Heparin and wafarin at same time

[Gdav]

Hi,

Jan 2021 AVR, bypass and reconstruction. Been OK since except for missing heat beats. 6 weeks ago I came back with the wife from her mother's and I had a stroke, even though I am on wafarin (was between INR 2 to 3, now 3 to 4).

Recovered 45 minutes later but went to hospital. Came out next day. Everything since ok, but my INR on Friday was 2.6 and the nurse said I should have heparin for the next 5 days.

I wasn't happy but ended up having the script for them.

I have taken 1 injection but just wanted to know if anyone else has had this occur to them.

I am not looking for medical advice just P.O.Vs and experiences. I am 55 Yr old reasonably fit

Thanks,

Gary

[Jocastina]

Hi, I'm sorry to hear you had a stroke. I had my mitral valve replaced in June this year. I'm 52. After my operation I had an AFib episode and so was put on amiodarone for 7 weeks. When I came off the amiodarone, my INR dropped, and so I was put on heparin (Clexane) which I used for 4 weeks until yesterday when my INR was finally in range at 3.1! The reason it took so long for me was because I had a stomach bug 2 weeks ago and that messed things up even more. I really sympathise - the heparin injections really aren't very nice, but I continued because it seemed the right thing to do to prevent any problems with low INR.One issue I found is that my GP uses a system called INR Star to calculate warfarin dosage, and every time I had a reading that was too low, INR Star suggested increasing my warfarin by extremely small increments (sometimes an increase of only 0.1 or 0.2mg average per day), so my GP spoke to the haematology department at the hospital to get their advice on increasing it a bit faster and they advised slightly larger increases. I guess it depends on what your dosage is and what other meds you are on so it all needs individualised advice.

Good luck with it.

[Madyy in reply to Jocastina]

Really good post

I’m two years on with my AVR and similar INR warfarin issues

[Gdav in reply to Jocastina]

Thanks for your reply, it is a head spinner isn't it. I am sure every day events have an impact on my INR.

[Hidden]

Been on Warfarin for 8 years, INR range is 2.5 - 3.5.I've had my moments, with INR both too high and low at times. When I've dipped below 2.0, the Pharmacist has given me a Heparin jab, Tinzaparin in my case, coupled with upping Warfarin dose for a couple of days. I normally have to be rechecked the following week. I'm only 5 mins from the hospital, so I'm not that bothered about being checked regularly.

[Gdav in reply to Hidden]

Thanks for your reply. I think this is probably the way things will be for me, I really must remember I haven't been doing this for long in the Greater scheme of things.Had my INR tonight and it was 2.9, so at least it's on the up.

[Hidden]

I'd be quite happy enough at 2.9

I peaked at 6.0 one day, probably due to a combination of antibios, steroid meds and too many lagers.

We chatted for quarter of an hour, before the Pharmacist took the reading again and it came down to 5.9, otherwise I would have had to stay in hospital whilst they got the level down with some drug. The life and times of a warfarin user.

[niffum32]

Hi Gary sorry to hear about your stroke I have been on Warfarin for 23 years first started when I had a mitral valve replacement in 1998 aged 40 and had an aortic valve replacement in 2015 my range when I first started warfarin was 3-4 now 2.5-3.5 usually for me personally heparin is given when reading goes below 2 and is given until it goes back into range as Jocastina says not nice at all it really stings not had to have it for a while now (just jinxed myself) my warfarin is always up and down hope you get sorted soon

[Coper10]

Hello, I had AVR in March and am on Warfarin, target INR 2.5 with a therapeutic range of 2-3. I had been put on INR* at the GPs too early before I had become stable enough. My INR had dropped to 1.7, then 1.4 for 2 weeks and no-one seemed concerned - it was me saying surely I should be on heparin injections with an increase in my warfarin dose! Finally a GP got involved, confirmed I was right and the situation shouldn’t have occurred. I had 6 days worth of injections while waiting for my INR to increase. I haven’t needed them since but it did rather shake my trust in the GP surgery.

[Gdav in reply to Coper10]

I don't blame you for worrying, the Tuesday before my stroke my INR had been 3.6, the evening of the stroke, in hospital it was 1.9.

I appreciate there is a difference between mechanical and tissue valves but what concerned me was the drop within 3 days and the resulting clot ( it was a clot and not a haemorrhage).

I am not a worryer but I would now be really concerned if my INR ever drops into levels beginning with 1. Anything.

As Heed said, the life and times of a wafarin user 😀.

Many thanks for all your replies, it's nice not to feel you are on your own.

[Gdav]

I suppose as a positive I now have 7 x heparin pens to use if my levels drop, just need the GP to push along my haematology appointment so I can have the INR test strips on the NHS and buy a home tester, which they have said I can do.