Tuesday, September 29, 2009

Lost within: INR / PT levels, Vitamin K, Coumadin, Labs: solution we found

Ever since I came home from the hospital, I have been on a lot of medication:
1) Blood thinning drugs (Coumadin)
2) Blood pressure lowering drugs
3) Cholesterol lowering drugs
4) + My previous anti depressants

Of course all of the above medications have interactions with one another.
My anti depressant drugs raise my blood pressure, which I have to bring down with blood pressure drugs, the blood pressure drugs in return effect my mood. But worst of all is Coumadin, it interacts with everything I eat.
You see, Warfarin (brand name Coumadin) according to National Institutes of Health,” is a medicine prescribed for people at increased risk of forming blood clots. Sometimes medical conditions can make blood clot too easily and quickly.
This could cause serious health problems because clots can block the flow of blood to
the heart or brain. Warfarin (Coumadin) can prevent harmful blood clots from forming.”

But, while taking Coumadin, you have to go to the lab and give blood to monitor your blood clotting levels continously.

Again according to N.I.H. “International Normalized Ratio (INR) and Prothrombin Time (PT) are laboratory test values obtained from measurements of the time it takes for a clot to form. Individuals at risk for developing blood clots take Coumadin to prolong the usual time it takes for a clot to form, resulting in a prolonged INR/PT. Doctors usually measure the INR / PT every month in patients taking Coumadin to make sure it stays in the desired range.”
But here is the catch: The food you eat can affect your blood clotting levels. Because: ”Blood clots are formed through a series of chemical reactions in your body. Vitamin K is essential for those reactions. Coumadin works by decreasing the activity of vitamin K;
lengthening the time it takes for a clot to form. To help Coumadin work effectively, it is important to keep your vitamin K intake as consistent as possible. “
So, you have to be careful around food such as:
Kale, Spinach, Turnip greens, Collards, Swiss chard, Parsley, Mustard greens…. The list goes on and on. You can eat them of course, but you have to be consistent. If you eat them, eat them every day in the same amount.

In the beginning it was weird to say the least. Mehmet would take me to the lab in the morning, I would give blood, the next day I would find out the INR / PT ratio results, according to which I would decide how much Vitamin K to take. Every second day I would be on my way to the lab, trying to catch up on yesterday’s results, as well as reading the same People magazine for days in a row in the waiting room.

After a while Mehmet started to research whether there is a better way. And he found it!

A do-it-yourself in-home test kit:

“The INRatio monitor is a diagnostic Point Of Care system that provides Prothrombin Time (PT) and International Normalized Ratio (INR) results using fresh capillary whole blood from a fingerstick.
The INRatio system reduces the headache of oral anticoagulation management, is easy to use, and features on-board quality controls with every test.”

The test kit is not cheap. But all in all, it might be cheaper than the lab-co-pays. For us the deciding factor was the real time ability to monitor today’s results with today’s medicine intake, and the convenience of not having to spend 1.5 hours in the lab every two days.
After three months we get this device home, monitor it for accuracy for one week (meaning we do the lab testing and in-home testing side by side for one week), and the make the switch over for good.

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