open heart surgery

[SophiaMacie]

Hi there my husband just had open heart surgery three weeks ago and was given a mechanical valve replacement , they are having some trouble with his INR levels and keep changing his dose of warfarin , it was 4.2 so the nurse said he wasn’t to take his tonight and start again tomorrow , has anyone else had this happen ?

[Rhinos67]

Yes, it took about 12 months for my INR to settle down. I trust the staff at Warfarin clinic and I now only have to go every 8 weeks or soJoanne

😊

[SophiaMacie in reply to Rhinos67]

thanks so much for your reply ,I’m just so worried all the time , thinking he is the only one having these problems , I hope you keep well in the future lots of love x

[Rhinos67 in reply to SophiaMacie]

Totally understandable. I joined a Facebook group, UK Aortic and Heart Defects Pre and Post surgery when I was first diagnosed in Oct 21. Still a member of the group and always seek reassurance and advice from them when I have a wobble. Sometimes it gets overwhelming.Maybe worth joining the group?

Joanne

X

[Cat04 in reply to SophiaMacie]

Its a great informative, friendly group

facebook.com/groups/1864350...

[Inchcock]

After my mechanical aorta valve replacement was done, it seemed to be up and down so often. The INR target is different for each patient. My target it 2,5 to 3.5. I did have one of 1,8, and had to self inject Enoxaparin into my flabby tummy three times a day, for a week. But its easy once they show you. So tell hubby not to fret if he was to do this. The community DVT nurse did the first one, and called back to watch me do my first 'selfies'. One on each side each time. It really is no bother once you get used to it. All the bestest.

[Coper10]

Hi, I had exactly the same after my valve replacement. After starting warfarin, after a few days I had to miss it a couple of days as INR went too high and then start on a lower dose. It takes a while to settle down. I recall having my INR done 1-2 weekly initially when home. After a couple of months it was more stable and now (nearly 3 years later), I usually have about 2 months between testing and it really is no bother. All the best to your husband.

[Still_Breathing]

Yes it's normal for it to fluctuate, however you can reduce this by being consistent with what you eat and drink.Once you do this the clinic will adjust your dosage to suit and hopefully your inr will be stable.

[Traveldreams]

my Dad had three valves replaced and a bypass in 2016 and his level fluctuated for the rest of his life. Eventually my Mum was better at predicting it than the hospital. He did end up on 3 monthly blood tests but never settled and nor did it cause any major long term complications.

[Deejay62]

Yes when I was on warfarin mine was changed often at first then I got into a pattern of testing every two months, then it would go high and I would have to miss a dose and be tested monthly.

I never watched what I ate so maybe that’s why. The only thing I didn’t have was cranberry and grapefruit. I love greens and they would raise it. It depends on what you eat drink or what medication you take.

If he’s just started,after a while he might be ok. After a few years on it I was able to be tested monthly with the odd month of having to miss a dose.

I have Atrial Fibrillation so I recently got changed to one of the newer ones with no testing. I don’t think your husband as that option, from what I’ve read concerning mechanical valves.

I think there’s an anticoagulation group on here you can join. I know recently they have changed some of the names. If it’s still here it’s worth joining.

[Mitchum]

Three weeks is very early to get a stable INR. It can take months. The trick is to eat and drink to a very similar diet. Don't suddenly stop having a glass of beer every night, don't turn vegetarian but, if you do, realise that it will affect your INR. Don't do a crash diet, or any diet, without closely monitoring your INR. If you are drinking 20 units of alcohol a week, don't start binge drinking or having thirty units. When you are ill or take certain drugs, assuming they don't interact with warfarin, it can still change the INR. The trick is not to change dosage willy nilly when it is high or low. You can test on Monday and again on Wednesday and it could be very different for no apparent reason. Don't panic, it will come into line. If mine is a little over my range (3-4) I eat a bit more broccoli , spinach or lettuce. When it's a little low I cut greens out for a couple of days or so. I could go on for ages but you will get the hang of it, particularly if you invest in a Coaguchek machine. If you're on warfarin you need to look at your lifestyle but, at the end of the day your life will be quite normal. If you need any specific information you can contact me anytime. He'll be fine. Promise!

[Classof1988]

I can't remember how much my INR fluctuated after my valve was fitted as it was a long time ago but I started off at 9mg per day and am now down to just over 6mg per day with tests at present roughly 8-10 weeks apart. Having a stable routine with regular exercise and not too varied a diet does help. I actually eat (and enjoy) grapefruit every day and am not on any other medication. The only time in the last couple of years that my INR went a little off target was when I started having a health drink without realising it could affect my INR (there were no physical symptoms and I have never had a problem with Warfarin). Your husband should be able to look forward to many years of a normal life. Admittedly I don't normally drink alcohol (my car is usually not too far away and when I was working my job was safety critical with a robust D& A policy with random testing) though the last time I had a glass of real lager(Carlsberg in Denmark!) it didn't taste as nice as the alcohol free version 😅

[Mitchum in reply to Classof1988]

It's interesting that you have grapefruit daily. There is no problem with that but you will find many sites where various people will state that you can't have grapefruit OR cranberries. As you and I both know one must adjust dosage to diet and not vice versa! Alcohol is also not a problem if the same amount is drunk on a regular basis. I'm surprisingly not unhappy with that🙂. There are numerous myths regarding warfarin that affect people's lives drastically and un-necessarily. Range decisions are made by individual cardiologists and vary greatly throughout the UK and the world. Mine is 3-4 but in USA, Germany, Australia for example the usual range is 2.5-3.5. I even know of someone that has 3.5-4.5. Quite high I think but......

[Okash]

hi there,

INR levels in this case must be kept in the 2.5 to 3.50 range. Warfarin dose can be adjusted to reflect the required INR range.

You don’t have to worry much , especially if the valve replacement operation is new. As time passes, things will be alright and INR has to be checked periodically ( say once a month).

This is from own experience , I had a similar procedure 12 years ago.

[Okash]

hi there,

INR levels in this case must be kept in the 2.5 to 3.50 range. Warfarin dose can be adjusted to reflect the required INR range.

You don’t have to worry much , especially if the valve replacement operation is new. As time passes, things will be alright and INR has to be checked periodically ( say once a month).

This is from own experience , I had a similar procedure 12 years ago.

[SophiaMacie]

thanks everyone , you have made both of us feel more at ease ❤️