Monday, March 25, 2013

Oh Help Me Now!


It is super funny being the youngest person in the STEPS clinic getting my INR Levels checked for Coumadin (Warfarin) therapy. I am as young as many of the RN's that are working there.  The conversation from the other patients I frequently overhear is hilarious! AND there are times I totally identify with their struggles, especially when their levels are out of their therapeutic range because of what they ate. Too much cabbage, cole slaw, kale, or other leafy greens to name a few of the items that mess with your Coumadin drug. 

Typically this is how it goes.  You walk in (if you are a reoccurring patient) the person checks you in, provides a medical identification bracelet and verifies with you your date of birth (DOB). You proceed to wait in the waiting room until your RN comes to get you for your level check.  Typically you are led to an office looking room with desk, table and chairs, a portable blood pressure machine that checks checks your Systolic and Diastolic levels as well as your heart rate. They take your temperature and begin prepping the machine that reads your blood level. Once the button is pressed on the machine the nurse has so long to prep your finger that they are going to prick , prick your finger and pull enough of a blood bubble to seep onto the blood stick thing sticking out of the machine (don't know the technical term) so that it can be read.  If all goes well this only happens once. (There have been times that I have had two nurses taking turns on three different times in the same setting to get one to be read correctly).  Next comes the questioning depending on your level. If you are in range you receive minimal questions. Questions like, are you feeling OK?, bruising? have you had any excessive bleeding?  Are you in pain?  If you are over range (which I have not been yet) I am sure there are other things they will tell you like, maybe eat more leafy greens to bring down the level back into range.  If you are under range, they will scrutinize your diet (I started keeping a log), this includes alcohol, and other items that keep your INR levels lower. 

Here are some articles I found that describe very easily what  affects your INR levels with Coumadin therapy and why.  Take a look.  A Diet With Coumadin Therapy found on Livestrong.Com and written by Roma Lightsey.  Also found Warfarin diet: What foods should I avoid? found on the 

Before I was allowed to leave the hospital, the pharmacist came into my hospital bedroom and schooled me on the in's and outs of Coumadin. It was an interesting conversation, and eye opener and wonderment (from me) as to how I was going to accomplish this task.  I LOVE MY GREENS! I eat them ALL of the time. I eat a large amount. I could eat straight avocado, cucumbers, large salads, asparagus, broccoli etc.  I eat it all! I also love to have wine and alcohol on a weekly basis and was being asked to limit that.  Why drink at all was my thought and still is at this point.  SUCKS. 
Well I have been good, keeping my diet consistent and limiting the green foods, (even my son keeps track for me now).  Today on our trip to the beach I began craving the yummy salad that I normally eat at Dory's Cove restaurant with my clam chowder. It is almost tradition for our family to frequent that place.  Sometimes we drive there just for dinner or lunch.  I wondered why my husband hadn't suggested that place for lunch rather we went to McMenamins Lighthouse restaurant.  It wasn't until we were home late  in the evening when I had mentioned that I was going to have some salad and that I was craving something like that to eat that he had mentioned the salad at Dory's Cove was the reason he didn't suggest that because he knew I would be upset and wouldn't order that for lunch. 
WELL I ATE A SALAD tonight! I did, I admit it. I ate a small bowl of salad tonight. It tasted so good. While I was eating it I was thinking of all the green stuff I had eaten in small moderation since my last INR check on Thursday.  I turned to my hubs and asked him to remind me not to eat much of it for the rest of the week until Thursday to even out my levels. But boy did that salad taste good!  I know the idea is not to alter your normal daily habits but that also means that you might be on a really high dosage of Coumadin and that drug isn't the nicest drug. So I chose to reduce my large weekly intake of greens to maintain a smaller dosage, which by the way my doctor stated that I seem to have a high dosage of Coumadin already.  We shall see what this Thursday's level is. Wish me luck!

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