INR

[Rienij70]

Hello good morning everyone. I have struggled for the past 5 weeks with my INR levels. I was very steady for the past 5 years, taken 3mg per day. I am now up to 5 mg 6 times per week and 4mg on a Sunday. Last reading was 1.7 on Wednesday. Also I am putting on weight for no apparent reason. Has anybody any ideas? 

[BobD Volunteer]

This does seem strange after so long in range and unless your diet has suddenly changed  I would suggests that you speak to you doctor about this as there could be something else going on in your body which needs investigating.

[Rienij70 in reply to BobD]

Thank you BobD, I am on the case, no my diet is about the same, I wonder wether putting on weight is playing a factor in this. My GP weight me this week and will again in 4 weeks time. Had a full blood test a couple of weeks ago and everything was normal.😊 Very confusing.

[cat55 in reply to Rienij70]

Hi just a thought did your doctor test for thyroxine levels as weight gain can be present with underactivity of the thyroid gland. Best wishes Kath

[Rienij70]

Thank you cat55, I think you might be on the right track. As I haven't changed my diet. 

See what my GP says next month. 😳 But would that effect my INR? 

[cat55 in reply to Rienij70]

Hi, that I don't know, I only suggested this as I gained weight and became very tired ,I put up with it for ages as I thought it was my age,  I did have AF before underactive thyroid diagnosed but at the time didn't take Warfarin.

[PeterWh in reply to Rienij70]

Phone Anticoagulation specialist. 

[Rienij70 in reply to PeterWh]

Hi Peter thanks for replying to my post, do you mean the clinic who test my blood? 

[PeterWh in reply to Rienij70]

Yes. If it is like the one that I go to there is a number that you can phone and speak to an Anticoagulation specialist (usually a nurse).

[Rienij70 in reply to PeterWh]

Hi Peter, I have been speaking to them each week, as they have been ringing me each time I have been for a blood test which is weekly at the moment, to give me new instructions about the dosage. Wednesday before last managed to go up to 2.0 and last Wednesday it was down to 1.7 again. Three weeks ago it was1.5  All they say is don't worry we soon get you back on track. It sometimes happens. 

[PeterWh in reply to Rienij70]

Hi Reinij

How's the INR going now?

[Rienij70 in reply to PeterWh]

Hi Peter, thanks for asking last two blood test 2.5 so spot on left me until next Wednesday for next test. That was a full 4 weeks. Now taking 3 days 5ml and 4 days 4ml. Hopefully settled down. Kind regards Rienij😊

[PeterWh in reply to Rienij70]

Great. Good news.

[Mike11]

Have a look at your blood sugar numbers.  Whilst you probably aren't diabetic yet, a trend upwards could cause this

[Rienij70]

Hi Mike, thank you will do.

[ILowe]

I have never heard of such a jump in such a short space of time. You are right to be suspicious. Possibly there is something going on which is causing both symptoms. You might like to google something like "sudden increase in weight" and see what is on the list of reasons. Eliminate the ones that are obviously not you, and narrow in a bit.

Then, when you see a doctor, go armed with questions. Experts are known to forget. Experts are known to be biased. Experts do not know the information that you, and you alone, have about yourself/ But they do have an expertise you need to tap. Ask questions. Why do you think it is this? Why do you NOT think it is this? Have you taken into account this fact? etc

Please come back to us so that we in the AF community can learn from you.

[Rienij70 in reply to ILowe]

Thank you ! I find it always difficult to fight for myself, very good sorting problems for other people! This time I will follow your advice and go for it. Thanks again.

[ILowe in reply to Rienij70]

Despite my apparent confidence on this forum, I actually find it very difficult to go against a doctor. I have also had some salutary lessons when I did, and I made the wrong decision. So, what I have found, from trial and error, is that I ask questions and keep a detailed personal history. I also look for mismatches. Then I ask, all humble like: "excuse me for asking but I do not understand. X said this", and " I know this, can you please explain?" This approach also enables the expert to feel good when they back down.

In a head on confrontation, they will usually win, because they have power. They alone have the power to prescribe certain medicines and to do certain procedures. So, experts have to be managed, and handled in such a way they feel good.

Another trick is to have someone with you who is credible. If I stand firm, the doctor will over-rule. When my wife intervenes and explains that this time (not always!!) she agrees with me, then they listen more.

I have been known to type up the questions and key facts and simply present them, then my wife and I both take notes. I have also taken in a printed medical article, and asked them to comment. In future I might even use voice record on my mobile.

I saw when I had eight weeks in hospital that patients who thought a lot, who asked questions, and generally struggled back, received the best treatment and the best result. The medics seemed to like the fighters. Bon Courage.

[Rienij70]

Thanks for that, I will try that. As I said when I go to the doctors and hospital appointments for my husband, I do ask questions and stick up for him as I am supposed to be his career. And that comes easy to me. But when it comes to sticking up for myself it becomes a different story. Although our GP is very approachable. It is my own fault really as I tend to put everything down to aging. But can't explain why my INR level has gone haywire in such a short time, haven't age that much!! I just hope that it will get sorted soon. 

[PeterWh in reply to Rienij70]

It is irrelevant how much warfarin that you take.  That is dependent on so many things including foods with vit K, other medical ailments / conditions, bad colds, flue, etc - the list is very long.  The key is the INR level at the end of the day.

[Rienij70 in reply to PeterWh]

Hi Peter, had my INR test last Wednesday, still 2.5. So have been kept on the latest dosage and can go 2 weeks before next blood test. So going in the right direction. No explanation why the increase in warfarine, haven't changed dietary intake. Only thing has changed is my weight, maybe that plays a part in it, will ask my GP next time I see him. Still mustn't grumble, there are people worse of than me. Hope you are well and enjoying your weekend. Rienij

[PeterWh in reply to Rienij70]

Often there is no explanation except that body doesn't absorb uniformly over time. You may have built up a slight resistance. Again no problem. 

[Rienij70 in reply to PeterWh]

Thank you Peter