well kids...

-today was rough. was more painful this morning and throughout the day than the last few. and so much so that i was tempted to revisit the ER in pursuit of some answers. but my brother reminded me that there's not much they can do that will differ from tues night. all i can say kids is it feels like i got punched in the crotch, and there's nothing pleasant about that. i've gone from aches of mere discomfort to aches of pinching pain in the groin area. on a 1-10 ratio, i'm feelin' a few 7's and 8's. it stinks when it hurts to remember these clots aren't going to repaired over night. i can thank my big man upstairs that i only have to go through 7 months of recovery. and that i didnt get diagnosed with more life changing diseases like celiac or diabetes...

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So, this is a lot of writing, but notes what I've learned about my coumadin therapy so far.. To start, the blood thinner I'm on, Coumadin, has one job to do, and that's to reduce the amount of blood clotting cells in my body. Anything that decreases Coumadin's productivity is a problem, so to speak. At the end of each week, I get blood drawn, and the lab will do a PT test that times (in seconds) how fast my blood clots when they add a substance called "reagent" to my blood. The reagent forces my blood to coagulate (clot), and the test measure how well the coumadin is working in my system. For people who aren't on blood thinner, i think the their blood takes 1 second to clot w/ the reagent. For me, i think it's supposed to take up to 4 seconds to clot. These blood tests are called INRs, and my Coumadin doctor will determine whether or not they should reduce my Coumadin dosage, or increase it based on my INR results.

There's only one thing that can fluctuate my INR results, and that's the amount of vitamin K i have in my diet each week. Rule of thumb: if its green and leafy, it's without a doubt high in vit k and working against the blood thinner.

I heard in the beginning that I should stay on a regular consistent quantity of vit k, and other places i read that there were certain limits to the amount of vit k i should take. I'm still not sure how to do this to be honest. There's a site that's been pretty helpful, it's Clotcare.com and this is the link i've found most helpful: http://www.clotcare.com/clotcare/vitaminkandwarfarin.aspx

They let you know what quantities in micrograms will affect your INR, but don't flat out tell you to avoid foods with vit k. I'm still not sure how much vit k to allow in my diet, but i do understand that the key is to eat similar amounts of food with vit k each day. If i add to my consumption of vit k, my INR will be lower, if i decrease vit k in my diet in a week, or one day, that will also show in my INR too. Clot Care also provides downloadable pdfs of tables dividing foods into high, medium and low concentrations of vitamin k. These table have been so helpful. I've printed out a few to carry with me.

I'm still weighing the pros and cons of a normal vit k diet vs. a lower vit k diet. On one hand, I want the coumadin to work fast w/o being slowed down by foods high in vitamin k. On the other hand, if i were to indulge in a delicious salad one day, that one indulgence would account for a huge fluctuation in my INR. And sure I could tell my Coumadin doc what I did, but the goal is to have consistency in the INR tests throughout all 7 months. So, we'll see.

DrGourmet is another good site with vitamin k recommendations and pdf tables.. the links for the tables are on the upper left hand column of this page..
http://www.drgourmet.com/warfarin/

well that's it for now. i've learned a lot of the nitty gritty stuff.. like how i gotta be careful when shaving my legs to not cut myself, and careful not to bump a limb into anything too hard or i could have some internal bleeding.. :( eeeehhh..

g'nite for real now :)