Medical Question

[jrw247emt]

We are sailing on the Miracle on March 28th. DH developed a blood clot in his leg last week and has been placed on the blood thinner Coumadin. Although he has been cleared to travel we were advised that he will need to have his INR checked while we are gone. I believe the ships infirmary has the ability to test his INR (from what I have read by searching the forums). Does anyone have any experience with this or any info regarding this? What about the cost of this service? Any help would greatly be appreciated.

[Ken076]

We are sailing on the Miracle on March 28th. DH developed a blood clot in his leg last week and has been placed on the blood thinner Coumadin. Although he has been cleared to travel we were advised that he will need to have his INR checked while we are gone. I believe the ships infirmary has the ability to test his INR (from what I have read by searching the forums). Does anyone have any experience with this or any info regarding this? What about the cost of this service? Any help would greatly be appreciated.

 

Try this contact:

 

Upon booking the cruise, guests who have special needs are required to contact Carnival’s Special Needs Desk (305-599-2600 ext. 70025) to discuss the details of their special needs. Carnival reserves the right to require that any Guest, who is not self-sufficient, travel with a companion who shall take responsibility for any assistance needed during the voyage and in case of emergency.

ken

[cb at sea]

Any way to check it before you leave, then when you return? Ask your doctor!!!!

[jrw247emt]

Any way to check it before you leave, then when you return? Ask your doctor!!!!

They will check it before we leave, however, it has to be checked every 2-3 days for a while until he gets and stays within the theraputic range. It is a very easy test to do. The machine that is used to test it is similar to the devices diabetics use to monitor their glucose.

[conchead]

They will check it before we leave, however, it has to be checked every 2-3 days for a while until he gets and stays within the theraputic range. It is a very easy test to do. The machine that is used to test it is similar to the devices diabetics use to monitor their glucose.

 

Doesn't the Dr use the INR results to let him know how to adjust the dosage?

Who would be telling him what adjustment to make?

[DaDivaMom]

Call special services if they are unable to meet your needs try to book an appointment in one of the ports. There are often ex-pat doctors available on many of the islands.

[skylock]

Doesn't the Dr use the INR results to let him know how to adjust the dosage?

Who would be telling him what adjustment to make?

 

Very valid question. They would need to phone the results to his doctor for any adjustments needed.

[Essiesmom]

Just remember, while he is on Coumadin, he shouldn't eat green vegetables...They contain vitamin K, which is the antidote to Coumadin...EM

[jrw247emt]

Doesn't the Dr use the INR results to let him know how to adjust the dosage?

Who would be telling him what adjustment to make?

Yes, the INR is used to evaluate and adjust the dosage if needed. Contacting the Doctor will not be an issue as we can call, fax and even email the test results. Just need to insure there is somewhere/some way to have the test done.

[Trplnckl]

IMO, you need to call the special needs dept as suggested earlier. I would want a definitive plan in place well before getting on the boat.

[billnye97]

IMO, you need to call the special needs dept as suggested earlier. I would want a definitive plan in place well before getting on the boat.

 

That is good advice and good luck both with the cruise and getting into a good therapeutic range.

[niagaracris]

Ask your Doctor for a Coumadin Protocol. This is a range of what dose to give based on your INR. We use the Protocol at work so we do not need to call the Physician for every change in dose. Also....I have never heard the green leafy vegetables r/t Vitamin K. You would have to eat a truckload to affect your blood level. Have fun on your cruise...and enjoy!:o

[jrw247emt]

Ask your Doctor for a Coumadin Protocol. This is a range of what dose to give based on your INR. We use the Protocol at work so we do not need to call the Physician for every change in dose. Also....I have never heard the green leafy vegetables r/t Vitamin K. You would have to eat a truckload to affect your blood level. Have fun on your cruise...and enjoy!:o

Indeed the special needs department did help me. He can have his INR checked on board. Asking his doc for the protocol is an excellent idea. Thanks to all for your help and advice. Now I can relax a little and start packing. Only a few more days!!!

[Tenga1899]

Best of luck! Glad you got that worked out for you. :)

[Tenga1899]

Just remember, while he is on Coumadin, he shouldn't eat green vegetables...They contain vitamin K, which is the antidote to Coumadin...EM

 

As well, avoid alcohol as it affects drug metabolism and the INR values. Vitamin E and Cranberry juice could increase the drug's effects, Vitamin K will decrease it's effects. And herbal supplements are all over the board on how they affect the drug's levels and such, I'd avoid supplements and alcohol while you are on the cruise and so far removed from your physician. :)

 

This is direct quote from Up-to-Date which is a resource we have access to here in school that is supposed to represent the most recent medical literature on various drugs and medical conditions:

 

"Dietary Considerations: Foods high in vitamin K (eg, beef liver, pork liver, green tea, and leafy green vegetables) inhibit anticoagulant effect. Do not change dietary habits once stabilized on warfarin therapy. A balanced diet with a consistent intake of vitamin K is essential. Avoid large amounts of alfalfa, asparagus, broccoli, Brussels sprouts, cabbage, cauliflower, green teas, kale, lettuce, spinach, turnip greens, and watercress; decreased efficacy of warfarin. It is recommended that the diet contain a CONSISTENT vitamin K content of 70-140 mcg/day. Check with healthcare provider before changing diet."