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.

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Now I am really confused

Jean1014
Jean1014
I am not sure what to make of this. When I left the hospital last Thursday (second time in since my pe's on march 1) they increased my coumadin to 10 mg and lovenox to 120. I had my INR done last Friday and yesterday morning. Each time, my doctor's (primary) nurse told me it was 1.6. When I got yesterday's results, she told me the doctor wanted me to take 1 pill one day, and 1 1/2 the next, and so on. I called her back to make sure I was clear on the instructions b/c I take two 5mg pills so I wanted to be sure of the dose she was telling me. I asked her do you mean 10 mg one day and 15 the next? She said yes. Today I found out she was WRONG! My visiting nurse called to double check what I should be doing and as it turns out, he wants me taking 5 mg one day and 7.5 the next, and dropping the lovenox back down to 100. If my INR is still 1.6, why would he decrease my dose??? Again, thoroughly confused!! Neither I nor the visiting nurse can get the actual doctor on the phone. This is ridiculous!
soulnik
soulnik
Yeah. That sounds wrong. If your INR is low, you shouldn't be reducing. Is your doc always so non-communicative? I'd call back until he talked to me.

I hope you get this squared away. I don't think they realize the level of anxiety this creates.
deleted_user
deleted_user
What a mess, I hope you can speak to someone who no's what they are doing. When you already have so many worries going on, this is really bad. Hope you get this sorted as soon as poss.
More2be
More2be
There is often confusion in the Warfarin dosing, both early-on and on-goingly. Because it must be carefully monitored and re-incremented, it is highly subject to alternating and half-pill doses in different strengths, leaving room for errors such as this one - which happened despite your best effort to establish an understanding. That does not excuse the errors, but merely shows how they can happen. Even after nearly three years on the drug, I had to play a 3-call phone tag with my doctor's office.
At least someone followed up and got it right before too much time passed.
It takes a while to get a stable INR for many people. It easily can take three days or more for a change of dose to show a change in INR. INR will fluctuate at least somewhat on its own. Eventually your stability will be found. Meanwhile, you are safe while you are bridged on Lovenox.
deleted_user
deleted_user
Wow! Don't let that lousy communication thing continue. It is one thing for them to continually adjust dosages. That's just how it goes with these things. But for them not to be completely clear about your dosages is simply wrong!

Always ask before you end the conversation: "So, am I correct that I should take ___ mg each day" and make sure they speak in mg not in number of pills.

You will find that you have to be your own best advocate. I nearly died of a third PE when they failed to give me the lovinox bridge. Don't assume anything. It is hard when you are sick, but stay strong and take good care.
Jean1014
Jean1014
Happy to say it finally got worked out today when the doctor called me himself! Glad I questioned what his assistant was telling me, because she was off both times. I swear she never even went to ask him. So while I am happy to have it solved, it has certainly shaken my confidence in this office! Just reinforces how much you have to stay on top of everything.
Thanks everyone!