been taking it. No doses were missed and nothing in my routine has changed and I don't get it.
I see that sort of variation in my INR, especially given that it was over 2 weeks. This represents a movement downwards which if was a simple steady daily drop would only need 0.085 INR units per day. If you think about this this way its actually no a sudden drop (and with two weeks in the middle you have no idea if it was sudden or gradual). This underscores why I do not support longer testing schedules and why I support weekly testing. Were you weekly testing you would have seen this much sooner and most probably before it went below 2
I went back to the lab this morning to be re-tested thinking there might be an error in the sample reading or even a plain old typo in the email result. We'll see.
I also think that a retest is a good idea, not just because its a double check, but because of the long duration (2 weeks) between tests you have no idea if it is working its way back up or still trending down. Knowing that makes a big difference to how to respond with adjustments in dose.
I'm just wondering if this is a relatively common occurrence or just a weird one-off because of.... I don't know, crappy weather...?
thanks
well you've only been on warfarin a little while yet, so you're probably still going though some changes in body. Myself I had a number of changes in the 3 or 4 months after my surgery, which is actually quite well known and experienced managers of INR should be well aware of it. My own dose changed from 4mg over that time to 8mg (which I now more or less am on).
I recommend holding your hand momentarily on dose changes but you should be aware that 1.5 is not an INR you want to sit on very long, I would strongly counsel you to increase that in the next 48 hours at most. So don't let them dally you around with your results. Depending on the findings please post back here ASAP to discuss what happens (even IF they already have a plan for what to do)
BTW who is managing your INR, surely they went spastic on hearing that 1.5 by now already.
Lastly here is one of the graphs of my INR that I make when I do my self testing (and indeed full self administration of dose)
when reading through that chart be aware the dose axis is on the right and the INR axis on the left. You can see INR changes and subsequent dose changes in weekly readings there. As it happens when my INR goes out of range I also do a mid week test to confirm and guide my decisions.
Best Wishes