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Kitten baby chick  alpakinci wrote 7 months ago

my wife was operated on mitral walve and tp. But INR very unstable...
2.12.17-INR 1,61-COUMADIN DOSE-5
3.12.17-INR 1,07-COUMADIN DOSE-7,5
4.12.17-INR 1,15-COUMADIN DOSE-7,5
5.12.17-INR 1,2 - COUMADIN DOSE-7,5
6.12.17-INR 1,5 - COUMADIN DOSE-10
7.12.17-INR 1,68-COUMADIN DOSE-10
10.12.17-INR 2,22-COUMADIN DOSE-7,5
17.12.17-INR 2,14-COUMADIN DOSE-7,5
30.12.17-INR 1,65-COUMADIN DOSE-7,5
03.01.18-INR 2,044-COUMADIN DOSE-10
08.01.18-INR 1,8-COUMADIN DOSE-10

Category: INR

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Total Comments: 7

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Brachiosaurus  warrick - (1) - posted 7 months ago

Also what is "tp" short for ?

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Kitten baby chick  alpakinci - - posted 6 months ago

tricuspid walve

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Brachiosaurus  warrick - (1) - posted 6 months ago

Ok so two valves replaced. I assume they are both mechanical valves? Or are they tissue valves which generally would mean she will only be on warfarin for a few months unless there are other issues ?
If they are both mechanical then I would have thought her INR wants to be in range as soon as possible.

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Brachiosaurus  warrick - (1) - posted 7 months ago

Some hopefully helpful links regarding unstable INRs and taking vitamin K supplements to stabilise INR, IMO dosing the diet is much better for the body than avoiding vegetables etc and depriving nutrients. But each to there own.
http://www.valvereplacement.org/forums/forum/anti-coagulation/854494-my-experiences-with-vitamin-k2-and-inr

http://www.valvereplacement.org/forums/forum/heart-talk/38392-vitamin-k2-and-warfarin

http://www.valvereplacement.org/forums/forum/anti-coagulation/41008-great-article-on-vitamin-k-supplementation-and-anticoagulation-control

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Brachiosaurus  warrick - (1) - posted 7 months ago

How long has she had the valve and been on warfarin? If she is just starting out then it is quite normal for the dose needs to increase over several weeks after surgery (they don't tend to tell you this). If she has been on it for a long time then you probably know her range which I assume is the standard INR 2.5-3.5 for a mechanical mitral valve. So it is very low for this range and the longer it stays like this the risk of a clot increases.
I assume that a clinic is managing her dose but to me it looks like it needs to be increased to perhaps 10mg daily on an even dose and see where this takes it. If you add up those last seven doses and take an average then its just short of 9mg per day so I don't think 10mg daily or even slightly higher will be unreasonable. Clearly her current dose is not high enough. I am on 9mg daily, my uncle who had a valve was on 11mg, my father who has a valve is only on 2mg, I know of another person who is on 15mg daily, so everyone is different and the amount you need is the amount you need and the right end result is INR in range regardless of the dose size.
Unfortunately there is no "goldilocks"dose with warfarin because many influences affect it (even the flora in your gut produce vit K) and thats why INR needs to be monitored frequently.

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Kitten baby chick  alpakinci - - posted 6 months ago

My wife's surgery was 1 month ago. I am aware, very new yet.
I think it should be 10mg. After 2 days, the professor will check. what to say?

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Brachiosaurus  warrick - (1) - posted 6 months ago

Yes 10mg would certainly be a good start and you might even find that it needs to be a mg or two higher than this over time. I think I started out on 5mg and had to increase around a mg per week for several weeks before it levelled out around at 9mg.

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