PT-INR blood testing for patients on Coumadin (Warfarin)

Yesterday I wrote about blood thinning and Vitamin K intake.  I will leave another link to the Johns Hopkins animated “Coagulation Cascade” information because the information there will be used in this post.

The “PT” part of the blood tests on people taking Coumadin is how long it takes a drop of blood to clot.  This test is called the “Prothrombin Time” test.  As with all medical lingo they have to come up with a really hard to pronounce word to scare the fool out of us commoners.

If you would like further information on THROMBIN and PROTHROMBIN and how they work in the clotting of blood I’ll leave a link for you – Thrombin.

For those of you that are not on Coumadin (Warfarin) but know someone who is might find this video helpful.  Blood thinner pills.

Referring back to the Coagulation Cascade and the process of forming clots in the blood is what the PT test is all about.  The blood test can be done at a clinic the doctor has recommended or by a Home Health Nurse.  At a clinic the blood will be drawn from a vein in the arm.  The regular type of blood draw with the tourniquet wrapped around your upper arm and a syringe poked into the vein that will allow blood to flow into a sample tube.  The test can also be done with an “At Home Test Kit” that is quite expensive.

A finger prick much like used in diabetic testing.

A finger prick

Blood is then drawn into a sample tube.

Blood drawn into a sample tube

A drop of the sampled blood is then placed on a specific testing strip that has been loaded into the machine.

Blood sample applied to testing strip

The sensor in the machine calculates how long it takes for the blood sample to go through the Coagulation Cascade cycle and gives a read out of the time it actually took for the blood to clot.

The machine calculates the Coagulation Cascade to determine how long it takes for the blood to clot.

I have no idea what the results shown on the screen mean – except that Joe’s blood is not thin enough yet.

The “INR” part of the blood testing is, essentially, a set of numbers indicating the median range optimal for blood clotting.

In the things I’ve been reading it seems a committee was formed to decide what the standard of blood testing for patients taking blood thinners would be.

The letters – INR – stand for INTERNATIONAL NORMALIZED RATIO.  All this means is that someone in Jakarta, India – Yellowknife Northwest Territories – Berlin, Germany – Edinburgh, Scottland – or Norman, Oklahoma in the US can have the blood tests done and the results can be determined by any doctor anywhere in the world.

For patients taking an anticoagulant the optimum INR results are to be between 2.0 to 3.0.  For Joe his results need to be in a higher range of 2.5 to 3.5.

There are things that will cause the testing to go whacko.  Having a glass of wine, or a jigger of whiskey, is not recommended.  Alcohol has properties that naturally thin the blood and can cause some nasty side effects.  All adult beverages are off limits to anyone taking a blood thinner.

Some antibiotics will increase the PT/INR tests.  Barbiturates, birth control pills, and Vitamin K will decrease the PT results which will cause an increase in the dosage of Coumadin.

Foods like beef or pork liver, green tea, broccoli, chickpeas, kale, turnip greens, and soybean products contain large amounts of Vitamin K that will alter the PT results.

My poor Joe.  He is lamenting the changes in his life and food consumption.  This is a difficult thing for the both of us to go through.

Joe:  I guess this means no more Chinese Food.

Me:  Yes, because of the salt content and the soybean products used in Chinese Food.

Joe:  No more deep fried chicken gizzards.

Me.  Yes, because of the deep frying.  I’m putting that on the NO list because it is an ofal somewhere near a liver and it is out.

Joe:  No more steaks either.

Me:  Yes, you can have steaks but they have to be grilled, broiled, or baked.  WITHOUT salt.

Joe:  Am I totally deprived of cookies and milk, too?!

Me:  No, you can have dairy products and cookies.  The amount of cookies will have to be kept to the Recommended Portion Size and not the “Joe size”.

Joe:  What about mashed potatoes and gravy?  Do I have to give that up as well?!

Me:  No, you can have mashed potatoes and gravy.  Here again, it will NOT be the “Joe size”.

Joe:  I want something sweet.  What can I have?

Me:  Go get some grapes, cherries, watermelon, or cantaloupe from the refrigerator.

Joe:  Can I have my Ranch Dressing with the watermelon and cantaloupe, too?

Me:  Yes, but once again – NOT the “Joe size”.  You can’t pour the dressing all over the fruit causing it to go swimming.

Joe:  😦 alright.

When I get too much guff from Joe I threaten him with a call to our “Dr. Loreli” and she will give him what for 😀  He hates it when his kids tell him to behave and listen to me 😀

Okay, now.  I think you are all up to date on everything I know about blood thinners and the treatment of Pulmonary Embolism.  I’m sure there will be something else to pass on later.

Before I totally forget, once again.

If anyone has a problem with constipation – I know not such a great topic – I’ve learned some things that I would like to pass along.  Joe has been having some issues and has been instructed to NOT STRAIN.  He could be in dire trouble if he has a bloody stool while taking Coumadin (Warfarin).

A “Black and White” Cocktail:

This is 8 ounces of prune juice, heated in the microwave for 30 to 45 seconds – just until it is warm.  2 Tablespoons of Milk of Magnesia stirred into the warmed prune juice.  Drink this concoction, don’t sip it.

Dulcolax or Coalesce:

Take one tablet with 8 ounces of water.


Fill the WHITE section of the bottle cap and dump contents into any beverage you want – except adult beverages.  Water, juice, coffee, tea, or soda.  This product is tasteless and dissolves completely in liquids with some stirring.  Joe is taking this product daily and it is helping him keep regular with ease of elimination.

All of the above laxative products are purchased over the counter in drug and grocery stores.  The effectiveness of each type is dependent on your body chemistry and how constipated you are.

Everyone needs a little help  now and then to keep regular and some of these are a little more potent than others.

Now I’m off to my craft room to get myself immersed in ink and glue 😀



About Message In A Fold

I am an over the road truck driver in Drive-Away Transport part of the year, and the sole bookkeeper of this operation the other part of the year. I do a lot of whining until I can get in my craft room and play with paper and glue. View all posts by Message In A Fold

10 responses to “PT-INR blood testing for patients on Coumadin (Warfarin)

  • Maureen Mathis

    Great info, and it sounds like you need a break!

    • Message In A Fold

      Yes. I had to go hide in my craft room for a while.

      How are you doing my friend? Your nest is getting a little more spacious and quiet these days.

      With all the spare time you have now what have you got cooking in your craft space?

      Love you – Leslie

  • aspot2stamp

    Another great round of information. As for the miralax we have to give that to the kids and it works!! Poor Sierra has always had issues and this does the trick. Poor Joe not getting to eat the things he likes 😦 My Dad is having to have a complete diet change and he is not liking it one bit. His blood sugar and colesterol and electrolytes have been wonky and he is so upset that he cant have fried foods and any beef or pork unless in small quantities, and hes dragging his heels on the sweets 🙂 Cant wait to see your crafty creatons. I cleaned mine up some and hope to play this evening (fingers crossed ) Have a great evening and tell Joe Hi from us and we hope he gets better soon.
    Love ya {{HUGZ}}

    • Message In A Fold

      Joe takes the MiraLAX daily and it has been the best thing for him. Even better than prune juice if you can believe that. I’m totally impressed that it is safe for the young ones.

      Your poor Dad 😦 Having to eliminate ALL of his favorite foods. That would be a cause for rebellion! I’d be the most stinkin’ worst person to be around if I had all my favorite foods taken away. I hope he finds the new food regimen tasty and more than palatable. That would go a long way to making the change easier on him. Still there is nothing quite like a bacon cheeseburger with fries 😀

      I hope you do get some crafty time in. You need it girlfriend. Play around with all your pretties and souvenirs from this summer and the fun you all had. Looking forward to seeing what you come up with. Any cards on the front burner? 😀

      Love you – Leslie

  • gardenpinks

    Poor Joe! This is a life style change not a diet although once everythng has stabilised he can eat a little more of his fav things once in a while but obviously not only are you having to cope with dealing with blood thinners and PE but also get Joe’s weight down.
    Joan doesn’t have an over weight issue she is well under weight so she is okay to have her daily fix of chocolate or cake and she drinks two glasses of sherry every evening! She would forget about her blood test and have a drink or two the night before and then remember her blood test and then be called back 24 hours later for a further blood test 🙂 It is the INR test that Joan now has weekly. Sadly Joan is now suffering from dementia so her husband has to do all the remembering for Joan – post it notes everywhere!! He also bought her a 7 day pill box and fills it every week so that Joan knows what tablets she has taken. So difficult for Derek and very much hard work as he now has to do all the cooking, some of the housework, etc as Joan has stopped doing anything much. So sad.

    Love and hugs
    Lynn xx

    • Message In A Fold

      I’m so sorry to hear about your friends. If I remember correctly, this couple has had you be their landscape designer. In so doing you have become friends. It is really sad to learn of once hale and hearty people being derailed by dementia 😦 Old age is friend to no man or woman. I’m sorry my dear friend.

      I feel bad for her husband. The woman he fell in love with and married has been lost in the shell left behind. What a tragedy. Still he is doing all he can to keep her with him and that speaks volumes on what love and patience truly is. Bless the man and his loving heart.

      Joe is doing better. He’s happy with the new food regimen. Especially when he gets on the scale and sees that he is losing weight while he is eating. In 2008 he dropped down to about 268 pounds after his Prostate surgery and all the other ailments he had on top of that. He couldn’t eat so his body was nearly starved and started eating on itself. To see Joe semi-happily eating this new way helps me to stick with it and not give in to our temptations 🙂

      My friend – take care of yourself out in the wilds of your garden with the pruning, pulling weeds, and composting.

      Love you – Leslie

  • Pati Mishler

    OHMYGOSH!! So much to learn, WOW!! I remember feeling just like you are feeling right now sis. Course, i didnt have to learn all this stuff, but, still, SO MUCH TO LEARN!!

    It all makes your head just about spin doesn’t it? WAY TO MUCH INFORMATION, on you both all at once, wow.

    I am glad Joe is coming around, and doing better, makes it easier on you also.

    You are right, reading labels are good for a few things, but, you cant get ALL the information a person needs off the labels.

    Sounds to me like you are getting good and studied up on your subject, before long, you are going to be a pro at all of this , yup, hide and watch, you will be amazed at what you find about the knowledge you have stored up in your head about all this down the road.

    I dont have to deal with Vit K, but it sure sounds like lots to keep up with.

    You take good care of yourself while taking care of Joe, and thanks for keeping us all up on whats going on.

    Love you both, Pati

    • Message In A Fold

      I’m on “information overload” right now. There is so much I have to keep track of. Joe went to see his kidney doctor yesterday and NOW I have to watch his Potassium intake. As if Vitamin K wasn’t enough!

      Guess a person has to do what they have to do to take care of their loved ones. Sheesh, I just want to go cover my head in the sand 😦 At least Joe is doing well and I hope he continues.

      Thanks Sis for your encouragement and your support. It means the world to me.

      Love you Sis

  • Bradley Lisser

    Can I simply say what a comfort to uncover someone who actually understands what they’re talking about over the internet. You definitely understand how to bring a problem to light and make it important. More and more people must read this and understand this side of your story. It’s surprising you are not more popular since you certainly have the gift.

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s

%d bloggers like this: