Pulmonary Embolism Support Group
By far the most common form of pulmonary embolism is a thromboembolism, which occurs when a blood clot, generally a venous thrombus, becomes dislodged from its site of formation and embolizes to the arterial blood supply of one of the lungs. Symptoms may include difficulty breathing, pain during breathing, and more rarely circulatory instability and death.
So my doc was out of town last week, so the other doctor in her office and the PA (neither of whom I've met) have been managing my INR. I'm still testing 2-3 times a week since I haven't stabilized since my surgery in November and my Ear, Nose, and Throat doc keeps switching up my antibiotics and other meds.
Anyway, so I was up to 3.6 last week. They had me hold a day and retest the next morning. I was at 3.3 then and they wanted me to hold another day and then go back to my regular dose of 6mg. Retesting on Wednesday five days later.
The last time I held two days in a row, I dropped almost 3 points (from 4.8 to 1.9) in two days. Of course, this didn't occur to me until Friday night, hours after I talked to the doc and when I was going over the INR plan for the weekend with my husband.
So, I was naughty ... I didn't do what the doctor said.
I didn't hold the second day. Instead just dropped my dose to 5mg. Tested this morning and I was at 2.6, which is just perfect and I'm feeling a little smug about managing my INR well myself. Of course, we'll see how the rest of the week goes, since I dropped another med on Monday which has been knocking my INR up.
Anyway ... anyone else out there ever go "rogue" and just start doing things their own way? Honestly, I'm usually 100% behind following doctor's orders and being a "nice" patient, but it kind of depends on whether you trust the doctor. In this case, I didn't (since they weren't familiar with me) and it came out OK, but I'm trying to keep myself from just getting too cocky and trying to do it all myself.
Thoughts?
Anyway, so I was up to 3.6 last week. They had me hold a day and retest the next morning. I was at 3.3 then and they wanted me to hold another day and then go back to my regular dose of 6mg. Retesting on Wednesday five days later.
The last time I held two days in a row, I dropped almost 3 points (from 4.8 to 1.9) in two days. Of course, this didn't occur to me until Friday night, hours after I talked to the doc and when I was going over the INR plan for the weekend with my husband.
So, I was naughty ... I didn't do what the doctor said.
I didn't hold the second day. Instead just dropped my dose to 5mg. Tested this morning and I was at 2.6, which is just perfect and I'm feeling a little smug about managing my INR well myself. Of course, we'll see how the rest of the week goes, since I dropped another med on Monday which has been knocking my INR up.
Anyway ... anyone else out there ever go "rogue" and just start doing things their own way? Honestly, I'm usually 100% behind following doctor's orders and being a "nice" patient, but it kind of depends on whether you trust the doctor. In this case, I didn't (since they weren't familiar with me) and it came out OK, but I'm trying to keep myself from just getting too cocky and trying to do it all myself.
Thoughts?
I could not have been as accurate in the beginning - two years ago- but I am now and the Dr seems to understand this too. I still go in frequently for testing though.
I just wish the d---- clots would dissolve!! I'm a lifer in every way but grateful to be alive too.
Love, Cindy
A general complication is that Warfarin is not about what it DOES but what it makes your liver NOT DO, which is make normal quantities of plasma-borne clot factors. Those clot factors, in turn, have varying half-lives of several hours to a couple days, so together with ingestion delay it can take 3 days to see the effect of a dose change. In spite of that, medical advisors try their best to adjust and hope for stabilization results more quickly.
INR can vary a lot in a short time and can even vary with side-by-side tests, as much as by 0.3 or even 0.7 in the same lab or different labs across town. I've been fortunate to be one of the more stable people. With frequent self-testing (5 to 15 days, usually weekly) I can see the INR creep up by 0.2 to 0.5 from test to test and take action accordingly before it becomes alarming.