The Anonymous Widower

INR Testing Around A Simple Procedure

A couple of weeks ago, my dentist found a small lump in my mouth,so he advised getting it removed and tested to see that it was nothing serious. The procedure was booked to take place on Thursday, the 30th of July and he advised me to make sure my INR was lower than 2.4 and not to take any Warfarin on the day before. Obviously, he didn’t want me to bleed too much, especially as the position of the lump made stitching impossible.

My INR had been 2.6, 2.5 and 2.6 on the Sunday, Monday and Tuesday, taking my normal dose of 4 mg., which as I take it most days, is unsurprisingly my average dose.

On the Tuesday, to lower te INR slightly, I cut my dose to just 1 mg., with the consequence by Wednesday morning the INR had dropped to 2.3. As the doctor had said no Warfarin on the Wednesday, my Control Engineering training said that could drop the INR below 2. So I just took 1 and the INR was 2.1 on the day f the operation.

After the operation, as I wasn’t bleeding I took 3 mg of Warfarin, but by the Friday morning my INR had dropped to 1.6, so that evening I took 6 mg. On the Saturday morning, the INR had gone up a bit to 1.7, so to nudge it towards the desired value of 2.5, I took six that day.

In the week of the operation despite changing the dose to control my INR, I sactually averaged 3.8 mg. over the week.

Since then I’ve taken my normal 4 mg. and my INR has been fairly steady around 2.4.

I think this exercise shows the value of self-testing your INR. Admittedly, I was employing my Control Engineering training and experience to give the doctor what he wanted and keep my INR at a reasonably safe level, but the ability to self-test regularly around an operation must make things better for everybody concerned.

The doctor told me afterwards that I hadn’t bled too much, but then when I’m cut by a professional as opposed to torn in a fall say, I don’t seem to bleed much!

In the end, the lump had been removed and I heard today, that it was totally benign.

 

August 10, 2015 - Posted by | Health | ,

3 Comments »

  1. Firstly, great news that the lump is totally benign.

    I have type 2 diabetes, and according to the “rules” should not to self test, just have a blood test once every 6 – 12 months. But I test. And the dosage of medication I take each day is based on my first reading of the day, but more importantly on what I am going to to do that day. A much smaller dose if I am going to be swimming a couple of miles, and larger one if I am doing no particular exercise and going out for a hefty lunch. Being more in control, I am able to keep my levels really low, and have no damage to my feet, kidneys or eyes as a result of the diabetes. it is my opinion that if more people tested there would be fewer people costing the NHS large sums of money in side effects of the disease.

    Comment by nosnikrapzil | August 10, 2015 | Reply

  2. I could have had similar lumps in my eye nearly twenty years ago,

    I agree with you on self-testing. Read this about the benefits of self-testing of INR to the NHS.

    http://www.acsma.org.uk/self-monitoring/benefits-to-the-nhs/

    NICE and the Commons Health Committe are very much in favour.

    It’s generally GPs, who aren’t, although round here, the Health Authority expects GPs to either buy a machine themselves or get the patients to do their own testing.

    I believe strongly, that anybody who is capable of self-testing, should do so.

    And those that can’t should be tested in the GP’s surgery or perhaps the bigger pharmacies.

    Remember too, we’re only talking about the Mark 1 machine. I suspect they’ll be a better system developed in a few years.

    Comment by AnonW | August 11, 2015 | Reply

  3. My dad was on warfarin, he didnt self test, which was probably for the best because my mother was neurotic about his levels and would have had him testing more often than he was supposed to and then driving the INR nurses and her GP crazy with phone calls every 5 minutes, and trust me this is not an exaggeration. however, she had a stroke a few months ago and has now become nice and sweet and gentle and worries about nothing. This is a great improvement.

    Comment by nosnikrapzil | August 11, 2015 | Reply


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