Ok, I had another INR on Monday (not doing a happy dance for this one)

Last wednesday was 2.5 and monday was 3.8.
hold patern (0mg) for two days (monday/tuesday )and 9mg on wednesday, thursday and INR on friday.


When the results came out, I look at Melissa( nurse replacing Angèle) and I said" one more reason that I believe that I am on Dabi".
Since my last INR,I know my k's have been constant, I have not consummed any alcool and have not taken any other medication, in other words,nothing that would make my INR plumet to 3.8 from 2.5 last wednesday.

OK, friday and my INR is 1.8, next test on monday...
Feeling like a yoyo these days...

Whew--yoyo indeed! Sounds a little like my latest yoyo. Hopefully we'll get back to "normal" soon!

Ok, I had another bloodwork done this morning and this one is puzzling me and the med staff.

1.8 was my INR on friday and today,monday it is at 1.6
As you well know, I have been compliant with my med dosage and intake, I fully understand about the vitamin K intake which is CONSISTENT, I have not had any major or minor changes in my diet, my daily water consumption (5 litres of water)has been the same for a long time.

My coagulation is monitored by the TAT Unit at the hospital and because of this drug study I am taking part of, it is regulated by a drug company.


Just one more thing to worry about, I will be doing some phone calls this afternoon, to see if I can talk with my hematologist and/or the study co-ordinator.

Stay tune...

Ok, back in range 2.7 and we are going to try going back to the dosage I was on previous to me stopping taking acoags for 2 weeks.


Next INR next thursday, hopefully, I can stay therapeutic!!

Hi Denis,

Glad to hear that you are back up in the range again. (home, home on the range?)
Get some fresh salt air. That may help!

Hey Denis!

Glad to hear that you're back in the zone!

How's your leg been doing lately by the way?

Hi TLG and Brenda,

Hmmmm, need to find myself some salt air Yes I'm finally therapeutic, but I hope I can keep it that way, none of this yoyoing, it's tiresome on the mind... Also need to stay away from those vampires.

Brenda, the leg is doing simply GRAND the hematoma is almost ALL gone, from having two knees on my right leg.
Now I just have to focus on getting back in tip top physical shape, work on my cardios, right now they suck or should I say they weeze?

So glad to hear your leg is doing well!! Woohoo!

Still, I'm learning... Actually, I stand corrected on a theory that I had all along.
I thought all this time that if you drank lots of water (highly hydrated) it would help to keep your INR hi (from the old thinking thicker and thinner blood. More water would help thin your blood...)
BUT the proper way of thinking is: if you are taking anticoags and you keep yourself hydrated, it actually dilutes the anticoagulants, meaning lower INR.
Or, if you are dehydrated the anticoagulants are going to be concentrated, meaning that your INR are going to be higher.

The explanation
Everything goes up when your blood becomes more concentrated - hemaglobin, platelets, and the level of coumadin too -so it ALL increases. For instance, a patient may come in and be dehydrated and have normal looking hemablobin and hematocrit values, but once given fluids to correct the hemoconcentration, the hemaglobin and henatocrit values may drop, and we may find that the patient is actually anemic if they are well hydrated. If this same patient were on anticoags, their INR might be in the therapeutic range when they come in, but after recieving IV fluid, their INR will be subtherapeutic (lower INR) because it has been diluted out with normal hydration.

So there you go...
It took me a year to find this out, EH this is my one year anniversary of my diagnose, I survived it, woohoo!!!

Sometimes the test results are wrong too. I'm willing to bet that 3.8 was a bogus result. I wish home testing were in the grasp of everyone. Maybe someday it will be, but I think a replacement for Coumadin will be found before that happens.

I'd need to know what your overall dosing is for the week, what kind of diet you eat and how much excercise you get to make any kind of determination for the yo yoing.

Hi blebs,
Let me throw something else in the equation, I'm taking part of this new drug study called "REMEDY" which is on it's third and final phase to prove that DABIGATRAN can replace the use of WARFARIN safely (not safer) as an oral anticoagulant. If approved by the FDA, it should be on the market by 2010.
This study is a *randomized, double-blind study* since I have to be doing some kind of anticoagulant, I'm either doing dabigatran or warfarin.
Here is a link to some litterature concerning dabigatran, yes I have taken it from Al's site, since I know you trust it.
http://www.warfarinfo.com/dabigatran.htm

Since this is a blind study, I'm not suppose to know which anticoagulant I'm doing, I know you are trying to help me figure out why the yoyoing, but in my case, I think you can see that we would be playing a guessing game. I have to do it by the book.
Plus, I explicitly trust the medical team that is presently caring for me.
(the Thrombosis Assessment and Threatment unit here in Ottawa)

I know, for something different, this team DOES KNOW what they are doing.

Yeah I reckon that would be a major factor and make it impossible for those that don't know which is which to determine. Dibigatran, from my understanding, is most likely the one to replace Coumadin. I'm just worried about what it may or may not due to our livers.

By the way, thanks for the info on the water Denis. I'm keeping this in mind, as I have a feeling that my INR might be getting higher (reading's on Tues.)

Yay!!!
3.1 heck I'de rather be a smiggen over range then under range

Next INR tst is in a week AND if everything stays in range, Angèle will bump me to two weeks.
Baby steps towards to having INR test at once a month...