warfarin advice

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zee112

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It's day two of using warfarin whilst at home, and ill be having an inr check today at the hospital. I wanted to ask you experienced people a couple of questions about warfarin, after all, who better to ask than the very people who take warfarin!

1) does breakfast have to be taken at the same time everyday or could I have breakfast one day at 8am and then the next at 10am.

2) if I fill out some days with low vitamin k food. And decide not to eat them, will it do the same amount of damage as high vitamin k food?

3) And finally, is the efficiency of warfarin impacted when you have a cold or a digestive issue.

Thank you all :)
 

pellicle

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Hi

zee112;n864585 said:
... I wanted to ask you experienced people a couple of questions about warfarin, after all, who better to ask than the very people who take warfarin!

1) does breakfast have to be taken at the same time everyday or could I have breakfast one day at 8am and then the next at 10am.
it matters not when you take breakfast or if you skip it .... who mentioned this to you (wondering if they've filled your head with other absurd ideas)

2) if I fill out some days with low vitamin k food. And decide not to eat them, will it do the same amount of damage as high vitamin k food?
really ... it doesn't matter ... really! Unless you eat improbably amounts of high vitamin K foods (like a full bucket of Kale on occasional weekly meals)

3) And finally, is the efficiency of warfarin impacted when you have a cold or a digestive issue.
usually not, but your INR can go up or down slightly in response to your feeling sick but generally speaking it makes not the slightest bit of difference.

Just to (I hope) dispell any bullshit you may have been fed by whoever gave you the ideas in point 1, generally your INR varies a little and how much is individual. You should get into the habit of taking your warfarin at a particular time for the sole reason that you'll remember to take it and know you have.

Get a pill box, labelled in days ... strictly follow that.

A few hours either side will make no difference (for instance I take mine at 7pm and have a phone alarm for that. If I am out and can't then I take it when I get home or if I'm going out drinking I may take it before I go.

My advice to you is bookmark my blog post here http://cjeastwd.blogspot.com/2014/09...ng-my-inr.html

read it, and go back and re-read it from time to time. I'm sure you will not remember all of it or all of the details in one reading.

I strongly urge you to document and record your INR (even if the hospital is doing the testing) because from that record you can learn. Knowledge is power and power is confidence.


Best Wishes :)
 

Superman

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I take mine in the morning. Typically one of the first things I do when I get up. If I sleep in till 8, I take it then. If I have to get up at 5 - I take it then. I take in the mornings because, for me, it's the easiest time to remember and be consistent. The clinic's generally press for evenings. I'm sure there is a reason - but I'm consistently in range so I don't worry about it.

I eat when I'm hungry and sometimes when I'm not, and sometimes I don't when I should. I eat what is available and don't think much about the impact. I test weekly at home.

I had green beans and asparagus with dinner Wednesday night. I'm not worried. In fact, I ate very differently than normal this week so far since I was travelling for work. Even brought my testing supplies with me since I was due to test one day while out.

My INR has been 2.7, 2.6, 2.8, 3.1 for the past four weeks.
 

dick0236

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pellicle;n864586 said:
I strongly urge you to document and record your INR (even if the hospital is doing the testing) because from that record you can learn. Knowledge is power and power is confidence.
I agree with all that Pellicle posted. The only "absolute" while taking warfarin is that the pill be taken daily and that you test routinely. Your own personal record will teach you that your day to day routines usually have little effect on your INR......and you need not rigidly alter your lifestyle.

PS: I take mine the first thing in the morning with all my other pills.....and my first cup of coffee.
 

marc_kowal

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I usually take my meds at night, when I take the kids up to bed, and I also have a phone app that I record my INR in and it also has an alarm in it.

I also use a vitamin K phone app that I personally love. It tells you how much K is in a particular piece of food and you can record how many servings of it you eat. I don't like having to adjust my meds to much, so I shoot for a certain amount of K each day. If I go over or under a bit, I don't sweat it. If I decide to have a large salad for lunch, I'll just take it easy at dinner. Others may not like my method, but hey, it works for me.

Good luck to you!

~Marc
 

zee112

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When I was discharged from the hospital on the 13th, I had an inr of 2.1.
My second clinic check on the 15th showed an inr of 2.0.
My third check on the 18th showed an inr of 2.7.
My fourth on the 20th showed 2.9.
My fifth today, on the 25th of April, showed 2.7. It seems to be pretty stable now, and the nurse is impressed. And as you guys have said, I've been eating normally, and it hasn't changed my inr one bit!

I am having a sixth test next Tuesday on the 3rd of May.

They've put me on 4/4.5mg alternating doses. It seems to be working pretty well :)
 

dick0236

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From your numbers it looks like you are getting the hang of it very quickly.......congratulations.
 

pellicle

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zee112;n864798 said:
When I was discharged from the hospital on the 13th, I had an inr of 2.1.
...They've put me on 4/4.5mg alternating doses. It seems to be working pretty well :)
good :)

Soon you'll be considering self management ;-)
 

bayou girl

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My surgeon said my INR should be between 2.5 and 3.5. It's seems I'm having problems getting up there.
4/22--1.7 2.5 4x week
4/26--1.7 5 that day and 2.5 every day
5/5----1.5 7.5 that day and 5-Mon, Wed, Fri and Sat; 2.5-Tues, Thurs and Sun
5/11--1.9 7.5 that day and 5 everyday
next test will be 5/16

I didn't think it would take this long to get my INR leveled off.
 

dick0236

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bayou girl;n865242 said:
My surgeon said my INR should be between 2.5 and 3.5. It's seems I'm having problems getting up there.
4/22--1.7 2.5 4x week
4/26--1.7 5 that day and 2.5 every day
5/5----1.5 7.5 that day and 5-Mon, Wed, Fri and Sat; 2.5-Tues, Thurs and Sun
5/11--1.9 7.5 that day and 5 everyday
next test will be 5/16

I didn't think it would take this long to get my INR leveled off.
It seems your AC clinic is bringing you up slowly and steadily. That's a lot better than the INR yo-yo effect and three weeks is not long for the initial dosing adjustment period......I understand that it takes months for some people.
 

pellicle

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Hi

bayou girl;n865242 said:
My surgeon said my INR should be between 2.5 and 3.5. It's seems I'm having problems getting up there.
well actually its a good thing to move up slowly ... there are potential complications that can occur with raising INR rapidly and rather than have you ill from that they are moving you up slowly. I'd prefer that if I was you.

It serves to demonstrate also that noone is worried that your INR is a little low ... so in turn later you should not panic when your INR is a little low for a week or so.

Next, I find your reporting impossible to be sure what the hell it means ... so I can't offer any firm advice till I'm clearer. Importantly, is this representing your initiation (first starting) on warfarin?

4/22--1.7 2.5 4x week
does this mean that on the 22nd of April you had an INR of 1.7 and took 2.5mg four times per week? What did you take the other days?

If nothing then I fear that they are quite cautious.
I'm inclined to believe that how I'm reading what you've written is correct because next you write:
4/26--1.7 5 that day and 2.5 every day
which means that your INR was 1.7 and that they gave you 5mg that day and you then continued on 2.5mg?

5/5----1.5 7.5 that day and 5-Mon, Wed, Fri and Sat; 2.5-Tues, Thurs and Sun
5/11--1.9 7.5 that day and 5 everyday
ok ... so now they are starting see some results ... I'd expect that your INR will begin to go up now.

I didn't think it would take this long to get my INR leveled off.
its never really "leveled off" .. mine is always a bit of a see saw ... here is mine on a good year:


and my surgeon is impressed how stable I am :)
 

bayou girl

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Pellicle, you have it pegged right. It is good to know that this is going along just the way it should, when you have no idea its good to hear from someone who been there done that.
 

MethodAir

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Lately, I've been testing at intervals greater than a week. After testing for a year or so, I somewhat go by feel. My diet/lifestyle is consistent and my readings have been very predictable. Not suggesting anyone else do that, but like anything else, you might do it with more assurance (and less thought) as time goes by.
 

dick0236

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MethodAir;n865425 said:
Lately, I've been testing at intervals greater than a week. After testing for a year or so, I somewhat go by feel. My diet/lifestyle is consistent and my readings have been very predictable. Not suggesting anyone else do that, but like anything else, you might do it with more assurance (and less thought) as time goes by.
My experience with warfarin is built around "habit". I take the pill at the same time each day(AM) and test at the same time weekly(AM on Wed). I used to test monthly at the lab but have home tested weekly for the past several years. The ONLY "accident" I've had happened only seven years after surgery when I had become too comfortable and lax about INR management. The cost and time to test INR is far less than the mental/physical costs of an "accident".
 

MethodAir

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dick0236;n865430 said:
My experience with warfarin is built around "habit". I take the pill at the same time each day(AM) and test at the same time weekly(AM on Wed). I used to test monthly at the lab but have home tested weekly for the past several years. The ONLY "accident" I've had happened only seven years after surgery when I had become too comfortable and lax about INR management. The cost and time to test INR is far less than the mental/physical costs of an "accident".
Yes, I take your point. My point is that as you gain more experience, it is possible to let Warfarin management move further outside your everyday consciousness and still have very predictable readings that are in range. I have determined what I need to have a buffer, and everything stays consistent. I just spend less time thinking about it.
 

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