over 4 years ago in Blood Clots
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Commented on Coumadin a necessity for blood disorders! almost 4 years ago
Commented on severe headaches when INR is high almost 4 years ago
How high are you talking about? This is something that you really need to talk to your Doctor or coumadin clinician about your concerns. It would be better if you got your answer from a professional and not someone on this site as we all will react to coumadin differently or not at all.
You can request any brand name from your Pharmacist if you were begun on that brand. Consistency is what matters not name brand. I have been taking the same generic brand of warfarin for 6 years now. My pharmacist knows that my levels are very touchy and is willing to do this for me. All Pharmacists are willing to do this for their patients if you request it. So while you pay more for The "real" thing to get consistency I pay half for mine and get the same consistency that you do. What really makes the difference is what you put into your body in the way of food and drugs not the brand name of a drug. As a long time practicing doctor, I learned a long time ago that the consistency is truly regulated by the FDA. All meds must meet their tough standards. Good luck to you as well.
Commented on INR Falling almost 4 years ago
Hi there PUP,
Has your intake of green leafy veggies increased at all? Is there any OTC medicine that you have been taking such as vitamins or anything that would include Vitamin K. That is what affects my INR's and makes them nuts. I had been steady for a year when all of a sudden I dropped my INR by 50% all because I started taking a Vitamin that contained a somewhat larger dose of Vitamin K than most do. When I changed the vitamin back to the original one and I was just fine. It is the little things that I have to watch out for. If you are sure that you didn't miss a dose and no new drugs then I don't know. Do you test at home? There may be some problems that would cause this if you do.
Commented on DVT whilst on Thinners almost 4 years ago
It is possible if you also have another abnormality within your body's your clotting system as a whole. If you don't have a clotting disorder it can happen but is very rare. Still it is not something to ignore especially if is the same leg/arm in which you have had previous DVTs. You will also note that most of the time you will see that the leg in which you experienced a previous DVT will swell and tend to ache on occasion. If, however, it becomes extremely larger than the other leg, is hot, extremely painful, or blue foot or hand make sure that you have it checked out ASAP.
One thing that amazes me is the level your INR must remain unless you have had a heart valve replacement. Good Luck
Commented on Therapeutic INR levels about 4 years ago
Cindy thanks for the list this one is excellent and I sent it to my clinician.
Keegan, watching his dark green veggies is a must since he is on a rather high dosage but his metabolism is probably a lot higher than us old folks who are taking it. 2.0 is considered therapeutic. At his age and on coumadin I am assuming that he has had a heart valve replacement? What does his doctor want for a therapeutic range? 2.0-3.0 or 2.5 to 3.5? If he is taking vitamins check to see how much Vit K they contain. There are also some really good lists out there of foods and their Vitamin K levels. Go over these with your son so that he knows what to look for. Allow him as much control as possible with his food choices but he has to understand how important it is to make sure that his INR remains where it needs to be.
When coumadin is first begun it is difficult to remain steady for about the first 3-4 weeks. His body has to adjust to the medicine, especially if he is bridging off of Lovenox or other injectable blood thinner, but once he does and he watches what he eats he should do just fine. Good luck to you guys!!!
Commented on how much vitamin K intake on warfarin 5mg/day about 4 years ago
Thank you so much....My dad told me that might retire but I will always be a doctor and want to help people. I won't give out medical advice but if I can help anyone on their journey I will try ;)
Commented on PRADAXA 150MG about 4 years ago
I am not sure about the Pradaxa and what to expect. It's name is also Dabigatran. I would be advise you to ask your doctor or coumadin clinician about the target INR you should be looking at. (If you were taking coumadin, it takes about 2 weeks to become stable and then the dosage that will work for you must be decided. ) Everyone I have ever spoken with that is taking COUMADIN are on different dosages as it works differently within everyone. When I switched from Lovenox (Clexane) to coumadin it took me 3 to 4 weeks to stabilize. Good luck.
Commented on I cannot seem to keep my INR levels at 2.3 over 4 years ago
It depends on his clinician and what they believe is the best regimen for him to take. I calculated my own. 5mg daily and 6.25 on Wed. and Sat. I have been stable for over a year now. The way coumadin is calculated is you divide the weekly dosage by 7 and this gives you a daily dosage. When it is a fraction the extra coumadin is spread throughout the week. Because of diet, age, medication, and several other factors, some people require more coumadin than others.
Commented on Warfarin 'lifers' after DVTs about 4 years ago
Please research it thoroughly before you start taking it. The Drugs website will provide a complete insert reprint (what is found in a PDR for doctors) Look at the side effects section and there will be a chart of what it was, percentage of test patients that had it (both those taking the drug and a placebo). Then discuss with your clinician any of the side effects. Coumadin has 3 side effects: Nausea, loss of appetite, or stomach/abdominal pain. These are very rare. Anything else is a symptom of being over or under medicated (bruising, headaches). ALL ARE SERIOUS and if they should occur you should go to the ER. I also don't understand why you are having your blood take 2-3 times a month.
FYI here is the FDA's report on Dabigatran:
If you will read my story, my doctor's and my own oversight was not to leave me on coumadin after my second DVT. Disastrous results ensued. So yes you will be on coumadin for life. One thing you might want to do is petition your insurance for a meter so you can do your own INR testing.
As far as riding a horse. I do, the only problem I had was falling off and breaking my arm in two places last year and having to have surgery. One Vit. K shot and I was in the O.R., Lovenox bridging for one week and I was back on my regular coumadin dose.
Why did you begin the coumadin in the first place? DVT? I would seriously discuss with your physician longer than 3 months.
Richard, I have been on coumadin for over 6 years now for massive PE's to my lungs after 2 consecutive DVT's in my left leg. Yes, you will be on this for life. I am a retired doctor and am one who prefers to take control of my dosing. I was up and down for about the first year and at the same time it seemed that they were adjusting my dosage every time I tested. I decided that I could do it better and established my own dosage. I have been steady, aside from 2 screw-ups on my part for over 18 months now. I run between 2.4 and 2.6 on average. Since I have been this stable I am stretching my testing out to every 6 -8 weeks. I also test at home. I have my own machine and I buy my strips. If I find that I am bruising excessively I will test myself, otherwise I take my test and call my clinician with the results. I hated the Lovenox and told them where they could put it unless it was absolutely necessary. Lovenox is usually used to bridge someone off of or onto coumadin and then stopped. It will get easier I promise.
I go by what we use to call the "green rule" If you want to eat greens remain consistent throughout the week. I found a really great list of how much K is in about 400 kinds of foods, nuts, etc. This has helped me more than anything to keep an eye on my K. Remember that if you take a daily vitamin or begin taking one check to see how much is in that as well. The amount you can eat will depend upon how stable your INR's are and how muck K your clinician tells you not to go over. I am very blessed in that I can eat quite a lot of mcg's of Vit. K before it affects my coumadin levels. Here is very self explanatory listing of veggies for the most part. www.coumadin.bmscustomerconnect.com they also have listings of fruits as well. Good luck and don't be afraid, it isn't all that bad.
Commented on My history over 4 years ago
I get migraines as well and I have been given the first medication that stops them in it's tracks...Migranal...It is a nasal spray and when you first feel the symptoms coming on you use it, lay down for about an hour and you should feel it to lighten up. For me it is gone in about 4-5 hours. If you are already using it...great!!!!!
As far as testing goes, ask your clinician to have your PCP request that you are approved for one. It really saves me time, money and travel and my insurance pays for my strips. Depending upon how often you test (I test every 3-4 weeks) unless I am having excessive bruising or I am clotting faster than normal. It has really come in handy 3 times in the last years when I was having problems (once my INR was 4.8 without any reasons).
Hi Aussie Guy, doctors want valve replacement patients to have a higher INR then patients like me with DVT's and PE's. I eat greens in moderation. Do you do your own testing yet? It is a lot easier than to go into the clinic. I only go in when I see my PCP. I still call in my results just to keep them happy. I switched my vitamin pills and my INR shot up above my upper limit of 3.0. I realized that there was more vitamin K in the new ones then my previous ones. Once I went back to the previous ones I came back into range. I eat quite a few greens even spinach and asparagus. As long as I eat approx. the same amount ever week I don't have any problems with my INRs. I was afraid at first but I did a lot of reading as to how much will alter the levels and it really takes a lot of greens. I just have to take a little more coumadin twice a week to adjust for the greens. You really don't have to be afraid of them. I think it is WEBMD or someone like that that has a really nice chart that will give you very accurate mcg levels of Vitamin K in foods. You clinician will be able to tell you how much you can take daily. I think you will be surprised at how many salads you will be able to enjoy. Good luck and let me know what the doctor says about the headaches. My bruising only increases when my INR is out of control or I have been working in my yard.
Commented on deep vein thrombus over 4 years ago
That depends upon your physician and family history of DVT's. 3mg of warfarin is a low dosage but you didn't state whether his INR's have been in range or not. You really need to discuss this with your doctor and any concerns you may have. You really haven't given much information about the patient ie. weight, height, what lead to the DVT...etc. Good luck.
Commented on Dosage 10/mg/day over 4 years ago
It is almost if not impossible to eat a well balanced meal and avoid any and all vitamin K. Ask your clinician for a printout of the Vitamin K values for the common foods and then eat as few as possible of those foods. My clinician gave me a 6 pages of foods and their Vitamin K values. She gave me a target range of vitamin K for a day. I do my best to stay within this range and maintain a therapeutic INR. There have only been a couple of times that I have eaten so much vitamin K foods that it affected my INR. Good luck.
Commented on my inr 2.2 over 4 years ago
Your clinician should be the one setting your dosage with the intention of keeping you within range. If you go +/- out of range he/she will decide what your range should be. There are many factors that they use to decide your level including diet and medications. Almost all coumadin levels are calculated by the computer now but I still use the way I was taught in medical school for myself. An example of the differences in dosing is as follows:
My dosage is 5.0 mg 5 x's a week with 6.25 mg twice a week while a friend of mine's dosage is 10 mg 5 x's a week and 7.5 twice a week. We both are within range.
One thing I will warn you about is not to try to place yourself on coumadin without your Doctor's advice. Going off and on coumadin at will adversely affects your clotting system. See a doctor to make sure that coumadin is the best choice for you.
Commented on mechanical valve over 4 years ago
I also use Allere. I have a Coaguchek by Roche. Mine was free. check with Roche and see if they have a patient assistance program. If they do they determine if they can give you a machine for free. I do have to pay for my reagents but that is only $66.00 every 2 to 3 months depending on how many times I test. You can also call Allere and talk to them about the costs.
A couple of Questions...
What does your weekly dosage look like?
What do they have you do when it is too high or too low?
How often do you test?
Have you always had relatively stable INR's?
Have you been keeping a food log?
Have you had any blood tests to determine if you have other clotting problems?
I was up and down like this until I decided my own weekly dosage. I test once a week and if I have been doing great I test every two weeks. The bruising is the symptom of it being too high. When mine was above 5.0, my cat stepped on my leg and injured the large vein. The blood seeped into my knee and I have to have it drained as I couldn't walk on it. When mine is too high I will bleed easily which is to be expected.
Commented on Doctor says therapeutic at 1.9 over 4 years ago
The machines don't round off to the higher value at .05 only .06 and above. Your INR could have actually read 1.95 and given a reading of 1.9. If you continue to run chronically low you should ask you clinician about gently increasing your dose.
Commented on INR dosage question over 4 years ago
That is a decision your clinic should make. You need to consider the weekly dosage. On alternating days you are taking 23 mg/week and at 3.5 / day you are totaling 24.5. that is a total 1.5 mg /week. If you are at the high end of your range it wouldn't be a good thing to do.
Commented on Leucocytes over 4 years ago
You didn't state how much difference your readings of leukocytes were. It shouldn't make a difference whatsoever.
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