Inr still not going up 😐

Inr still not going up 😐

Should I take injection tonight ?

Called on call register at st Thomas last night wasn't a very nice man wasn't help full told me I was testing to often and not to bother to take injection spoke to a very nice Irish lady last Tuesday who was completely opposite very nice concerned and more then helpful. Wanted to call for some advice tonight but didn't want to get through to the male doctor.

Will call the Anticoagulation clinic or may be prof hunt Secatary for some advice .should I take injection tonight ? Have had amourus fugax when my inr been 2.8 plus now have micro clots on brain due to warfrin not working have been but on aziophrine max dose now 150 mg daily

Suffered a major stroke 2011 so don't under stand doctor telling not to bother to take injection

Bit confusing 😳

9 Replies

  • Tim I don't know at what level your INR has to drop to before you were told to inject heparin. You must follow your Doctors instructions when they prescribed the Heparin for you. Also did they say you had to be having any symptoms when the INR dropped to start the heparin. We can't instruct you what to do as we are not Dr's. You must follow the advice you have already been given when told to inject. I'm sure it will wait until tomorrow if you need to call anyone about it.

  • Tim

    I agree with my colleague APsnotFab.


  • I've had similar happening this week as you know. I've also been told varying things and I feel as though I'm winging it at the minute!

    GP told me not to bother with injections but the next day my rheumy said ignore him! I then only had few injections left so phoned my haematologist secretary and she write me a prescription stating to inject when my inr is low.

    Strangely (or not?) I've felt great on the fragmin! I usually know roughly where my inr is but was very surprised it had dropped again to 2.7 as I felt so well !!

    You need a plan - like I did. I now know I personally inject if I get symptoms or when my inr is below 3.5. I'd ask Prof Hunt to spell it out to you what you should do when your inr is low, for how long and what dosage.

  • Kelly, Are you maintaining your normal amount of vit k intake when you are injecting. Because if you inject and then continue to eat high vit k level your INR will not adjust properly. The fragmin works on different area of the clotting cascade, not vit k. This may be why you feel so well when you measured at 2.7... does this make sense? It's my understanding the fragmin is just there to keep you safe from clotting, not to address your vit k-INR, for they do not work the same .

  • Hi

    Yes I'm doing everything as I still should on warfarin and keeping my diet the same. I'm aware they don't work the same. The fragmin must be doing something for me to be well when my inr is low so that's very reassuring isnt it x

  • Who is monitoring your anticoagulation? I was put on it when a patient at St Thomas' in 2008, but since then have been under the care of the anticoagulation clinic at my local surgery, or hospital if having surgery.

    I have a clear plan in place

    My yellow anticoagulant record book has all my details, my INR range and where to call for advice if I need it.

    I record my results and any changes (except minor ones) are on their system.

    I am given a date on which to phone with my results and told what dosage to take. But if I am out of range then I phone for advice. I always test in the morning so easier to speak to someone.

    I test once a week - only more often if asked to because unwell or trying new medication. Or if I am holiday and eating different food (I don't drink)

    Every six months I have my machine reading checked against the clinic one and if the readings are out by over a certain amount it would have to be sent away for recallibrating.

    Finally I was told by my GP and the clinic that it takes three days for a different dosage to show, so no point testing each day.

    You really need to get yourself sorted out soon.

  • Tim can your doctor switch you to just the fragmin as a daily dose? And stop the warfarin altogether- might be worth looking into. Check with your Dr, good luck, stay clot free!

  • How are you - are you back in range and did you get injections dosage sorted?

    I've dropped again to 2.5 so still taking fragmin. I usually take 5.5 and I'm up to 7 - hope mine starts playing nicely soon as well!

    Make sure you get a firm plan in place for next time as well x

  • 3.5 yesterday told me to take 11mg then 12 alternative days 😊

    Seems to be working but will see went up to 3.4?the other day then crashed done the nxt to 2.6 will have to wait and see what happens over bank holiday 👀

    Have a nice w

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