Coumadin

[Guest guest]

My routine for afib has always been to take an aspirin a day, and if I go into

afib to double up on my cardizem and relax to try to self convert... IF the afib

has not gone away after 24 hours, I usually make an appointment, since I know

that action needs to be taken BEFORE I reach the 48 hour mark, which I have

always been told is when the liklihood of real blood clots forming starts... or

perhaps the reality is that that's when they have already formed (by 48 hours)

and the risk is to self-convert then and have one released into the body.

If I don't convert within 48 hours, I start a series of Lovenox shots.. two a

day for usually 5 days... and coumadin. If I convert shortly after the 48

hours, I continue the lovenox for the 5 days, and coumadin for a month.

Since my last bout was 6 weeks, and required cardioversion, my doctor is going

to keep me on coumadin for 3 months at least.

to respond to another email on coumadin and aspirin.. my doctor believes that

one can take a couple aspirin for pain or headache every once in a while..

certainly not daily, but for some of us for whom Tylenol does nothing aspirin or

ibuprofen are the only choice for pain relief!

Stef

[Guest guest]

My routine for afib has always been to take an aspirin a day, and if I go into

afib to double up on my cardizem and relax to try to self convert... IF the afib

has not gone away after 24 hours, I usually make an appointment, since I know

that action needs to be taken BEFORE I reach the 48 hour mark, which I have

always been told is when the liklihood of real blood clots forming starts... or

perhaps the reality is that that's when they have already formed (by 48 hours)

and the risk is to self-convert then and have one released into the body.

If I don't convert within 48 hours, I start a series of Lovenox shots.. two a

day for usually 5 days... and coumadin. If I convert shortly after the 48

hours, I continue the lovenox for the 5 days, and coumadin for a month.

Since my last bout was 6 weeks, and required cardioversion, my doctor is going

to keep me on coumadin for 3 months at least.

to respond to another email on coumadin and aspirin.. my doctor believes that

one can take a couple aspirin for pain or headache every once in a while..

certainly not daily, but for some of us for whom Tylenol does nothing aspirin or

ibuprofen are the only choice for pain relief!

Stef

[Guest guest]

My routine for afib has always been to take an aspirin a day, and if I go into

afib to double up on my cardizem and relax to try to self convert... IF the afib

has not gone away after 24 hours, I usually make an appointment, since I know

that action needs to be taken BEFORE I reach the 48 hour mark, which I have

always been told is when the liklihood of real blood clots forming starts... or

perhaps the reality is that that's when they have already formed (by 48 hours)

and the risk is to self-convert then and have one released into the body.

If I don't convert within 48 hours, I start a series of Lovenox shots.. two a

day for usually 5 days... and coumadin. If I convert shortly after the 48

hours, I continue the lovenox for the 5 days, and coumadin for a month.

Since my last bout was 6 weeks, and required cardioversion, my doctor is going

to keep me on coumadin for 3 months at least.

to respond to another email on coumadin and aspirin.. my doctor believes that

one can take a couple aspirin for pain or headache every once in a while..

certainly not daily, but for some of us for whom Tylenol does nothing aspirin or

ibuprofen are the only choice for pain relief!

Stef

[Guest guest]

> Can someone please list the site with amt. of vit. k in

> vegetables ...I had copied it and cannot find it. My levels have

> been crazy since I was in Fl. Thanks Breta

>

this site pretty much gives everything

http://www.nal.usda.gov/fnic/foodcomp/search/

it's on the afibsupport links page (under diet)

http://health.groups.yahoo.com/group/AFIBsupport/links

[Guest guest]

> Can someone please list the site with amt. of vit. k in

> vegetables ...I had copied it and cannot find it. My levels have

> been crazy since I was in Fl. Thanks Breta

>

this site pretty much gives everything

http://www.nal.usda.gov/fnic/foodcomp/search/

it's on the afibsupport links page (under diet)

http://health.groups.yahoo.com/group/AFIBsupport/links

[Guest guest]

> Can someone please list the site with amt. of vit. k in

> vegetables ...I had copied it and cannot find it. My levels have

> been crazy since I was in Fl. Thanks Breta

>

this site pretty much gives everything

http://www.nal.usda.gov/fnic/foodcomp/search/

it's on the afibsupport links page (under diet)

http://health.groups.yahoo.com/group/AFIBsupport/links

[Guest guest]

> You folks give such great advice and you have been a great help so

far to a new person like me so maybe you will share some secrets of

how to keep my PT/INR levels on an even keel. ..............

Hello: I too have trouble maintaining my INR but I try to eat

salmon two three times a week and stay away from red meat. My diet

is plant based. Try eating some dairy with your meals this will

reduce the absorption of dietary iron. The more iron one absorbs

the higher the hemoglobin and hematocrit. So check what your hgb and

hematocrit values are.

You are entitled by law to receive a copy of your lab values, but

you must ask for it..... Unless you know your hemoglobin level and

eat things like ginger(crystallized, garlic along with your high

vitamin K veggies you will have difficulty in maintaining your

INR. Drinking liquor as well as cranberry juice or antibiotics may

interfere/reduce or potentiate Coumadin's effect. I hope this will

helps and that you are feeling better today. Isabelle

[Guest guest]

> You folks give such great advice and you have been a great help so

far to a new person like me so maybe you will share some secrets of

how to keep my PT/INR levels on an even keel. Just when I think it

is going well (having levels between 2.0 and 3.0) a 4.5 INR pops up

and next thing I know its 1.5 and since I am in AFib weekly that's a

concern to me. Luckily my afib is only about 12 to 16 hours each

time. I have printed out the vitamin K list and pay attention to not

overdoing many things in a week with vitamin K.

>

> I went back on Coumadin last August after being off for 2 years and

so far have not even made it to having monthly tests done as my

levels go up and down. I actually have a script that reads " anytime "

for the tests and usually it is weekly. These old veins are starting

to give the lab trouble and it scares me to be at 1.5 and in afib.

At least my cardio has stopped insisting that I be admitted to the

hospital at 1.5, since my refusal to go into the hospital in October.

> Barb

**************

Barb and you other newbies, I hope my own experience will help.

When I first went on Coumadin after being diagnosed with afib a

couple years ago, it took a long time initially to get my INR up to

therapeutic values. And once I got there, I never seemed to be able

to stabilize it. I had a nurse in my EPs practice whose

responsibility it was to take care of all of us on Coumadin, adjust

our dosages, etc. She also had other duties. and when she left the

practice a year later, told me she had just burned out. But during

the year she was managing my coumadin, I was always up and down.My

INR was as low as 1.5, as high as 6.0. She had me going to the blood

lab for blood draws almost once a week for a year.And it became

torture for me to have blood drawn because most of the people doing

it were not well trained, and it was hit and miss with me.

My new coumadin nurse has had me stabilized for over a year now.

My former nurse would over-correct when my INR was low, and under-

correct when it was high, and I think that was a large part of the

problem. My new coumadin nurse adjusts my dosage in small increments

when necessary,and tells me, this change is not going to show up in

your INR right away, it takes some time, so you don't have to have it

checked right away. He also has instituted co-ag checks by finger

sticks in the office, so no more digging-around in-my-arms blood

draws in the blood lab. I go in for a finger stick once a month now,

and am almost always between 2.0 and 3.0.

He also told me that I could eat high vitamin K foods as long as I

was consistent in eating them. Consistency is the key, and my dose of

coumadin can be adjusted to fit my diet. I am currently on a low fat,

low carb diet for weight loss, and so, much of what I eat is salads

and vegetables with chicken and fish and some beef. I avoid the

higher vitamin K foods on the list, like green tea and cauliflower, I

think those are two of the highest. I make a big salad spinner thing

of salad two or three times a week with spinach, romaine lettuce and

whatever fresh vegetables are on hand or in my garden. Okay, it's a

little boring. But I make sure to have that big salad for lunch most

work days.

Otherwise, I go to parties, out for dinners, and on vacations,

just like a " normal " person, because, after all, we are normal

persons, we just have this difficult to manage disorder, afib. Okay,

so it's a little worse than difficult to manage. Okay, a lot worse,

sometimes. Oh, my coumadin nurse told me that even the INR can be

affected by stress.

Please talk to your cardiologist or ep about your difficulty

becoming stabalized on the Coumadin. What I've told you is only my

own experience, but I hope it helps. There is currently a lot of

research and development going on regarding afib, including a new

drug to replace coumadin. Best of luck to you, Barb, and to all of us.

[Guest guest]

> You folks give such great advice and you have been a great help so

far to a new person like me so maybe you will share some secrets of

how to keep my PT/INR levels on an even keel. Just when I think it

is going well (having levels between 2.0 and 3.0) a 4.5 INR pops up

and next thing I know its 1.5 and since I am in AFib weekly that's a

concern to me. Luckily my afib is only about 12 to 16 hours each

time. I have printed out the vitamin K list and pay attention to not

overdoing many things in a week with vitamin K.

>

> I went back on Coumadin last August after being off for 2 years and

so far have not even made it to having monthly tests done as my

levels go up and down. I actually have a script that reads " anytime "

for the tests and usually it is weekly. These old veins are starting

to give the lab trouble and it scares me to be at 1.5 and in afib.

At least my cardio has stopped insisting that I be admitted to the

hospital at 1.5, since my refusal to go into the hospital in October.

> Barb

**************

Barb and you other newbies, I hope my own experience will help.

When I first went on Coumadin after being diagnosed with afib a

couple years ago, it took a long time initially to get my INR up to

therapeutic values. And once I got there, I never seemed to be able

to stabilize it. I had a nurse in my EPs practice whose

responsibility it was to take care of all of us on Coumadin, adjust

our dosages, etc. She also had other duties. and when she left the

practice a year later, told me she had just burned out. But during

the year she was managing my coumadin, I was always up and down.My

INR was as low as 1.5, as high as 6.0. She had me going to the blood

lab for blood draws almost once a week for a year.And it became

torture for me to have blood drawn because most of the people doing

it were not well trained, and it was hit and miss with me.

My new coumadin nurse has had me stabilized for over a year now.

My former nurse would over-correct when my INR was low, and under-

correct when it was high, and I think that was a large part of the

problem. My new coumadin nurse adjusts my dosage in small increments

when necessary,and tells me, this change is not going to show up in

your INR right away, it takes some time, so you don't have to have it

checked right away. He also has instituted co-ag checks by finger

sticks in the office, so no more digging-around in-my-arms blood

draws in the blood lab. I go in for a finger stick once a month now,

and am almost always between 2.0 and 3.0.

He also told me that I could eat high vitamin K foods as long as I

was consistent in eating them. Consistency is the key, and my dose of

coumadin can be adjusted to fit my diet. I am currently on a low fat,

low carb diet for weight loss, and so, much of what I eat is salads

and vegetables with chicken and fish and some beef. I avoid the

higher vitamin K foods on the list, like green tea and cauliflower, I

think those are two of the highest. I make a big salad spinner thing

of salad two or three times a week with spinach, romaine lettuce and

whatever fresh vegetables are on hand or in my garden. Okay, it's a

little boring. But I make sure to have that big salad for lunch most

work days.

Otherwise, I go to parties, out for dinners, and on vacations,

just like a " normal " person, because, after all, we are normal

persons, we just have this difficult to manage disorder, afib. Okay,

so it's a little worse than difficult to manage. Okay, a lot worse,

sometimes. Oh, my coumadin nurse told me that even the INR can be

affected by stress.

Please talk to your cardiologist or ep about your difficulty

becoming stabalized on the Coumadin. What I've told you is only my

own experience, but I hope it helps. There is currently a lot of

research and development going on regarding afib, including a new

drug to replace coumadin. Best of luck to you, Barb, and to all of us.

[Guest guest]

--- In AFIBsupport , barb fowler <thereshope2002@y...>

wrote

> Thanks ,

>

> When I was on coumadin previously they had a nurse practitioner

controlling my doses and it was awful. This time it is a physician's

assistant and she does a better job and I now am taking a more active

role so that she does not over prescribe me. She sometimes tends to

go too high or low in her changes and I feel it necessary to be

proactive at this point but every week is a challenge. She also told

me keep Vitamin K on an even level at least now they have stopped

trying to put me into the hospital at 1.5 or 5.6. Now we just adjust

the meds.

********

Barb, thank you so much for thanking me. I'm hoping you can get your

inr's into the range that is neccesary.You are so right. Every week

is a challenge . Best of luck to you.