Post atrial flutter ablation - update #4 - AF Association

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Post atrial flutter ablation - update #4

Susiebelle
Susiebelle
β€’15 Replies

I am in hospital - in because my INR is stuck on 1.1 - heparin injection today & 10 mg of warfarin - hopefully it will start moving .....

They will not discharge me until I am within therapeutic range for two successive days - in the right place - and hospital food is good ..... Ho hum .....

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BobD
BobDVolunteer

About time too. Hope all goes well now.

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Susiebelle
Susiebelle
in reply to BobD

Thank you

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PeterWh

Right place and belatedly they are sorting it out. Hope stay is not too long. Make sure you have follow-up blood tests a couple of days after leaving and then shortly after again. This is because, at least for me, heparin gave boost which didn't last and then INR dropped. I picked this up because I had coaguchek and I increased warfarin dose myself (I had ablation the Monday before Easter and picked this up on Saturday so no one around at coagulation clinic - I knew I was taking a very small risk but to me benefits outweighed by a long shot - this has to be a personal decision).

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Susiebelle
Susiebelle
in reply to PeterWh

Hi - I am thinking of investing in a Coaguchek for the same sort of reason - where did you buy yours & how was your blood clinic about self testing ,

Thank you for prompt reply - this site is coming into its own with my recent experiences

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PeterWh
PeterWh
in reply to Susiebelle

This site is brilliant. I was told about AFA webpages at the start of my AF journey but only found this site 4 months later when I revisited AFA site for something.

I bought mine directly from Roche and not only were they cheaper but you can get it VAT free from them if long term.

In my case local anticoagulation service is closer than GPs and all local GPs use it (just over a mile and free parking). They won't agree to supplying strips. However I wanted the peace of mind after ablation since my INR had been all over the place and swinging widely (swing up to 2.5 !!) from week to week for the 12 weeks prior to ablation. More settled now but still on weekly testing so I only use it infrequently when I can't make clinic (eg when on holiday) or if INR is close to limits. Very glad I bought it though.

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Susiebelle
Susiebelle
in reply to PeterWh

So how do how to art your dose of warfarin?

So for example I have been 1.1 for three consecutive days.

The past two days I have also been given heparin.

Lay two nights taken 10 mg of warfarin, 8 on Sunday and 6 on Saturday

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PeterWh
PeterWh
in reply to Susiebelle

My intolerance to warfarin is at the opposite end of the spectrum to yours!!!! Originally I was only having around 2.5mg or 3 mg per day and sometimes a little bit less or more at the weekend. There is a time lag between taking it and stabilising of one to three days. Now 7 months after ablation (ablation affected the warfarin - believe interaction of AF with vagal nerve) I am on 5 mg per day but INR can vary between 2.5 and 3.5 for no apparent reasons (I am one of a very few who they told to stop green veg and green salads because of the intolerance even though I was taking a balanced amount every day). I had intolerance confirmed completely separately by company unaware that I as taking warfarin.

One thing that occurred to me is do you eat a lot of green veg and salads?

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Susiebelle
Susiebelle
in reply to PeterWh

Well - in hospital I have been resisting sprouts & broccoli - at home Eat green beans but I think I will make the warfarin work around my diet once I get back into range and so it gradually - so investing in a Coagucheck, I think, will help me monitor INR closely without being too obsessive ... So will look today.

Where do you buy your strips - same place ?

Many thanks for your responses - it really does help

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PeterWh
PeterWh
in reply to Susiebelle

Yes same place.

These days almost all anticoagulation clinics (and Bob) say work the warfarin around your diet and that works for over 99% of people. However for the few it doesn't often because of metabolism or intolerance or both. In my case probably both. They don't know why sometimes my body obviously absorbs loads of vitamin k and then other times doesn't. Testing showed some intolerance to warfarin.

God idea to get into range and then work diet around. In my case waiting for second ablation and as INR still swings quite a bit I am still staying off green things so I stay in range for a good % of the time.

There is a very good USA website which has document which lists thousands of things with vit k content (one sorts by vit k content and the other is alphabetical listing).

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Susiebelle
Susiebelle
in reply to PeterWh

Brilliant - thank you very much - hope all goes well with you πŸ˜€

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Susiebelle
Susiebelle
in reply to PeterWh

There is some research into the role of the vagal nerve & AF - interesting but whether it applies to me I have no idea

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PeterWh
PeterWh
in reply to Susiebelle

Originally I didn't think that it applied to me. However after my ablation at the end of March my digestive system became more stable (including INR swinging less) and whereas I has diarrhoea at least every other day (sometimes for a number of days on the trot) that has subsided considerably and maybe only once or twice a week. Pretty sure that it was the AF affecting the vagal nerve.

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Susiebelle

Wednesday : INR today is 1.3 so though incredibly slow it is on the move & inthe right direction

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PeterWh
PeterWh
in reply to Susiebelle

Mine swinging too high!!!

Previous blood test was 2 weeks ago and INR was 2.7. Yesterday had blood test at 11:00am (clinic finishes at 11:30am then samples transported to lab). Call from anticoag nurse at 2.00pm to say INR is 4.2 (1.5 swing) so had to reduce warfarin from last night!!! I was surprised that they only reduced it from 5mg per day to 4.5mg (remembering previous post it is a good job that I am not in Northern Ireland).

No particular change in diet.

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Susiebelle
Susiebelle
in reply to PeterWh

Well I go to have blood test this morning - self injected heparin the past two nights - so my thoughts are what about the weekend ....

Will ask today - hope all is well with you

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