confused

[squady]

just been reading up on rat poison warfarin I'm due to start on the stugh 25 of this month by the net I have to have a test four times to get the balance right .can someone tell me how they control the drugs I don't want to go back and forth to boots with a script every time

[Hidden]

You should be given full information when you attend for your first test.

You will be given a supply of the drug in varying strengths.After the initial blood test you will be told the correct dose to take . You will then be tested frequently until the optimum level is reached, with the dosage adjusted at each stage as necessary.

The correct level, known as INR ,international normalised ratio , will not necessarily be reached in 4 weeks. It could be longer or shorter and will be followed by regular testing.

You'll soon get used to all the rigmarole involved so don't worry.

Sandra

[squady in reply to Hidden]

thanks Sandra that's cleared it up I just wish they told me the whole story in the first place

[Rellim296]

Squady, the best bit about Warfarin (in my opinion) is choosing which pills to take! Colourful entertainment and a little mental challenge to use the pills up in a logical way. You will probably be issued with a selection of 1mg (brown), 3mg (blue) and 5mg (pink) pills and your daily dose will vary according to your blood test results. You might find yourself taking a pink and two browns one day and two blues the next. Just as you get used to a regime and get into the swing of it, your dose may be changed to keep you on your toes. It can be best to use a weekly pill box and put them all in the slots once a week - easy to check that you've taken a dose.

[squady in reply to Rellim296]

Rellim thanks for the reply sounds like a bag of fun its a pity the testers are such a price I don think my surgery nurse will take kindly to the extra work good idea about the pill boxes

[Rellim296 in reply to squady]

Yes, lots of fun. 9mgs is a good one: three blues or a pink, a brown and a blue. Or a pink and four browns if you aren't using the browns much. 10mgs can be two pinks or three blues and a brown. Or a pink, a blue and two browns. Such choice!

I don't think the nurses would want us all to self test or swap to NOACs as they might find themselves out of a job. Self testing is a good idea though.

I hope you find warfarin dead easy. Most people do but some of us are awkward customers and frequently in disgrace.

There seems to be a seven day dosing system - there is at my surgery anyway - and in a week you will take, say 6, 7, 6, 7, 6, 7, 6 and then 6 again. This offended my sense of order and I once took alternate doses without any repeats for a couple of weeks and then (and here's the big mistake) I told them that was what I'd done. Such a fuss! It upset the computer dreadfully and the nurse tutted and sighed and I was ticked off severely. I didn't ever do it again. They always questioned me and asked if I had been taking the right dose and had I ever forgotten.

I'm sure they will be helpful to you to get started off. Best to follow instructions and toe the line!

[squady in reply to Rellim296]

I will toe the line but once i know the score they can whistle dixi ive got to se the hospital first and then 4 weeks later go back again I'm getting to old for all this

[PeterWh in reply to squady]

See my response below. Testing will probably be twice in the first two weeks, then weekly then switching to monthly if your INR is relatively stable.

[PeterWh in reply to Rellim296]

I feel left out as I don't think I've had more than 5mg.

Where o am the Anticoagulation service tries to have you only following one of two systems so as to make it as easy as possible. Either the 7 which is the same dose every day or a 5 + 2 where the dose is the same Monday to Friday and slightly different Saturday and Sunday.

[Rellim296 in reply to PeterWh]

So your dose has never been more than 35mgs in a week Peter? Mine was in the 60's most of the time. I was at one time on 10mgs every day except one when I took 9. Our surgery apparently had one patient on 18mgs a day and another on 1mg every other day. They don't do it by halves where I am! I'd have preferred a steady daily dose of something point five.

You are absolutely right about not filling the pill box beyond your INR test date. I usually got my test results and new dose there and then at my GP's surgery, except when blood wasn't taken with a finger stab but with a venous sample which got sent away and I would get a phone call to tell me result and dose. I could then write it in my yellow book. I could collect written confirmation from the surgery.

[seasider18 in reply to Rellim296]

I'm on 8mg a day.

[seasider18 in reply to squady]

At the Surgery I go to they have over 300 patients on Warfarin. A Wednesday afternoon job for two nurses plus a Monday afternoon for another. They also have timed phoned appointments for housebound self testers to give their results.

One nurse loves doing it the other hates it. The surgery get £10/£12 per test.

My INR has now stabilised and I'm on six week appointments.

[PeterWh in reply to Rellim296]

Squady. You may find that the local Anticoagulation service does the testing rather than your surgery. Also in our area they also prescribe 0.5mg tablets as well.

Tip (especially to start with) and this is based on what they do where I live. Only put enough tablets in the box to take you to the evening before your test. If following the morning test the INR is low or high they may ring you to change the dose. Then you don't have an extra day's tablet(s) hanging around. You will get a letter in the post the next day which either confirms the telephone call or is ok or only a minor tweak in the dose then the letter will tell you to keep the same dose or do the tweak.

I remember from other posts that you have other health issues and didn't have access to a car. If that's still the case you can arrange for the community nursing team to visit you yet home to take the blood.

The lead Anticoagulation nurse for the area is located in the hospital nearest you and he is very good.

[squady in reply to PeterWh]

thanks again pete I will investigate the local service in Hertfordshire hat you say makes good sense

this has brought up the point if I get them to make me into metal micky will I have to take rat poison for what is left of my crappy life I will be back on the road in october

[Mazza23 in reply to squady]

Why can't you take one of the new drugs I have taken eliquis apixaban for 2 years no probl

[squady in reply to Mazza23]

e got af copd ad bronchiectasis and old age so I'm told it has to be rat poison

[Mazza23 in reply to squady]

That's a shame

[seasider18 in reply to squady]

I'm told that rats are now immune to it and they need something stronger.

[PeterWh in reply to seasider18]

Actually they have always been immune to it because they eat loads of green things particular veg which are of course full of vitamin k. Antidote works quicker on them than it does for humans. Also overall it is slow acting and causes bleeding which is now considered in humane.

[seasider18 in reply to PeterWh]

Inhumane to a rat? The creature that has been responsible for so many human deaths.

[squady in reply to PeterWh]

when on leave from the army used to earn a weeks wages for a few hours work I pellet one rat ten yard target every one a jumper

[seasider18 in reply to squady]

There was a rat on the steps of a block of flats where we lived some years ago. I phoned the council and they sent someone down. He found their nest and said it would cost me £36 for him to put down poison and come back to check it had worked.

I told him it was not my rat but a communal one and I was not going to pay for it. He phoned his boss and eventually said 'No charge'

[squady in reply to seasider18]

that is no surprise he was called out so a cake of poison was nothing and the good will done him well

[seasider18 in reply to squady]

We had a side area at the flats with storage cupboards for each flat and a an area to store bulky things. I put an old dressing table out there and a long time later was going to dispose of it. When I opened a drawer there was a mummified rat in it. Could not figure out how it had got into the drawer.

[squady in reply to seasider18]

it climbed up the back of the draws then crept between the draws into the one you found it in it must have been popping its clogs

[seasider18 in reply to squady]

There seemed no way in to us. Strange it did not just rot away and create a smell.

It looked as thought it was in a cocoon.

[PeterWh in reply to seasider18]

Obviously dry in there

[squady in reply to PeterWh]

very dry last for ages as long as weather holds

[seasider18 in reply to squady]

If you are travelling around they should give you details of clinics for the areas you will be in.

One of my neighbours gets addresses of clinics when he travels in Europe. I think that someone on here was tested when in Australia.

[squady in reply to seasider18]

I have two places in mind one is about 4 miles I'm back on the road in 8 weeks being retired I have plenty of time on my hands do you know if peeps with pacemakers are on warfarin for ever after the surgery ive been looking but nothing as yet

[seasider18 in reply to squady]

Forever and ever if you have AF.

[seasider18 in reply to PeterWh]

Hospitals in Sussex no longer do testing. It is done at surgeries where I am but in Brighton it is mainly done at pharmacies now.

[squady in reply to seasider18]

thanks seaside my nearest clinic is half hour up the motorway that's where my appointment on the 24 of august is at been waiting since 7 march 2016

[seasider18 in reply to squady]

Which are do you live in?

[squady in reply to seasider18]

I live in hatfield hertfordshire nearest hospital lister that's where the clinic is

[seasider18 in reply to squady]

You may need a hospital initially but no one should be expected to travel 100 miles.

Google INR testing Hatfield and you will get results such as

sidneyhouseandthelaurels.nh...

[squady in reply to seasider18]

truth to tell I can get to the hospital in about30 min that's for my initial meeting then on the 7 September I go to the qe11just outside of hatfield

went to the doctors about getting tested and they will give me a test as long as they have the paper work then send the sample for testing I might as well get the bloody bus and sort it ione go

[PeterWh in reply to seasider18]

I don't think squady will be driving at 200mph!!!!

[squady in reply to PeterWh]

don't hold your breath I have done kingsclere to skye in a day 600 odd miles but I will be being watched for a little while

[squady in reply to PeterWh]

thanks for that m pushing for pace and ablate and the pacemaker can help when the copd gets worse

[seasider18 in reply to PeterWh]

Never underestimate the British Army.

[squady in reply to seasider18]

all part of life thanks for all the help

[PeterWh in reply to squady]

Ask why it's not St. Albans hospital as that is nearer. I suspect that it may be because of the old historical boundary between west Herts pct and east Herts pct whereas now it's all Herts CCG. St. Albans wait was less than 1 week!!!

[squady in reply to PeterWh]

I is the boundary bullxxxx but the qe11 is just a spit down the road busses every 15min then there is the flagship at stevanage

[Naproxen1]

I love your comments t 296- they are so funny! Cheered me up no end.

[MarkS]

If you can, do get a Coaguchek and test weekly. It makes such a difference to successfully managing warfarin.

I take 9mg, that's one red, one blue and one brown. I mark up the red strip with the day I take that pill (i.e. Mo, Tu, We etc on the foil above each pill) with a marker pen. That works for me and makes travel a lot easier.

I also take a Vit K2 tablet every day as that stabilises my INR, but I don't mention that to any medical staff other than specialists as they don't understand!

Mark

[squady in reply to MarkS]

hi markS I can get the kit and spread the cost over 6 month 0% interest I want p ace and ablate not an ablation followed by more ablations I can cope with copd and bronchiectasis not avib as well

[PeterWh in reply to MarkS]

I only mark on 3 days M, W, F because you know the rest and mark to left as more visible and more space so letters slightly larger.

[MisUse]

I get mine done at Chelsea and Westminster, my readings are very irratic, and all sorts of things can affect INR, specially change of drugs, antibiotics. Seem to have finally got mine under control again, so don't have to go for 4 weeks. My regime at moment is 2mg Sun, Mon, Fri, 2.5mg Wed, and 1mg Tue, Thurs and Sat. I have a 7 day box! I would love to change to one of the newer drugs, but due to aortic valve problems can only take warfarin.

[squady in reply to MisUse]

hope it stays that way for you I had it out with the hospital no choice same as you

[Annekw]

I prefer the new NOAC's ! I take Apixaban 5mgs morning and evening ,no problems!