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Bleeding and Clotting Disorders

Warfarin treatment

07/18/2007

Question:

I am on Warfarin for life. I have a DVT in my leg. I`ve had to change doctor`s and my new Doctor saw my result`s which were 1.7 I asked him about increasing my medicine and he said it was not necessary, he would call if it got to 1.5 I said the lab always kept me between 2-3. After being at 1.7 for a couple of months, I went to an urgent care facility because I was having severe difficulty in breathing. The staff told me I had to increase my medicine. My Doctor said not to worry. Now all of a sudden he called me in to the office and told me we have to get the INR higher. I asked him what it was and he said 1.7 I told him that`s what it`s been for a few month? Then he calculated and told me to take more medicine, which made my INR go to 1.9 I called the office and I suggested taking certain amount on certain days and see how things are. Now after 2 weeks I`m at 3.1, the nurse said stay on the dose and see us in a month?

Please advise why would the Doctor all of a sudden be changing his tune when my INR was 1.7 and then again 1.7? One time I see him and it`s no big deal, then the next time I have my test and he`s all frantic and how I have to come in and discuss things.

He also said that the INR # will not make you feel any different, is that right? Thank you.

Answer:

I cannot comment on your physician's goal of INR, although there has been an argument in patients with low risk of recurrent blood clots that INR between 1.5 and 2 is beneficial. This is still debated. The INR, however, does not effect physical symptoms.

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Response by:

Eric H Kraut, MD Eric H Kraut, MD
Professor of Hematology
College of Medicine
The Ohio State University