Covid and INR

[Tellingfibs]

I am recovering from a mild dose of Covid which, apart from a bad headache and fever/chills for a day has only left me fatigued. However, I am wondering if Covid raises the INR number. I know a lot of you on this forum take the newer anticoagulants but my cardiologist wants to keep me on Warfarin. It’s a couple of weeks since my last INR and my next one is a week away and I am a little anxious that the number is creeping up. Although I haven’t had any digestive trouble, my diet this last couple of weeks has been slightly different and hasn’t included many greens ! I am tempted to pop out tomorrow and get a bag of spinach 😂

[BobD Volunteer]

just relax . It all takes time to move so wait for your next test and adjust then. No way will I consider testing when I'm still recovering.

[Tellingfibs in reply to BobD]

I’m telling myself that even if it has gone up, there’s no reason to suppose it will have reached ridiculous levels. Me being a fuss pot, as usual. I appreciate your calmness.

[Jalia]

I agree with Bob . I didn't notice much difference to my INR when I had Covid earlier in the year even though my diet was different ...loss of taste!

[Tellingfibs in reply to Jalia]

That’s interesting. Like Afib, INR is very individual.

[jeanjeannie50]

My INR went up at the start of my covid and pneumonia and there were a few days when I didn't take any Warfarin. I'm grateful that I have my own INR testing kit. If you are worried why not get your INR test as soon as they can fit you in.

Jean

[Tellingfibs in reply to jeanjeannie50]

Yes, I was toying with the idea. Still testing positive after 6 days so they won’t see me yet.

[Hidden]

Hi,

Sorry to read of your issues with CoVid and INR readings. So, far I have not been affected by CoVid so I can't comment on INR in that context.

What were your INR readings ? How far out of range were you ?

I have been on Warfarin now for nearly 13 years and apart from a few issues along the way I've had no problems. That said, I have made no concessions to Warfarin at all, either food or alcohol or other drinks. I am fortunate though that I hate greens so varying /fiddling with my greens isn't a problem for me. But, all that I do I try and make it consistent over time. I am constantly in the INR range of 2.4 to 2.8. Occasionally hit gets up to 3.5 but so very rarely. Like Jean jeannie - I self test at home.

The one thing that Warfarin absolutely adores is ........... consistency !! Consistency and more consistency. So, putting CoVid aside for now .......... has your diet varied in some way, no matter how trivial, gone from being consistent to inconsistent in terms of your food intake ?

Forget Spinach, get Cabbage !

Seriously you need to look at the consistency of your diet before and after your stoush with CoVid and see if there is anything you can define as inconsistent. My non medical view is that CoVid per se hasn't done anything rather its how your diet has become inconsistent that's the issue.

John

[Tellingfibs in reply to Hidden]

Thanks John, the bout of Covid has caused inconsistencies in my diet, as did the the few days camping beforehand. Not dramatic, but I understand what you say about Warfarin liking consistency. What I do find makes my INR shoot up is stress. I can’t say I’ve felt a lot of that. Also, vomiting and diarrhoea , but not had that either. I might get away with a bit of adjustment when I next go to clinic. I am interested in the home testing, and the clinic did look into the price for me - it was rather expensive ! Also, it’s very easy for me to attend clinic. I am still pondering though because it’s exactly such circumstances as these that it would be reassuring. The clinic did say however, that the NHS doesn’t recognise the results of a home test. I am still thinking about it…….

Annie

[jeanjeannie50 in reply to Tellingfibs]

My clinic recognises the result of my home tests (my machine is the same as theirs). I call them every 6 weeks with the result. I have had no appetite since being poorly so that may have affected my INR - have lost a stone (14lbs) in weight.

[Tellingfibs in reply to jeanjeannie50]

Crikey Jean, a stone is a lot to lose, but on the plus side, I suppose it gives the body less work to do ? I hope you are gradually building up strength and feel more like your old self as each day passes. My INR clinic here in Wales won’t officially recognise home testing, although they do say they would ‘take note’ if I self tested and had concerns. The NHS here has the same attitude to my granddaughters type 1 diabetes. We wanted to buy her the latest monitor so her parents found it as easy as possible to see her insulin levels, but it won’t link up with their system which is ( understandable these days ) a bit behind times. Get better soon Jean.

Annie.

[Hidden in reply to Tellingfibs]

Hi Annie,

Just looked at your comments and those in your reply to jeanjeannie.

Just a thought or two. If you go onto NICE website you will find much material on INR self testing at home and if you were so inclined you could use it to challenge both your Surgery and also your local Clinical Commissioning Group (CCG).

I original went down the self testing route with the support of my very progressive surgery back in the day. I did it because at the time I worked shift work driving buses and to keep any appointment with the surgery was impossible. I understand that the Roche Coaguchek testing system has a facility where you can buy the device over 12 months interest free. Their website would no doubt be able to assist. I take my kit wherever I go - yes even on visits to my family in Australia when such visits clash with my testing dates.

TBH Annie, I suspect your Surgery is living in the age of dinosaurs and if you were of a mind to you may find it beneficial to search for a local surgery which is more progressive and will be supportive and operate its very own INR clinic. The NHS does recognise and support self testing. Very important for you to read the NICE Document.

When I moved to Cornwall I first enrolled with a surgery on my doorstep that was backward and wouldn't accept my home testing. I found another surgery with its own INR Clinic also nearby but not quite so convenient to get to without a car. No problems.

Get back to me if you need to.

John

[Tellingfibs in reply to Hidden]

That’s fascinating John. I get my INR tested at the hospital. They are very good and fit me in whenever I like ( I prefer frequent tests ) and they did look up the Coaguchek for me. I will look at what you suggest - and thank you for taking the trouble to give me the info.

Annie.

[Thomas45]

The NHS in my area accepts home readings. I email them to an arrhythmia nurse every six weeks.

[Tellingfibs in reply to Thomas45]

I’m surprised it isn’t accepted everywhere as it seems to me that it is a time saver for all concerned and must surely save the NHS a lot of resources.

[ILowe in reply to Tellingfibs]

The INR test is cheap. Resources is not the problem. When hospitalised last year in Wales they almost all said, either they had never heard of self-testing and self-dosing, or that I was the first. I had a string of people coming to discuss this odd patient. I had to prove my competence beyond doubt. In Wales, warfarin dosing is the responsibility of primary care. But the big question remaining was, who has control? They all agreed with me that dosing is easy, but they were very nervous.

[Tellingfibs in reply to ILowe]

just think - you may be used by NHS Wales as an example, and go down as a test case for INR self testing - what a way to achieve fame ! 😂

[ILowe in reply to Tellingfibs]

Yep. I did rather wonder if they should be paying me as an undercover inspector to find out which staff were competent, and to educate the rest! They made so many elementary mistakes in dosing. We patients have an important role in teaching medics!

Back to the subject of the post. A few weeks ago I had some kind of bug, and for a few days I was off my food. Now, messing it up for a meal or two is neither here nor there, and I will indulge in some delicious brussel sprouts. But this lasted a few days. Experience shows that this always messes up the INR for a long time. What I should have done (I am self testing and self-dosing) is test immediately I went off my food in order to have a base-line figure. Was I running high at the start of the bug? If so, some 'nudging' of the dose was in order since no food = higher INR. But if I was running low on INR then I could afford to keep my nerve and do nothing.

[Tellingfibs in reply to ILowe]

All that testing and calculating must keep the brain active ! It’s like you are running Bletchley Park all by yourself ! ☺️

[Hidden in reply to Tellingfibs]

I have been acquainted with a wide range of posts from this fellow AF'er on this subject for many, many years and they are fascinating reading. Some are quite technical, others are down to earth. So yep, your comments about Bletchley Park are pretty spot on. 😂😂😂

[dedeottie in reply to Tellingfibs]

I live in South Wales and the surgery accepted my readings as long as I took my machine in every few months to check accuracy. X

[Tellingfibs in reply to dedeottie]

That's interesting. Perhaps it’s just the hospital setting. There is a move locally to transfer INR testing to local GP surgeries, but so far, ours hasn’t been chosen.

[ILowe in reply to dedeottie]

A few months ago, a top consultant in Cardiff told me this. He said I know you have been abroad and outside the system. Now you are in the system again, and things have changed. Anticoagulation is now the responsibility of primary care. Perhaps not all GPs are up to speed with that. I am glad you have negotiated something with your local surgery.