Anne, its not that hard to keep your INR therapeutic between 2.5-3.5. I don't eat any differently than I did before I was on Coumadin, well except I not longer drink the green tea, but I didn't really care for that anyway. Like I stated in an earlier post to someone about keeping your INR therapeutic, if you were to check your INR daily you would find that it changes so easily over almost nothing. My doctor told me that I should continue eating and doing what I have always done, he even recommended I take a multi-vitamin with vitamin k in it to make sure I get the recommended daily dose. They adjust my coumadin to my lifestyle and not my lifestyle to my Coumadin. Every once in awhile I do drop below therapeutic but usually it bounces back within the week. The only time I struggle keeping therapeutic is while I am on antibiotics, they seem to mess with me, so I know to be extra vigilant while on antibiotics.
Hope this helps.
Hugs
ferr

Thanks, Ferr.
It is helpful to hear from someone who has the INR of 2.5- 3.5.
You inspire me with your perseverance after 4 PEs!!

My doc doesn't want me to go all the way up to 3.5 because of the bleeding risk.
She's wants my target INR to be 2.5 to 3.zero. That's what seems hard.

I have not personally been consigned to a tight 0.5 range but a co-worker of mine tends to her elderly father, who has been carrying on for several years with congestive heart disease. He has a doctor who tries to be a perfectionist about keeping the patient right at INR 2.0. The doctor is similarly precise about several other aspects of the case. The patient himself follows all orders and checks in with that doctor weekly. Of course, sometimes he goes off-targett but given how long he has outlived the usual prognosis, the approach appears to be working.

With frequent self-testing, diabetics have made similar strides. The most conscientious ones may test several times a day and try to keep their blood sugar in a tight range, fretting no more than necessary when it inevitably goes astray, but in the attempt they often go 40 years or more avoiding the complications that used to routinely come within three to ten years.

Well theoretically my range is 2.5-3.0. But as long as I'm under 3.5, they don't change my dose. I take that to mean that really my target range is 2.5 -3.5.

I've just been put up to 3.0-4.0 but anything up to 4.5 is OK. My doctor said that younger people are able to tolerate higher levels of coumadin and that as I have an IVC filter this should stop it clogging. I actually feel happy at the higher level as I know that if my INR drops a bit I am still going to be anticoagulated. However, I must say that the reason my range is high is that I have had repeat PEs and the last one whilst on coumadin but with INR of 2.0-3.0.

Thanks for all of the comments.

I just clotted on coumadin with an INR range of 2.0- 3.0 and we are trying to figure out the next steps.

I'm heading to the coumadin clinic in a few minutes...

Hi

me too 2.5 - 3.5 I reckon high 2's are ok, although I've been stuck at 2.2 for a little while..It's an imprecise science but I'm happy to be somewhere between 2.5 - 3.00 but not getting too stressed if slightly over or under you've got to live life in the midst of it I reckon x

Thanks for all of the help.
It's good to know that I'm not alone.
It turns out that my INR was 2.77 when I was in the hospital.
I'm curious to see what my new target will end up being when my hematologist gives her opinion. So far, I have only talked to my primary care doc.

My current range is 1.5 - 1.8 and so far I'm staying within the numbers. I'm going in next week for my first test in a month (the first time I've gone that long) so we'll see.

Hi, guess I'll jump back into the coumadin discussions, since I'm back on it again (new clot in my leg...ugh). When I was on coumadin before, my target was 2.5-3.5, though most of the time I didn't go above 3.0, but keeping the higher target mostly just kept me from going below 2.0, which was what was the problem before adjusting my target. From what I understand our INR can ever get quite high (briefly) without generally being a problem. When my other medications messed up my INR before, and I jumped up to 4.7, my doctor actually said he'd prefer me at 4.7 than 1.7. Of course, my dose was promptly adjusted to stay lower, but that experience just showed me that being a little higher than what we consider normal really isn't quite the reason for worry that I had previously thought. They told me once a guy came in, and due to his own irresponsibility (he'd been taking coumadin without coming to get his blood checked) and his INR was over 23!! Even at that, somehow he'd not had any spontaneous bleeding problems, just probably very fortunate not to have had any accidents. I'll be going to my coumadin clinic for the first time today since starting coumadin again, and I don't know what they're going to have as my target yet, but I imagine they'll stick to the same as before....I hope you're doing okay with everything, and will be feeling better soon. I'm so sorry you had a repeat episode!

Sarah

I have the same target range. My doctor would like me between 2.5-3.0 but knows how unrealistic that is, so increased it to 3.5. As I've said in other posts, I do not eat any differently than I did before. I let them adjust my dosing. The only thing I did change is I stopped taking my Fish oil, Cal+K and I stay away from green tea and cranberries. Although I do sometimes slip up on the cranberries. I eat salads 5 days a week and dinner most times will include spinach or broccoli. I do have to go in for weekly testing and usually have to adjust my dosing every other week.

Mine was targeted at being 2.0 to 3 then 2.5-3.5. I agree with the earlier post that says you should NOT have to adjust your diet any. Keeping your levels the same is really about consistancy not cutting out food groups. Just eat what you would normally eat in your diet, normal meals, don't skip them. that's far more important then worrying about vitamin K and diet. They can and should adjust your coumadin dosage to your regular diet and lifestyle. Hence it's much easier to maintain. I do think alcohol, and drugs like pain killer, cold meds, antibiotics ect and being dehydrated can easily affect your INR levels however so be cautious about that. I'm sorry to hear you've struggled with repeat PEs. I'm thankfully nearly a year out from mine and so far so good on vitamin E and aspirin therapies. good luck to you!

The range my doc has suggested is 2.5-3.5 (ideally 2.5-3)

I've only had one PE episode, but they were concerned from the lack of concrete cause that I might have a predisposition to clotting.

I was quite stable between 2.5-3 for a month or so, until going on holiday and moving house!

That is a normal range but can be hard to to keep since warafin suppresses appetite a. It has been two months for me and sitll my INR is off. Hang in there, it will eventually work out.

Hi - When I left the hospital after extensive bi-lateral PEs and a saddle embolist, (& DVT) my range was 2-3. A week later I was back in the hospital because the DVT had continued to grow and had extended from my calf to my groin. A IVC filter was placed and the surgeon recommended a range of 2.5-3. I tend to trnd on a three week cycle - INR slowly goes up and at about three weeks we adjust it. Then it slowly goes down for three weeks etc. So, I remain on weekly testing. I spoke with a anticoag trainer yesterday and she suggested tracking it with my menstrual cycle as that can affect INR (new info for me). She also suggested changing how the warfarin dosing is figured. Right now I take 3mg 2x a wk and 6mg 5x a wk. The ratio of 3mg days to 6mg days is what changes as my INRs fluctuate. The trainer suggested getting a supply of 1mg pills, adding up the total mg per day, then dividing by 7 for a daily dose (after talking with PCP of course). She also told me that the INR reflects the dose from 48 hrs prior. The most annoying thing is that because this is an "odd" range, if someone new comes onto my case, like when my PCP is gone, they assume 2-3 is the correct range and I have to point out that it isn't. I did just get a home tester which will make it all easier I think.