Heart valve replacement 11-11, target INR range of 2.5>3.5 set by surgeon. Took three weeks to establish that this is only accomplished with high doses, alternating days 10 mg. and 12.5 mg. during first two months after release from hospital, adjusted to alternating 10 and 8.75 which kept level in range with two highs of 3.4 and several lows of 2.2 with weekly visits to lab over next year of tests at a similar dosage.
Dosage changed to alternating three days 8.5 and four days 9 maintained INR within target range with only one high of 3.6 and one low of 2.2 during past five months.
I Always avoid foods listed with high vitamin k.
PCP called with INR results on 9-5 to give me a read of 2.8, continue dosage and repeat in a week, on 9-12, a read of 2.9, continue dosage and repeat in a week, on 9-19, a read of 3.3, skip dose and repeat in week.
On 9-23, before scheduled blood draw for 9-26 I received call from PCP telling me to skip the Monday dose, cancel blood draw for 9-26, repeat test on 10-3 and make arrangements for another doctor's office to perform monitoring because though she would remain my PCP she would no longer monitor the tests, which was the only function I even needed her for in the first place.
Been on Medicaid since surgery, starting on Medicare next month.
Other Doctors in area affiliated with my health plan are not currently accepting new patients for any reason.
I suppose that since she has so graciously agreed to remain as my PCP, then she will presumably continue signing for my prescriptions, but how do I monitor the INR level, or get advice on whether to adjust the dosage if the level should be too high or too low?
Labs don't call patients with test results. They only call the doctor who is expected to determine whether or not a change in dosage should be made and advise the patient accordingly.
So now what?
Just maintain the dose and hope the range remains at a safe level?