Deep Vein Thrombosis (DVT) Support Group
Deep-vein thrombosis, also known as deep-venous thrombosis or DVT, is the formation of a blood clot ("thrombus") in a deep vein. It can be caused by something preventing blood from circulating or clotting normally. Join the support group if you are coping with DVT and find others who are going through the same challenges.
PCP & Hematologist disagree with my warfarin dosage. PCP keeps my INR on the low side, sometimes falling way too low (1.6). Hemadoc takes it higher, to 3.0. I see PCP's lab 1x week for the INR, and he has played around with my dosage a couple of times. Have only seen hemadoc once, he said PCP should just leave my dosage alone, & if PCP has any questions he can just call him on it.
PCP freaks out when I get on the high end, & that freaks me out cuz I think I'm going to bleed to death. And I get the creepy feeling that both docs are just kinda guessing at this - I'm FV Leiden homozygous with a current DVT (1st one) and the only thing these guys agree on is that I'll be playing this game for life (that's something ELSE I'm not sure I believe!)
Has anyone else here had dueling docs?
By the way, I'm new to the site and I'm so glad I found you guys!
PCP freaks out when I get on the high end, & that freaks me out cuz I think I'm going to bleed to death. And I get the creepy feeling that both docs are just kinda guessing at this - I'm FV Leiden homozygous with a current DVT (1st one) and the only thing these guys agree on is that I'll be playing this game for life (that's something ELSE I'm not sure I believe!)
Has anyone else here had dueling docs?
By the way, I'm new to the site and I'm so glad I found you guys!
First off, the low target INR range for coumadin is "only applicable" to those on long term therapy, not being treated for a current DVT. If you are still within the six month period of having a DVT you should be on a higher target INR range of 2.0 to 3.0.
I too am FVL Homozygous. I had two separate DVT episodes and am a coumadin for life candidate who is on the Prevent Trial Low Target INR range dosing.
When you say your PCP keeps your INR on the low side, what target range is he talking about? If he is using the Prevent Trial dosing requirements of 1.5-2.0 then he is definitely wrong. If he needs professional guidance because he is not familiar with treatment of patients with thrombophilia (blood clotting disorders - FVL) he can contact the folks at the National Alliance for Thrombosis and Thrombophilia (NATT) (see www.stoptheclot.org).
Also here is a link to resources regarding INR management for patients who have just suffered a DVT or PE. The first article is published by my physician, Sam Goldhaber of Harvard Medical School (Brigham and Women's Hospital):
http://circ.ahajournals.org/cgi/reprint/106/20/e138.pdf
Regarding Low INR Coumadin Treatment, here is a "Ask the Doctor" Q&A which addresses this issue from the fvleiden.org website. Dr. Moll who wrote this article is on the top blood clot specialist in the U.S.:
http://fvleiden.org/ask/09.html
Here's some good information regarding FVL written by Dr. Mary Cushman of the University of Vermont:
http://circ.ahajournals.org/cgi/reprint/107/15/e94.pdf
If you need more guidance, feel free to email me through this website. I am not a member of the medical profession, however I am a DVT/PE survivor and patient advocate.
Regards,
Tom
Your INR should be between 2-3...period.