Tips for those taking coumadin - Educate Yourself

[Laurie]

Hi everyone, reading all the discussions has truly shocked me. I am a Cardiac nurse and I managed over 600 patients. I would like to share with you some of the things I always shared with my patients.
1. Only allow 1 doctors office to control your Coumadin - some people have a primary doctor and a Cardiologist etc-- only 1 of them should manage your Coumadin.
2. Never Never stop your Coumadin for a procedure until cleared by your managing physician to do so. Many doctors are unaware of the complications that can arise by telling someone to stop their Coumadin for "x" number of days prior to the procedure
3. Any changes in medications need to be shared with your doctor managing your Coumadin - antibiotics, allergy meds, steroids, pain relievers, cough medicines, herbal supplements etc can all effect your PT/INR -- let your managing doctor know you are starting something new.
4. Any unusual bleeding or bruising should be shared with your doctor immediately.
5. Always Always check your "mg" of the tablet - make sure you are taking the correct "mg".
6. Make sure you write down your values of the PT/INR - and your dose that you are to take. I always had my patients write it on their calendar with the date I wanted them to return to have their blood drawn again.
7. Everyone should have a PT/INR checked at least once a month - if you are out of range - you will need to be checked more frequently. If you are ever told that your INR is > 6, you will most likely be sent to a facility to receive a dose of Vitamin K. If it is extremely elevated, you should have someone drive you to an Emergency room - any cut, fall, or bump at this point could cause serious bleeding.
8. Dont allow your doctor or managing facility to ever say to you " we will only call you if your blood work is out of range " -- you tell them you want called with Every result - if they dont -- you call them!. Many times, I would not receive someones bloodwork - my patients always called me if I didnt call them - then I had to find where they had their's done. So always make sure and get your results!
9. Dont allow your doctor or a nurse to tell you that you cannot eat vita k - your body needs it - you only need to eat it in moderation - meaning dont eat greens and salads everyday. Your coumadin can be monitored around your normal eating habits. Also avoid hard liquors and alcohol as this will increase your inr. You can have an occassional drink but always notify your physician as they may want to check an inr sooner.
10. Dont be afraid to talk to your doctor and share your concerns. If your doctor is making changes that you arent comfortable with or if they arent checking your inr soon enough after changing your dose - TELL them you want it checked sooner. Dont blame the doctor if you arent going to tell them how you feel - its your body - you need to understand all you can about coumadin. You can even learn how to check to see if you are being managed properly - education is key. I will teach you all I know and what I have done to keep my patients safe while on coumadin. And yes, there were times I yelled at some of my patients - only the ones who knew me well enough- and were taking chances :)
I hope some of this is helpful to all of you. Taking Coumadin should not be frightening - if you are managed properly - it can be just like taking any other medication. Hope this helps.

[David Eugene]

Thank you, Laurie, for all your advice! We really appreciate the time you take to help educate us. Talking to you decreases my anxiety of taking coumadin.

[Laurie]

David, we work as a team. Whatever I can help educate you on, the better you will be informed and know how to ensure you are getting the best care :)

[sally]

Laurie, thank you for your qualified advice. I am trying to learn all I can while on this rat poison, lol. One thing I cannot find and am wondering if you can help with... I'd like to find a listing of some common over the counter meds that I CAN take while on coumadin. It's like playing the childs game of "telephone" trying to get an answer from the dr as the question has to pass thru so many hands I never seem to get the answer to what I asked and I can't phone them for every little question or I'f be on the phone all day. I can find lists of what NOT to take... but what CAN I take... cough drops? allergy meds...arnica? airborne? any help would be appreciated. I'm only tested once a month and can't exactly plan to need cough drops 3 days before a test. thank you

[Laurie]

Sally, I dont really know of any list out there but what I would recommend is to ask the pharmacist while you are in the store. They do have a computerized list of the ones you cant take with coumadin but I think the list would be to huge for those you can take. Sorry I cant help you there.

[laura]

hi can anyone please let me know how can i look up a doctor in california to get my inr level checked, like in what type of clinics or how do i search for a clinic that does the testing please, i went to a anticouagulation clinic in washington but now that i am in california i cant seem to find a clinic i have called hospitals and they say they dont have that type of clinic please please help i have not gotten my inr level checked for about 3 months im very worried, thnx

[Laurie]

Laura, you need to find a regular doctor or a cardiologist that you will see on a regular basis. When looking for a new doctor make sure you ask questions about how familiar they are with regulating coumadin. You can always get your inr checked if you have a lab slip and call your previous clinic, they should assist you until you get a doctor lined up. If not you should know what range you should be in 2-3, 2.5 - 3.5 ? Why has it been 3 months since you had it checked? Even though you cant find a clinic, there has to be doctors that manage through their offices so dont worry about that. Clinics are not found everywhere - many areas just have it done through the office.