The last few days I've had meals that have contained more broccoli and salad than I should eat as I take Warfarin .

[feejbee]

My last INR reading was 2.5 on the 9th Dec I am not due at the clinic for another check until 13th Jan. I have a coaguchek machine so I can check readings in between visits (my surgery doesn't know of this as they disapprove of it and won't sanction a test strip prescription) I have checked my INR today and my reading is 1.8 . My question is would it be OK to increase my Warfarin to 6mgs for a couple of days ? I have had a previous TIA and a stroke so am keen to keep in range of 2 - 3. I don't particularly want to do anything without medical advice but there is nobody to contact until after the New Year.Any advice welcome.

Happy New Year to you all

Fi

[BobD Volunteer]

As we were told at HRC Fi, it would be better to set the range at 2.5 to 3.5 to over come any possible false readings. We were also told that there was little danger going up into the fours so I doubt you can push yourself that high. I couldn't possibly tell you what to do but I know that I would probably increase my dose for a few days and re-check. You don't say what your normal dose is so I can't see how much you propose to increase it by. An extra 1/2 mg won't hurt. I have threes and ones and can get most combinations I need from them. Whatever you do try to ensure that you are on your designated dose well before your next INR test or they will get confused.

Bob

[feejbee in reply to BobD]

Thanks Bob. I normally take 5 mgs and I don,t really like to go below a reading of 2.5 although my doc is quite happy with anything above 2 but I'm not, particularly after hearing all the E.P.'s views. Anyhow I've taken 6mgs this evening and will do that for a couple of days and then recheck.Fi

[farmerwalt in reply to BobD]

Hi Bob,

As usual agree with everything you've said.

It's a pity I didn't get to the AFA patients day this year. I would hve love to have met you and had a chat "in person"

Best wishes for 2014

Walter

[rosyG]

I 'm sure you know that your INR will increase about 4-5 days after the increased doses so best to check then to ensure you get back to the correct level without getting the level too high.

[jeanjeannie50]

Hi Fi - With your history of having a TIA and stroke I think you have done the right thing by increasing your dose of warfarin slightly. Luckily you have a coagucheck machine so can keep an eye on your INR.

I think I would take 6mg every other day until it came up to around 2.5. Recently by just increasing mine by 1mg a day I took my INR up to 6.2. I increased from 3mg to 4mg every day and was horrified at the result. Now I take 3mg every day apart from 2 days when I take 4mg and it keeps quite level.

[farmerwalt in reply to jeanjeannie50]

Hi jeanjeanie50,

If you are normally on 3mg daily then increasing it to 4mg is a 33% increase so it will make quite a marked difference, as you found. Increasing from 5mg to 6mg, as in Fi's case, is only a 20% increase so the effect will not be as great, but of course still has to monitored.

Around Christmas we'll need to work out how much cranberry we need to take with the brussell sprouts to balance the effect of each other on our INR. (that would be a good research project for 2014)

Best wishes for 2014

Walter.

[jeanjeannie50 in reply to farmerwalt]

Hi Walt - Yes, you are right I hadn't thought of it as in a percentage increase. Since being on this site I've learnt so much. Happy New Year to everyone.

[MarkS]

Going to 6 mg for two days seems very sensible. If it were me, I would then retest. If it's still less than 2 I would stick at 6mg for another couple of days, 2-2.3, cut back to 5.5mg, above 2.3 cut back to your usual dose of 5mg.

I self manage (i.e. I decide myself what dose I'm going to take) and trials have shown that it does provide the best form of INR control.It's quite easy when you get the hang of it, though I appreciate it's not for everyone.

Mark

[feejbee in reply to MarkS]

Thank you all for your replies.I will take notice of all of them. It seems that on this site you receive far more helpful advice (if you are a responsible individual and use a degree of common sense) than from many medics - that's if you can gain access to them in the first place. I took 6mg yesterday and will do so today then go down to 5.5mgs and test until I get to nearer an INR of 2.5

Fi

[rosyG in reply to feejbee]

I think that's a good compromise- keep testing every 3-4 days until you are back on track!!

[farmerwalt]

Hi Fi,

Like you, I've had previous TIA's and like to keep my INR around 2.8. As Bob says, couldn't possibly tell you what to do since we are not medically qualified. Can only tell you what I normally do. I self manage my INR/warfarin so adjust the dose myself. I normally take 5mg daily and if I was at INR 1.8 I would take 7mg and then recheck the next evening before taking my next dose,(I take mine just before bed each evening) Normally going back to 5mg gets me back on track. I had a disagreement with the anticoag nurse about checking it every day until I was back in-range. She said that I should not check it every day, but I told her that was exactly what happened when I was in hospital a year or so ago.

Sorry to hear that you do not get your test strips on prescription. There have been 1 or 2 other posts about that recently. I was talking to my son, who is diabetic, about that and how diabetics get theirs. He was saying that there have been several cases where local health trusts were not supplying the diabetic test strips and the patients had to refer the matter to the Health Ombudsman, and the local trusts were told that they had to supply them. The national NHS has said that the CoaguChek test strips are available on prescription so perhaps those who are not getting them should be referring this to the Health Ombudsman. As I and others have said, it is a NATIONAL HEALTH SERVICE with the same rules applying to ALL.

Oops! there I go again. Better get down off "my high horse" and get on with some work.

Hope you get your INR back where you want it and if possible get the test strips situation resolved.

Best wishes for 2014

Walter.

[feejbee in reply to farmerwalt]

Thanks Walter . I'm feeling much better the last few weeks than previously ,so 2014 might just be a time for a fight ref. strips on prescription , as you say it is a National Health Service and surely I'm saving it money in the long term by taking responsibility for my own health by, hopefully, not ending up in hospital.

I am paying for my own strips as Ican but there must be many others that can't and that surely that's not fair- We all must do everything we can possibly do to avoid a stroke.

I know that in France you are never allowed to go more than a fortnight without being tested so how come here we can go for several weeks or months without testing? Have we different blood to the French ? I expect many might think so !!

Fi

[jeanjeannie50 in reply to feejbee]

Fi - I too have recently gone on to monthly checks for INR and I'm not happy about it either. If this is how it's going to be now, I think 'll be getting a coaguchek too. Interesting that you say the French are not allowed to go more than a fortnight.

Good luck and let us know how your INR goes with your slightly higher dose of warfarin.

[Marion62]

Hi

I'm on 10 week testing with no additional tests given for change or addition of any medication which I am not happy about. My GP controls the dose and retest date.

Over the last year it has gone between 2.0 and 2.9 but no doubt it could have gone above/below but I am none the wiser. My dose has always been 3mg since the first month. It does concern me when its at the lower end. My GP said he would only be concerned if my INR went below 1.5 or above 5.

Good luck Fi in you fight for testing strips on prescription.

Best wishes

Marion

[rosyG in reply to Marion62]

Marion your GP is way off track-both on lower and higher end of the range. Can you ask for more frequent testing?

[Marion62 in reply to rosyG]

Hi rosyG

Have tried - must try harder in 2014 !!!

I have an appointment in 2 weeks time so will mention it again then.

Thanks

Marion

[KayRee8]

If it were me, I would increase my dose from 5 to 7.5 for two days But only because I have been on it so long I know how my body responds and have discussed emergencies with my Cardiologist. I have had a TIA at 1.8 and would never risk it again. You have to make the call for what is right for you. Good luck in your decision. Happy New Year