On 10/23/2010 1:32 PM, John Hudson wrote:
>
>> My mom was on Coumadin (The fancy, prescription name for the rat
poison
>> warfarin.). A constant fuss to keep the dose right, so the blood
level was
>> enough for the desired thinning effect and low enough that she
didn't just
>> start leaking blood.
> Nothing at all difficult or fussy !
>
> Blood sample taken every month and the INR reading determined.
>
> Increase or decrease your daily intake of leafy greens to fine tune
the INR
> given the daily dose of warfarin.
>
> Been at it for years ........... my wife is very good at drawing the
blood.
Yep, very narrow therapeutic index for Coumadin-- INR must be
controlled just right.
There are some home instruments that make it much more convenient--many
insurances will pick it up here.
Phillips makes one of these gizmos. I do not know the details on the
differences of the few approved home monitors available.
No mistakes allowed. Some studies have shown weekly home monitoring
has outcome advantages.
http://www.inrselftest.com/content/
This weeks NEJM did not confirm any difference but patient satisfaction
was higher with the home monitoring.
One wonders if the fact that study sites using monthly clinic
monitoring might do much better than the community average
and the fact that patients that do studies tend to be more adherent
wouldn't bias the data a bit. Vit K containing vegetables do decrease
the INR.
http://www.nejm.org/doi/full/10.1056/NEJMoa1002617
I can't link to the full text but I can e-mail a pdf.
Mike,
Frazzled, trying to keep his precious but deathly ill cat going for a
while.
--
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