Flu & high INR

[Janeh1960]

Hi all, so sorry it’s a long one but I want to give a warning to anyone on warfarin who contracts Influenza A, as I did 2 weeks ago, to make sure your INR is checked asap.

I was extremely unwell, never had a virus so bad, had Covid 4 times and was nothing compared to this.

I ended up being admitted to hospital breathing difficulties, dehydration etc & a nosebleed.

I have Asthma as well as APS, Sjogrens & Hashimotos.

Before I went into hospital my nose started bleeding, not something I suffer from, so I self tested & my Coaguchek machine gave an error message saying my INR was over ten & too high to read!

Once in hospital I told them my INR was too high & when they tested it was actually 19.9!!

Very scary indeed, particularly as I was either coughing or vomiting or both at that stage & could so easily have torn a blood vessel inside somewhere, at 19.9 not much drs could’ve done to stop bleeding quickly enough.

Haematology took over my care & a vit K infusion brought it down overnight to 1.2, so then on Fragmin injections.

Even with no warfarin in my system my INR started rising again!

Completely out of control.

Whilst I was in there Haematology told me 2 more people with APS were brought in with flu & their INR was up to my level too, one lady went over 20!

They’d not seen it that high before & trying to work out what was going on & how to fix it.

It’s now taken two weeks of a mixture of inpatient stays or daily visits to hospital for tests & checks to get things anywhere near o.k.

Asthma got worse & worse, drs wouldn’t give me the steroids I needed as the anti coag team said they mustn’t as that would increase INR.

Until last Saturday when the Asthma got so bad the dr had no choice but to take drastic action, he said it’s no good having a perfect INR if your dead of an Asthma attack & if we don’t act now you will be.

Iv steroids & other drugs, nebuliser & steroid tablets literally saved my life, a nurse said to me afterwards if the dr hadn’t taken action when he did I wouldn’t have made it home alive.

Last visit today , INR settling, two more days of steroids & Asthma is improving but then told my Potassium was now dangerously low (2) so had to have a 4 hour potassium infusion.

So many ‘near death misses’ in the last two weeks, could have bled out at 19.9 INR, couple more hours & the Asthma would’ve killed me and a level of 2 Potassium could’ve given me a heart attack.

All because of the flu and I’d been vaccinated 2 months ago.

So please if you even just suspect that you might have the flu & you take Warfarin seek help sooner rather than later xx

[GillyA]

Hi Jannah, I was laid here in bed, feeling pretty sorry for myself as I’ve been in hospital since Boxing Day with a bleed. I’m serious, but not life threatening, your situation makes me realise how well off I am. Thank goodness for the NHS, for all it’s issues, they really do save lives, and their expertise and knowledge are so important for us ‘interesting and unusual’ ones.

I wish you a swift recovery.

[Bobbydoodle]

Thank you for sharing so we can learn from it but most importantly I hope you recover quickly. What an awful experience physically but i’m sure mentally and emotionally too x

[soul22]

HiMy goodness thank God Dr acted

Mine also went very high post cancer surgery u had infection they had me on double blood thinner for couple weeks once infection calmed so did my inr.

I came home self injection levels back good level

I had clots in blood drain post surgery thankfully no emergency surgeon fastly upped dose.

[Willow7733]

Wow!! Thank you for the warning. I have asthma too on top of everything, and it is so bad lately. The only thing that has made me feel even remotely like my old self again was fragmin. It helped me so much, and I was clot free for the three months I was on it. I am back on Warfarin now because my insurance from work will not cover the fragmin. It is a struggle. I can't imagine an INR of 19!!! I was at work and the pharmacist at the coagulation clinic, the clinic, and my hematologist called me freaking out my INR was 7. I can't seem to stabilize when on Warfarin.

[GinaD]

Glad you made it through all that. And thank you so much for sharing. Who 'da thought? I will definitely be on the lookout

[KerryA]

Thank you for sharing. I hope your INR and asthma stabilise properly very soon.

Best wishes for better health in 2025

[Ray46]

Worth noting that pretty much any illness can destabilise INR, Covid has definitely done it for me both times I've had it, first time I was unstable (time in range went from >90% to <60%) for months after, second time I hit 6+ in the acute phase. I now burn test strips tracking it any time I am ill because I know it's a risk.

The most recent guidance says to only take half-doses of paracetamol (which leaves us with zero OTC pain control options ), I've taken full doses on doctors instructions and can also confirm that that pushes it up after a few days of full dose.

On the other hand, I've had Haematology suggest that pain raises INR as well, so pain or pain relief, either way you are in trouble. So the obvious answer is don't get ill. Yeah... I wish.

[Janeh1960 in reply to Ray46]

I agree, I’ve had Covid 4 times & my INR crashed to about 1.5 everytime.

You’re right, we can’t win really every blooming thing affects INR 😊

Just choosing the path of least risk at the time seems to be the way to go.

[snorkle272]

Thanks for sharing this. I hope you are feeling better.

[KellyInTexas Administrator]

I know any virus ( itself) can change the inr. Add medication, and really no telling what will happen.

Steroids did raise mine up as well.

I’m so sorry you have been through this. I heat this is a particularly nasty strain this year in the USA and in the UK.

From my reading, we are experiencing very similar surges.

Roughly 98% of new cases of flu in the first week of Jan were Flu A, compared to 2% which were Flu B.

Our hospitals are experiencing very high levels of influenza admittance. I read that Merseyside ( Liverpool and Manchester) and at or slightly over capacity as of a week or so ago. I hope it’s on the down side now, and I’m certainly glad you are over the worst of it. That was a really scary ordeal for you.