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.
Well … almost “All Over”. I’ve just got to get through the copious amounts of “Happy New Year” messages and we’re done until next September/October when the whole farce starts again. I think I’ve said enough about me and Christmas over the years, so I’m drawing a line under it (see below) except to say that it is only 363 days until Christmas day (again)!
So what’s in the future? Well tomorrow I have my Medication Review, whereby the doctor ‘reviews’ my current medication, and advises accordingly. Now, as I could be seriously compromised if four out of the five were ever stopped, it seems a little bit of a waste of time to actually review them. But review them he must, so that’s happening as 09:20 tomorrow. I suppose it will give me a chance to query the changes that are being made to the way my blood is tested. With being on Warfarin, I have to have regular tests to ensure the level of the medication is correct. At my end it is a simple extraction of a few millilitres of blood which is sent off to the Anticoagulation clinic in York. Two days later I get the result. At the last test, the phlebotomist mentioned that she did not know what would be happening in the future with blood tests and here words of comfort were “No-one knows what will happen in the New Year!” The health-care assistant hinted that it may be an all day clinic, once fortnight or so, but she really was clutching at straws. However maybe, one of the senior practitioners will know a little more.
So much for increasing the regularity of my posts. I think it must have been the ‘double’ post on the 8th that upset things. Joking aside, not much has really happened over that past week. Did a couple of short walks but nothing spectacular.
I had my Warfarin review on Wednesday. Now I think this is a silly idea. Because it is a controlled drug or POM (prescription only medication) the law says I have to have a review every 12 months. After my operation, the the surgeon explained that I had been fitted with a metal valve and as such I would need to take an anti-coagulant (ie Warfarin) for life. My GP confirmed this during my first appointment with him, a week after leaving hospital. It was also explained to me when I had my first INR blood test. So why do I need to have a review? Nothing has changed. I still have the replacement valve and it’s not going to go away. I don’t really see why I need a review. I did ask the GP at the time of the review, but he was very non-committal and answer. However, he did come up with a new idea!
Every so often, I have a blood test in which a phial of blood is taken from a vein in my left arm (a venous draw) . This is then sent to the Anti-Coagulation Clinic for analysis. I get the results, typically two days later. The new idea is to do the testing at the GP surgery. Basically I will have a pin-prick test, like the blood sugar test and the results would be available within minutes. It will still take ten minutes to do the test, but it would cut down on a lot of other time.
I have to book a special session with the lead clinician on this, but it sounds like a great idea.
So that’s about it for the past week. Lets see what the next one brings.
I appreciate that you may be feeling a little left out at the moment and I know you’re missing the cod liver oil capsules. However I feel that you may not be aware of the reasons for my discontinuation of that Omega 3 supplement that you so cherish.
I am unsure if Brain actually mentioned this, but in June of last year Heart went through a bit of a traumatic experience. Brain did assure me that the correct signals had been issued, but he is getting on a bit, and may have missed you off the list.
To cut a short story even shorter, Heart had a procedure undertaken in a medical establishment. This procedure meant that Heart had one of his valves (I understand it was a Mitral valve) being replaced or repaired. I am reliably advised that you would have been informed at some point. At the end of the day, the procedure and resulting medications mean that the Omega 3 supplement (that you know as Cod Liver Oil) has had to be withdrawn. Now, I am not aware of the full reason for this, but Mouth says (and this is in Mouths words) that “… it buggers up your INR and messes with the Warfarin …” Eyes had Googled this and it seems that the information is accurate as far as Wikipedia is concerned.
So that is it in a nutshell. In order that Heart keeps up its proscribed function, it needs this Warfarin stuff. For that to work properly, the Omega 3 supplement has to be forgone. I can understand your reluctance to accept this, but I hope you realise that without Heart, your position as Knees are untenable.
The hospital appointment went well. No waiting about much, which is one of the features of York District Hospital. That is probably why North Yorkshire NHS Trust is in such a bad way financially.
My consultant does not seem worried about the progress of my condition. He did explain a bit more about the problem I have. It seems that the valve that is not working correctly, is in a part of the heart that is more difficult to repair. He explained that repairing this valve is not an operation that is usually done in Britain. so what we are looking at is a replacement valve. This also has its risks and downsides. A metal valve and life on Warfarin. But he did say that I am not at that stage yet, and that here is no point doing an operation when it is not yet needed.
My new works laptop is due any day now. I’ve not taken the old one out of the drawer since last Wednesday. There’s not much point really, as I think the battery has died. It did not seem to be charging when I last used it. I have taken the floppy drive out as there is no point throwing that away, when I may be able to use it somewhere else. It will fit the other laptop, if not my new one.
I emailed the tickets and poster off this evening. I just hope they are alright. It is difficult to know what someone wants, when you only hear the details second hand. I think they look quite good, but we will wait and see. I think I will offer to laminate some of the posters. They will look better, when they are attached to the street lamps.
I planted out my Dahlias on Monday. There is about 14 of them, and they look quite good. They have done a lot better than the Nasturtiums I planted. I have the strangest feeling that the compost was too good for them. I recall reading somewhere, that they grow better in poor soil. The leaf-beat has been a great success too. We have lots and lots of leaves, and managed to cook some on Sunday night, albeit not really enough to go round.
That old work colleague from my cooks days, that I contacted on Friends Reunited, sent me a ‘jokey’ email today. I get quite a few of them from various people (mainly Sue), but this was quite a useful one. I was just reading through the list of people that he had sent the mail to, when I spotted the email address of another old colleague who I would like to keep in touch with. We met up a few years ago, when his son was going to the same school that my son goes to. This may be just the step I need to find another old friend from those days, who I would dearly like to get in touch with. That would be really interesting. JT was the guy who got me interested in computers in the first place. I have trawled the internet, trying to find him, but to no avail. I will email RH tomorrow…fingers crossed.