Coumadin - anyone?

Hi - I posted earlier this week re: being dx'd with sick sinus syndrome - waiting to see an EP but meanwhile cardiologist started me on coumadin. Started tonight - I am concerned - afraid of course I will have a hemorrhagic stroke or bleed to death - have hx of ulcers, only one kidney, diabetes and frequent UTI's. Mostly concerned about adjustment of dose - being tested tomorrow but then I have to wait until next Wed to go to the coumadin clinic to be tested again. I am a vegetable eater due to diabetic and lower protein diet - if you can't eat carbs and you can't eat protein - and shouldn't eat fat - not much left and I am trying to lose wait. So dr says - just make sure you eat same amount of foods with vit K in them each day - well - it is hard to find a listing that has amts of vit K in foods. Anyone with any experience and/or suggestions with being on coumadin, please advise. Thanks in advance - so glad I found this place.
Paulette

12 Comments

coumadin

by thomast - 2009-11-24 10:11:56

The most common food with a lot of vit K is brocolli. Of course vit K will cancel the effects of the coumadin. I have been on it for 5 years with no problems. I get tested once a month. I take 4 mg per day, I usually test anywhere from 2.3 to 2.8. The ideal range is from 2.0 to 3.0. So I am usually Ok I understand that in Europe you take a meter home with you and adjust your own dose, wish they did that here.

Thomas

Food graph for you:

by pacepal - 2009-11-24 11:11:13

Hi Paulette...check your private message...I have a
graph to e-mail to you....it has to be sent unicode & would
not print correctly on this site...hope it is what you are
looking for....Karen

Do you worry

by Ohiogirl51 - 2009-11-24 11:11:55

Thomas - do you worry about cutting yourself or bumping your head - any ill effects from taking coumadin - losing hair, bruising, nose bleed? Dr told me I could eat Vit k foods - salads mostly if I eat the same equivalent every day - hard to judge if salad one day and asparagus the next - trying to find a chart that list the vit K micrograms in a cup of asparagus,m romaine, broccoli, etc so I can interchange. Thanks for your help. Just wondering - do you have a PM andif yes - how long?
Paulette

Coumadin (warfarin)

by mrag - 2009-11-25 02:11:20

I don't think it deserves quite that bad a reputation. I take 1.5 mg per day (it varies now and again) and I also take an aspirin (81mg) and plavix so my blood is like water. I fell on the stairs one time and watched my leg turn black and blue over the course of the next few days, but otherwise real bad bleeding has not been an issue. Food wise, the trick is to be consistent day to day although I've not been that good with following that advice and it hasn't hurt me very much. The monthly blood test, at least where I go now, is a simple pin prick and a drop of blood-takes 5 minutes. Much, much better than big needle in little vein ;-)

Do watch the cranberries at Thanksgiving. Usually your doctor (or pharmacist) will have a nice food chart for taking coumadin. And you can find stuff easily enough on Google, just type in coumadin.

Results

by Ohiogirl51 - 2009-11-25 05:11:33

Got a call from the dr's office - INR is 1.3 - I should be 2-3 so continue on and be rechecked on Friday. Getting a second opinion next Wed and an MRI on Friday. So things are coming together and hopefully I will know soon what the final plan is. Thanks again for al your help.

Paulette

Why?

by golden_snitch - 2009-11-25 09:11:10

Hi!

After what has been posted by "us" to answer your last question, I don't understand why you start taking the Coumadin. I would really wait until you have spoken to an EP as what your holter monitor has shown doesn't justify a need for coumadin. Leave it up to the EP to decide whether you need it or not. But those very, very short runs of AF in your holter, if they were really AF, are no reason to take coumadin. Doesn't matter if it's a big deal (with many risks) taking it or not: any med that is not really necessary should not be taken.

Also, at least here (in Germany) when you start coumadin you have INR levels checked every two or three days in the beginning. Waiting a whole week seems a bit too long for me.

If there really is an indication to start the coumadin, then I'd say/agree with the others that it's not such a big deal after all. I'm taking it since 2005. You don't need to avoid green veggies, you should just make sure that you eat about the same amount of those every day. I home-monitor my INR and can only recommend this.

Best wishes
Inga

Coumadin

by dottodot - 2009-11-25 09:11:50

Hi Paulette, A couple of things. If you go to www.drgourmet.com you can find a lot of information on foods and coumadin/warfarin. They list whether its high, medium, or low or there's a separate list that measures the mcg of vit K. I found that very helpful. It usually takes a while to get your dose and you will be more prone to bleeding or bruising but generally isn't a problem. Thomas mentioned home monitoring and it's available in the US-as a matter of fact I'm looking at it. There are specific requirements and you wouldn't be able to do it for at least 3 months. My INR fluctuates so i've elected to do every other week testing and the home INR requires weekly testing in order for Medicare and/or most insurance plans to cover it. There is a clinical trial called the Watchman Procedure where they place a filter in the area of the heart which they believe will protect at least 98% of strokes for people in atrial fib but they've only completed phase 1 so it may be a long time before it would possibly be a standard of practice (at least several years). So for right now coumadin/warfarin is the best management that's out there. Good luck.

Dose the diet, don't diet the dose

by agilitydog - 2009-11-25 10:11:37

With coumadin, forget Dr. Gourmet-he's full of malarky, trying to keep you to 80 or so mcg of vit K per day. Forget the cranberry interaction- it's anicdotal, not a controlled study. I eat them regularly. Eat all the veggies you want, and your dosage will be adjusted accordingly.
You'll take several weeks to get your INR regulated, then regular testing will help keep you in range. Don't try to change your diet to accomodate your dosage. A competent coumadin manager will adust your dosage to your usual diet. the key is to be relatively consistent. INR is not a set number, it is a range. Many of us are happy if we are between 2.0 and 4.0, so don't panic if you are 0.1 out of range!

No, you're not going to bleed to death, yes, you can use a real razor blade, yes, you can eat broccoli, spinach, kale and whatever else you want, just don't splurge all at once.

Go to warfarinfo.com and read up. especially read the old wives tales.
Then if you still have questions, you can come ask them at valvereplacement.com
Those of us with mechanical valves are on coumadin/wafarin, many self test and self manage - yes! we have those home INR machines in the US, and they are covered by Medicare! Weekly testing is required by some plans, but not all. I test weekly because I fluctuate a lot. Some people test every other week. I believe Medicare says testing no more than once per week, on average. You'll have to be on coumadin for about 3 months and in range for several weeks before you can get a home machine. Some doctors are in the stone age and won't prescribe or support home machines.

Ideal range is different depending upon your condition. My range is 2.5 to 3.5 with a mechanical mitral valve.
For A-fib it's different. The key is a competent manager, and learning enough to understand your dosing...and perhaps learning to do it yourself if you want to.

coumadin

by thomast - 2009-11-25 12:11:30

To answer your question, yes I do bruse easly, and if I cut myself it takes a little longer to stop the bleeding. If I really bang my arm for instance, it will turn black and blue for awhile, so try to be careful. Of course being 77 means I do some of those things even without coumadin.

Thomas

Thanks - dr said to start it now

by Ohiogirl51 - 2009-11-25 12:11:57

I started the coumadin last night - went for INR this morning - waiting to hear from dr's office to see if I need to adjust the dose and I am going to ask if I can be retested Fri or Sat so I don't have to go so long between testings since I just started.
Inga - I started the coumadin because the dr insisted since I have to wait until Dec 11 to see the EP. I thought I should follow his advice until I get to see the EP or can get in for a second opinion elsewhere. My thought - better safe than sorry and the way my luck goes - I could be dooming myself if I don't start it - I know - might not be the most optimistic outlook but I'm not a dr. I do appreciate all the responses and help and I will look at the websites.
I think the shock of it all got to me at first - never really expected anything to be wrong. Now the anxiety symptoms have set in - SOB, aches and pains and nervousness - I am going to try to relax a bit (after I host Thanksgiving dinner) and realize that I am fortunate that medical science is as advanced as it is and pray for the best.

Paulette

friend has been on warf for 28 years

by Hot Heart - 2009-11-29 03:11:29

Hi there

My friend just has to have reg blood tests to check how thin or thick her blood is and then she adjusts the dose accordingly. She only takes the occasional alcoholic drink, but has been totally fine.

HH

food list

by clemsongirl - 2009-11-30 11:11:40

Check out this website for a detailed list of vitamin k levels in food. It's listed under the middle section titled "What foods can I eat while on Coumadin (warfarin)?"

http://www.drgourmet.com/warfarin/index.shtml

There is also information on this website which disputes the "fact" that cranberries cause problems with coumadin levels.

Best of luck!

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