Many of my posts will be related to my personal experiences at work. Day in and day out, I encounter various situations that are very important to warfarin management and success. I see many patients during the course of a week, so these particular situations arise over and over. One important aspect of your management is for your provider to be able to get a hold of you. What I mean is, the ability for them to speak to you live or leave you a voicemail message. Why is this so important you may ask? Your doctor’s office needs to contact you (most likely via phone) when your INR (remember, your INR is that magic number that tells your provider how to dose your warfarin) is out of range. If they can’t reach you, it may be dangerous to you. For example, let’s say your INR comes back high at 5.0. Your normal range is between 2 and 3. This constitutes a “high” INR. This means that your blood is on the “thinner” side. Most likely your dosing instructions will start off with, “hold your dose this evening,” meaning don’t take it this evening. If there is no way of reaching you successfully, you would not get these instructions and therefore, would take your warfarin as directed. Your INR may be even higher if that is done. Also, you have the potential for bleeding.
My simple advice to you is this:
#1-make sure you have an answering machine on your home phone and/or cell phone.
#2-make sure you know how to take off your messages from your machine. You’d be surprised how many of my patients tell me they have an answering machine but that they don’t know how to use it.
#3-If you have no answering machine or do not know how to use it AND your provider has not reached you live to discuss your results, call your provider’s office after EACH INR, for your results. Many times they will be normal, but this eliminates you missing an “out-of-range” result, and hence, and potential problem.
I usually will try to reach a patient a few times, but I know with my personal situation, I make about 50 calls per day, and no offense, I don’t have time to continue to call a patient over and over to try to reach them.
Remember, communication is key in regards to your successful warfarin management.