Hi @jmac23. Glad to know of your most recent medication concern. I've been on Coumadin for several years with varying dosages, most in the same range as yours. My doctor mixed 5.0 and 7.5 dosages (and 0.0 once after my INR doubled unexpectedly) over the week to take account of variables in my diet and in missing doses or in carelessly taking the wrong dose on a day. Coumadin is sensitive about Vitamin K nutrients because that vitamin is the prime antidote for Coumadin, and since so many foods have Vitamin K, they can affect your day to day INR and put you at risk of a blood clot (when the INR is dropped too low) or an unexpected bleed (when INR runs up too high). I've had both problems. Three years ago I experienced a small stroke from a small blood clot formed by A-fib when my INR dropped too low. Too weeks ago I got a large bleed just under the skin on my forearm when my INR rose unexpectedly from too many vegetables with Vitamin K in them. In both cases, I was grateful that my HMO provided help in managing my Coumadin dosages as well as readily available lab tests to help identify problems caused by the variations mentioned above. The "bruise" from my recent bleed cleared up a few days ago; all the subcutaneous blood that had escaped from a superficial vein was absorbed and disappeared.

In the rare times of INR changes, lab tests and dosage changes can be inconvenient, but they also keep me focused on what I have to do, how I have to eat, what I have to do to avoid injury, and how to respond if I ever again have a stroke (CALL 911). That kind of definitive focus keeps me out of trouble. I also appreciate my medical team's protocols -- doctors who explain what's going on, answer my questions fully, and accept me as a partner in my therapy as well as a PhD pharmacist who knows how to manage my anticoagulant and its antidote and who calls me within a few hours of my lab tests to discuss what I think caused my INR to change or remain stable. All of that said, I have no intention of abandoning Coumadin and switching to another drug. Martin