I had my INR (international normalized ratio) test yesterday and it was a lot higher than I expected. My range is 2.5 to 3.5 with a target of 3.0. Yesterday it hit an all time high of 4.3. I have put a short guide to INR on a page on this site for those who are not aware of what the INR is.
I take Warfarin, which is an anticoagulant (commonly known as a blood thinner) to control my INR and I have a regular test to ensure that it stays within the range decided for me. I have been on Warfarin since my Mitral Valve replacement back in 2014. As I understood at the time, the surgeon has three options when performing the surgery. The ideal option is a repair, then the next option is a replacement with an organic valve (usually from a pig) or a mechanical valve. The surgeon will decide when the chest is opened which option is required. For me he opted for a mechanical valve. As it could be dangerous if blood clotted in or around the valve, an anticoagulant is prescribed to increase the time taken to clot.
For a long time, my test has been within the range and often hitting my target. Back in August last year, I had a small infection on my leg for which anti-biotics were prescribed. I was advised to get an INR test after taking the anti-biotics as they are known to have an effect on blood clotting times. And indeed this proved to be the case as my INR went as high as 3.9. It seemed to take a long time to get back to ‘normal’ but by the end of the year it was looking better.
I had my previous test mid January this year, and whilst it was in range, it was only just. The nurse decided to increase my Warfarin from 15mg to 16mg (3mg Sunday and Tuesday, 2mg every other day). Not a huge amount, but I think it proved a significant change. After yesterday it is now back to what I was taking before, which is 3mg Tuesday, 2mg every other day. I’m back for another test in three weeks and we shall just see what happens.
My INR results came back today, and it had gone down to 2.7, which is around about the target date. The anti-coagulation clinic still wants me to be checked in a week, but strangely they have requested that I be tested on Wednesday instead of the more usual Tuesday. It’s not a problem changing the date, as Tuesday has always had issues with work. Only thing that concerns me is that is now the middle of the week, which could have implications when we have time away. However, we shall cross that bridge when we come to it.
Tomorrow sees me paying a visit to the Cardio-Respiratory unit for an ECG. I’ve not had one of these since before I had my operation, and I’m more bothered by how I can get parked than what the results will be. This is a pre-cursor for the appointment with the doctor (or Consultant as I like to think of him) next week. I’ve not seen Dr Me****y since before the procedure back in March 2014. I would have thought I would have seen him before this, but I think there has been some mix up with my post-care appointments over the past two years. It will be good to see him again
From his ‘homebook’, R**s seems to have had a reasonable day. There had been a couple of issues at the beginning of the day, due to a delay in getting in to the unit, but they say it improved during the day. It was a little unusual, but he was apparently wearing his ‘weighted blanket’ in the taxi home. He came out of the taxi in a happy mood and seemed okay. Around about 7ish, K**h took him his usual meal and he seemed to snap, which we were not really expecting. The usual nipping occurred and it required a dose of his PRN medication. He calmed down after about 15 minutes, but one of the after effects is to reduce his hunger. So not much dinner tonight.
He is full of cold, and I think that has had an effect, but he seems a bit more settled now.
That is what I was going to talk about. The ‘interesting’ weekend! But, after writing the first couple of lines, I decided that the weekend was not about me, and that it was not fair to write about it. So you may not get to get to know … yet.
Instead, it’s going to be an interesting week. Well that maybe pushing it a little. I have another INR test tomorrow, only a week after the last one. I cannot believe I had got up to six weeks between tests. I still think that stress plays a part, but maybe I’m just kidding myself and it is really too much alcohol. I was going to have an alcohol-free evening, but it has been a poor day at work and that and the small issue with R***’s computer, meant that a glass of wine was required.
It was the slightest thing with his computer. We had somehow switched off the power to the 4 way adapter and his laptop was running on battery power. Unfortunately, the battery had got to 2% power, before it became clear what was happening, so he got a little stressed when his machine told him about his battery needing charging. It took a good 30 minutes before the pop-ups stopped, but things like that seem to linger in his autistic mind and worries him. Still, he seems to be calmed now, so we may have got away with it this time.
Then, the ‘interest’ continues when I have my hospital appointment on Friday. I am supposed to be at a ‘team away day’ on the other side of Leeds and I was going to take the afternoon of as ‘flexi-time’. But I’m not happy with having to increase my journey time by an extra 30 minutes, just to satisfy someone’s managerial ego. My current line manager, totally agrees (but only because she doesn’t want to go) that I would be greatly inconvenienced by this. I may have to take the decision not to go and possibly invent some excuse why it would be not a good idea.
I was sat at work, chatting to one of the IT partners when I got a text message. By the time I had finished talking, I had almost forgotten the text. It was from the doctors confirming my next INR test date. Strangely, they had simply sent a previous message which was stating that I was booked in for a test on the 9th February.
I rang the wife and asked her if she had booked me an appointment and I explained that the date was wrong. She told me that the anticoagulation clinic had left a message and that I needed a test on the 8th March.
The shock was that my INR, which should be in the range of 2 to 3.5 with a target of 2.5 was actually 4. This is the highest it has ever been and was strange because my last test was back to around 2.6.
Now I’m putting this down to a combination of stress and the fact that I had drunk a bit more alcohol (although not much more) than usual. The doctor has said that he has not heard of any research into stress and INR levels, but it was quite feasible given what stress can do. However, I think it may have more to do with the alcohol!
Here’s a question for you. The clinic should have rung me on my mobile as that is my primary number, and the phone did ring at around 10:30. However, there was no number and the display simply said ‘Private Number’ which means nothing really. I tend to ignore calls like that, on the grounds that if it is important, then they will leave a message. I don’t like the fact that callers can hide their number and given that I already have 2 numbers for the clinic, I would have thought they would have used one of them.
I’m wondering how many of you answer calls from people that hide their number?