Travel

[clumsydancer]

Hi all,

I had my surgery on 5 April and am about to return to work. Once I do, I am expected to travel for several weeks to the other side of the world. I have my locations to get checked, but my question to you guys is if we are to take our Coumadin at roughly the same time every day, but in the eve, how do you get on scheduleule when travelling?

 

[ski girl]

I recently travelled to the US from Australia, 15 hours difference. I just swapped to taking my warfarin in the morning. Your INR won't fluctuate greatly if you are late or early by a few hours, and the most important thing is that you don't forget to take it because your habit is to take it in the evening!

 

[Protimenow]

As Ski Girl said, the most important thing is the TAKE the warfarin. What I'd like to suggest is that you get a meter and supply of strips. The meters are battery powered, and should travel well. This way, you can test weekly to be sure that the stress of travel, time shifts, dietary changes, etc. don't do much to alter your INR.

It's likely that as long as you're properly hydrated, take your dose 'on time', and don't make any major dietary or other changes, you should be fine and won't have to be concerned about any changes to your dosing.

(Plus, of course, there's Internet access pretty much everywhere - you can always check in on this forum if you have any pressing questions)

 

[clumsydancer]

Good stuff! Yes, very true about the Internet. I can email my doc too, but at the moment I am still stabilizing my INR with a home nurse. I won't know who to call except my doctor after I'm done with home health care.

 

[Protimenow]

This is strictly what I, personally, do -- and I've been fairly stable probably for decades, but I self-manage my dosing. I also, from this point forward, make sure that my meter is accurate and (or at least, reliable - if it's always a certain amount higher than the labs, I shoot for that higher amount), and I make sure not to run out of strips or to miss testing each week. With charts available here, and a bit of common sense -- and possibly some input from others on the forum - you should be able to manage your dosing. It certainly helps to have your own meter and, if possible, test weekly.

Until your INR IS stable, some professional help may be warranted.

However, if I was finally traveling for extended periods, I would bring along my meter, strips and lancets. I would also make sure to update my 'INR Diary' spreadsheet to keep an ongoing record of INR, dosage, and any relevant events.

 

[clumsydancer]

Yes, good advise. I'm trying to get a meter of my own through insurance now. I'm hoping they'll cover it, but, if not, I may just buy one. I can certainly see the benefit.

 

[yotphix]

If you're just travelling around North America, don't even worry about it a bit. If I'm changing time by more than six hours, I do it in two steps, though I'm not sure it's necessary. I always travel with a meter, and test more frequently than at home since diet, sleep habits and exercise frequency are often different while away.

 

[gerrychuck]

Any professional support available to you via email, phone, etc would be extremely valuable. It sounds like you will be travelling right at a time when your INR may be changing quite quickly; mine was very stable a month after surgery, but immediately after that I really started increasing activity, and started eliminating meds (particularly amiodorone) resulting in having to monitor closely and adjust warfarin dosage constantly until things stabilized again at about 3 months post-op. During that time my dosage increased from 4 mg/day to 8 and it felt like I was chasing the INR with dosage adjustments, and frankly it took a little while to catch up. Throw a major trip with all of it's inherent changes in routine, activity and diet into the mix, and you are most definitely going to want to have a way to monitor your INR closely to stay on top of things. Good luck!