Stomach Bug

I had a bit of a stomach bug which included some Diarrhea - not terrible by any means, just a bit.

My warfarin was an obvious concern, so i monitored it every couple of days.  Everything seemed OK, and I fully recovered.  I then tested 2 days later and it had plummeted to the lowest ever - 1.8.

I was very concerned about this, and was considering going to hospital to get some Heparin cover whilst the warfarin was inaffective, but decided against.  It was only a little under acceptable, so i decided to take a high dose instead.  I took 9.0 and topped it up with 2.0 the next morning, effectively an 11.0 dose.

By the next day it had climbed to 2.1, then 2 days later to 2.8.  Back under control, thank goodness.

Here are the results and doses:

Amoxicillin for 7 days

I had previously cut my finger quite badly, with a flap of skin.  I'd done the usual, including antiseptic clean, but unfortunately a few days after it properly healed it started really hurting.  It then started to swell and get bigger.  I ended up seeing the doctor who diagnosed Cellulitis in the finger, and put me on a 7 day course of Amoxicillin Antibiotics.

Due to previous dental experiences of antibiotics, I was aware of its ability to lower the INR.  I jacked my usual average dose of around 7.5 up to 8.5 or even 9.0 and managed to keep my INR just about in range, but right at the bottom of the acceptable level.

Here are the results and doses:

Holidays and Timezone Changes

I always test and dose at 9pm every day.  Going on holiday or business trips has enough capacity to disrupt warfarin without forgetting a dose, so I decided to timezone adjust my dose to keep it at 9pm.

On this occasion I'm going to Bangkok, and i'm taking something around 8mg daily.  Bangkok is 7 hours ahead of home, so I worked out my dose assuming 8mg is over 24 hours like this:

8/24 = 0.333  x 17 = 5.66.  So I need a 5.6 dose instead of 8.

Then when I return I do the opposite:

8/24 = 0.333  x 31 = 10.3.  So I need a 10.3 dose instead of 8.

Here's an example, results and doses: