mechanical mitral valve replacement done. inr all over the place. help!!

[buster2k10]

Hi all , only just felt ready to post update , had op done on the 17th july no major complications , i already take morphine slow release tablets and oramorph for break through pain ,so after op i had a phentinol pump ? I cant remember fri sat sun or mon really just little bits of memory coming back , i do remember the pain tho ,omg that was awful not from the incision, but back and neck pain ,i suffer from chronic pain so i think the op made me have a flare up. My husband had told me the surgeons would do their job and i needed to do mine,my job was to do as my told ,which i did . my inr level was 1.9 on the wednesday so wouldnt discharge me but on the thurs was 2,1 and thankfully was discharged . Had to get it rechecked agin on fri from gp and it was 2.9 , Yesterday(thurs) one week since discharge had inr checked again was 1.6 ......my target is 2,7 . so now i am worried that it has dropped so much ? the gp has upped my warfrin to 4 mg and am back there tue hopefully with inr on target.

Im really worried that it has dropped am i gonna end up back in hospital? ive never took warfrin before so this is all new. im feeling really fragile and emotional ,i am having odd twinge in my heart ( i think) i am still on alot of pain relief .to be honest i thought i would feel better than this? is this normal?since been home i have had a great deal of stress form my 15 yr old grandaughter who normally lives here but because of sheilding and my op has gone to stay with her mum and now doesnt want to come home ,i have brought her up since she was a baby ,she hasnt text msg or rang to see how i am ,i called her when i was in hospital to say i was ok but she said she was busy with her mates! but she would ring back that was 9 days ago! does stress effect inr? .im sorry for the long post with the grammer and spelling mistakes. i just feel lost alone abandoned and scared!!plus im tired all the time.

[Shar28]

Hello, my husband had his Aortic Valve Replacement about 2.5 years ago and chose a mechanical valve so he’s on Warfarin too. Please don’t worry too much about your INR. It’ll settle. Your body has been through a huge disruption and needs to settle down again. Anaesthetics etc will be coming out of your system. As time passes and your drugs regime settles, you resume your normal diet (instead of hospital food) you’ll find your INR settles too, if my husband’s experience is anything to go by. I know some people find it’s up and down, but Warfarin is a very well used drug over many years so the medical profession has a good handle on it and can guide you. Also, there will be a range that’s acceptable, not a single target number. Eg/ target 2.5 range 2 - 3.

For more information you should have a yellow book with a contact number for the anticoagulation clinic. Or your GP.

The AF website has some really good factsheets on Warfarin too. Here’s the link

heartrhythmalliance.org/afa...

I think the best advice my husband was given was to adjust the Warfarin dose to match his diet and to eat a wide range, particularly of veg so he gets all his nutrients. Don’t adjust diet to achieve target INR on a certain dose of warfarin.

There’s also info on the BHF website

bhf.org.uk/informationsuppo...

In terms of emotions, you’ll be up and down and all over the place for a while - it’s that settling down thing again.

I’m so sorry to hear about your granddaughter, it sounds a heart wrenching situation (no pun intended). I’d love to be able to say something profound and insightful to help you but I haven’t got any magic words I’m afraid. A couple of things struck me - could this be her way of coping with her worry about you? And the novelty of being with her mum? Are you in touch with her mum? Maybe all you can do just now is text her every so often asking how she is to keep lines of communication open and let her know that despite everything you’re still there for her.

All the best to you and your loved ones.

[Hidden in reply to Shar28]

That was great advice Shar.

[buster2k10 in reply to Shar28]

thank you shar ,im so happy i have this site ,i think im just feeling sorry for myself x great to know i can come here and off load thank you xx

[Lucybird]

Hia. I had mechanical aortic valve replacement and am on warfarin. It does take a little while for your INR to become consistent so I wouldn't worry too much about it, just make sure you're following all the instructions e.g. no cranberry juice, not too much vitamin K (usually in green leafy veg).

Medications can effect INR too, so it could be that.

[buster2k10 in reply to Lucybird]

as far as i am concerned i been eating right and my medication is the same as hospital, my husband does all the cooking and we have looked to c if there is anything that i have eaten thats bad ,only thing i had was a packet of jelly beans and jelly babies .

[IrisCarter]

Hi, I also have a highly variable INR. It can swing between 1.9 and 8! I was in hospital for 26 days after my MVR because of it. We now have it swinging between 2.5 and 4. My target is 3 - 4. The variation you are experiencing is not extreme and it does take a period of time for most people to be stabilised so try not to worry too much.

I was sent to the Medical Decisions Unit at the hospital with very low BP and an INR below 2 and had an injection. I was allowed home the same day.

My understanding is that once my INR is more stable I will be given the injections to administer at home if necessary and I will be able to buy my own machine for testing.

Can I ask why your G.P. is managing your warfarin as it is usually the Anticoagulation clinic?

[buster2k10]

hi iris, i go to my gp practise and a nurse does the inr but she then asks the doc what strenghth warfrin to put me on ,only been twice ,only been out of hospital a week . seems a commmon problem with inr levels ,i was starting to worry they would send me to hospital .thanks everyone x