INR 5.4

[Mallard]

Hi can anyone advise please. I am on holiday abroad and my INR on Monday was 2.3 at the hospital before I set off. have tested today on my coaguchek machine it is 5.4. Just wondering has anyone experienced this and what did you do? Best wishes

[daisyd]

What is your INR range mine is between 3 and 4 and if I had this INR and abroad I would miss a dose don't go too mad with greens vit K or red wine. Send an email to your anticoagulant clinic and ask them for advice I personally would go back on the warfarin the next day same dose as before. have your clinic given you any Clexane to have if your INR drops too much, it will take a few days to take effect of course I am not medically trained so you might be best talking to a doctor or pharmasist

Good luck this always seems to happen to me on a Sunday or bank holiday

Good luck, enjoy the rest of your holiday

[Mallard in reply to daisyd]

Thank you Daisy, my normal range is between 2 and 3. So will definitely miss tonight's dose. Typical bank holiday weekend as well. I have no clexane. But will keep an eye on my readings. Soooo glad I bought this machine. Thanks for sharing

[Hidden in reply to Mallard]

I know it's sods law it's always on a bank holiday when everything's shut that something happens!

[Mallard in reply to Hidden]

Always 😂

[moo196]

Can you get tested abroad? I travelled extensively since my cvst, but never got a coagucheck machine as I was allowed up to 6 weeks between checks and self adjusted my dosage according to the diet and further meds I had to take (are you taking different meds right now? Anti malarial meds increased my inr.... And maybe your diet is currently different?)

Good luck!

[Mallard]

Hi moo - I can get tested at most hospitals abroad but to be honest I didn't want the hassle and I figured the machine would pay for itself eventually, as it would cost 30 euros plus travel for each test. I'm glad I have the machine I wouldn't be able to relax if I had that reading at a medical centre, I would have to know how I'm doing. Must admit it scared me a little and definitely not happy on warfarin it's too sensitive. You are brave going 6 weeks between tests, but I suppose over time, you become more confident. I'm at an early stage and I must say the thought of managing warfarin indefinitely fills me with dread. The consultant said we will talk about me coming off it in 6 months but if need be I will request a newer anticoagulant. I'm more frightened of a bleed internally than I was the original PE.

Best wishes

[moo196 in reply to Mallard]

I discussed the use of a self test machine, but decided that I was the sort of person who would worry about the general fluctuations of readings, as you are now.

If your diet has changed, increased alcohol?, less sleep, other meds etc, can all impact on the inr. How often were you told to monitor your inr?

I'd agree with your wish to use warfarin rather than the newer anti coags.

I also think that you will become more confident about using warfarin over time.

[mestala]

Simple change of diet can dramatically alter test results,that's what I've found over the 6 years I've been on the a/c Sintrom.I was living abroad when I had multiple PE's and when I came back to the uk last year I asked if they could keep me on it,and they did get it for me.

I'm comfortable with it,although this time of year my diet changes a little so I have to keep an eye on that.My range is between 2/3,and I have an inr test every 6 weeks.Whilst I have been back only 5 months,my results have been mainly in the range I require.

Thing is not to panic,my own personel opinion is stick to what suits you.I'm afraid sacrifices[food wise] have to be made,it does frustrate at times,but hey,it keeps you going.

Good luck

M

[moo196 in reply to mestala]

Just wanted to say that the best advice I was given was to dose the diet, don't diet the dose.

I'm vegetarian and there's no way I would sacrifice the items listed as "avoid when on warfarin" I easily eat at least three of them every day... Sometimes in one meal eg a lovely salad with spinach, avocado and blue cheese, or spinach, broccoli and chickpea bake.

My dose was adjusted to take account of the intake of vitamin K through these foods (usually took 8mg) and thank the nurses who suggested this was best for me. Bad enough having a blood clot on the brain, let alone having to change an otherwise reasonably healthy diet.

I'd ask again if you feel you are having to sacrifice anything.

[Mallard in reply to moo196]

Hi moo I don't blame you, your diet is excellent and you are right to adjust to your own needs. I haven't gained that confidence yet and feel like I'm splashing about in the water. I'm still glad I have my machine. I wouldnt over use it to be honest because the test strips are so expensive. I can't get them on prescription apparently because my GP won't support the use of the machine. It will only be used for travel.

[moo196 in reply to Mallard]

Just to say that I got tested weekly to begin with too. Need to keep diet etc fairly constant too. Good luck!

We even did a trial run of my anti malarial tabs before I travelled, to find out what what effects it had on inr.

Enjoy yr hols

[AnneTS in reply to Mallard]

Does your GP still have the right to prevent you from self-testing? Look up the NICE guidelines which are very positive on the subject of self-testing. A GP might not support self-testing based on the competency of the patient but that doesn't seem to be your problem! Annel

[Mallard in reply to AnneTS]

Thanks annel- I had an appointment with my consultant on Tuesday and explained how unhappy I was on warfarin- he is writing to my GP to tell her to put me on one of the new blood thinners. He explained about anecdotes etc, but in the end I just want an end to this endless monitoring. I could argue with the GP about NICE guidelines but I don't like Warfarin, so it was a battle I wasn't prepared to win. Best wishes

[AnneTS in reply to Mallard]

That sounds like an excellent way forward Mallard. All the very best to you and a much easier solution to your blood monitoring! Annel

[misswoosie in reply to AnneTS]

If a Doctor thinks someone is very anxious about their warfarin/INR and is likely to start doing readings too frequently and changing their dose of warfarin off their own back then they may say it's not suitable. Also, there is a big difference between self testing and self management.

[Mallard in reply to mestala]

Thank you 😊

[Mallard]

Hi thank you for all your replies- I currently get tested at the hospital weekly.

[werd]

Hi mallard.you do not say what your daily dose is .if i was you this is what i do.miss 1 day.2nd day take half dose 3rd day test.i have been on warfarin 44 years yes 44years and had the coaugchek tester 4 years now .good luck.ps stay off the booze.yours werd

[Mallard]

Thank you Werd, I shall give it a go in light of 44 years experience I can't argue with that. Shame about the booze, I do like a couple of drinks on holiday, I've always drank in moderation and the thought of cutting it out completely makes me sad. I'm slowly starting to resent being on warfarin as selfish as it sounds. Best wishes M

[moo196 in reply to Mallard]

We all have to make compromises in life. Alcohol is just one little thing that might have to be cut out (I'm allowed one drink these days). Find some alternatives

[Mallard in reply to moo196]

Looks like I don't have much choice at the moment. Thanks moo - best wishes

[Mallard]

Quick update - still on holiday- INR today is 2.2 so feeling much happier - thank you all for your support- a long way from home so it was much appreciated 😊

[Mallard]

Thanks Anne I appreciate your support. Best wishes

[Scotsboy]

Get the app WARFARIN HTK it is free and its the best app I have found for dosing after your reading goes out of range. The icon is a round circle full of pills good luck.

[Mallard in reply to Scotsboy]

Thanks Scotsboy just had a look, so many helpful apps - thanks for the information it's really useful. Although planning to swap the warfarin in a couple of weeks, but really good info for others. Best wishes