Did I take my medication?

Did I take my medication

I have never been good at taking – or more like remembering to take – my medications. As you know, it is imperative for individuals receiving anticoagulation therapy to take their blood thinning medication on a daily basis. An anticoagulant helps your body control how fast your blood clots; therefore, it prevents clots from forming inside your arteries, veins or heart during certain medical conditions. If you have a blood clot, an anticoagulant may prevent the clot from getting larger. It also may prevent a piece of the clot from breaking off and traveling to your lungs, brain or heart. It is important to note, the anticoagulant medication does not dissolve the blood clot. With time, however, this clot may dissolve on its own. Dosages for warfarin (or Coumadin), a common anticoagulant drug, ordinarily range from 1 mg to 10 mg once daily (Source). The doctor will prescribe one strength and change the dose as needed (your dose may be adjusted with each INR result). Not only is it hard to remember to take medications, especially if you are not used to it, but it can be even more complicated if dosages vary day to day or change periodically. It is no surprise that people taking anticoagulants may often wonder, did I take my medication? Read on to discover my top tips for keeping track of yours.

OatBook
OATBook reminder

Did I take my medication? Not yet!

The OATBook is a mobile phone app that helps you track, monitor and store your complete INR history in one place; keep your dosage times consistent and never miss a dose; and stores your appointments and reminders. It makes managing your warfarin easy! I literally could not manage my INR/medication without it and it has become a crucial part of my Oral Anticoagulation Therapy, as the name OATBook suggests. The OATBook took a little time for me to get used to, but once I did, I quickly found it was essential to managing my warfarin dosages, INR levels and blood draws. Plus, it lets me know via an alarm when to take my medication daily (11:32 p.m.) and will continue to go off until I check that I have done it. It also reminds me when I need to get a prescription refill. It costs between $1.99 and $2.99 and is only available for iPhone presently. You can find it HERE. Also, be sure to read my full OATBook review and see more screenshots of the app.

Pillbox
2-weekly-pill-box-photo-researchers-inc

Easy to refill, easy to remember.

I use a pillbox in conjunction with OATbook. My phone tells me when to go take my medication via the app and the pillbox ensures that I actually did it if there is ever a question later (i.e. right after I go to bed and I get back up thinking did I take my medication? The pillbox is very inexpensive (I’ve seen them for a $1 at the dollar store!) and can be found at any drugstore, pharmacy or grocery store. It’s also great if you are going to be away for a few days, you can just take the box with you and not have to worry about carting around your pill bottles. I fill up my pillbox at the beginning of each week (depending on my dosages from the doctor) and am good to go until the next blood draw.

Smartphone Calendar/Alarm/Reminder
smartphones_rect

Essential? Maybe so!

According to forbes.com, more than half of us have a smartphone nowadays. Why not use yours to keep track of your medication? Use your calendar, notepad, reminders, or alarm clock to note when and how much medication to take. You could also set an alarm on your watch. Whatever works for you – works!

Traditional Calendar/Notebook
pen and paper

There’s nothing quite like it…

Write it down – the old fashioned way. Check it off in your calendar, include it in your daily reflections, add it to your To-Do list or put a post-it on your bathroom mirror.

Share your story. How do you remember to take your medication? Do you have any great tips to share? Do you struggle to remember to take your blood thinners?

There is hope for healing and you are not alone,

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How to track and manage your INR with OATBook

OATBook Review Title Photo

I left the hospital after a total of ten days, five of which were spent in the cardiac intensive care unit (ICU) after my DVT and PE. I wasn’t even sure what happened to me – although I had a vague idea that I was lucky to be alive from what I kept hearing – and was even less sure of what would happen next. I left on Arixtra injections, a cousin to Lovenox anticoagulant medication, only with less clinical research available and non-reversible if I were to be in an accident and have uncontrolled bleeding. I don’t think I even knew what that mean beyond, “Don’t get in an accident.” I heard the injection, which I was prepared to administer myself, but not prepared for the increasing difficulty of it, would keep my INR stable. ‘INR’ was completely new to me and something I hoped would go away in a week or two.  What is INR and how can you manage your INR with OATBook?

INR stands for international normalized ratio. The INR provides some information about a person’s blood’s tendency to clot (which is often described as how “thin” or “thick” their blood is). There are several scientific factors as to why and how this number is evaluated to be as reliable as possible. A normal INR is approximately 1.0. People taking the blood thinner warfarin (oral) typically have a target INR of 2.0 to 3.0, although it all depends on your body and what you and your doctor have discussed. People with an INR higher than the normal range who aren’t taking warfarin may have a medical condition that needs further evaluation. A low INR is rarely significant.

Injections (such as Arixtra or Lovenox), while extremely expensive (I was looking at $2,300 before my deductible for 20 injections), are often easier to regulate in terms of INR as long as you are able to give yourself an injection at the same time each day, which I was. When taking an oral anticoagulant such as warfarin (Coumadin), a patient usually has to have weekly blood draws (at least in the beginning) to monitor INR.

I was on those injections for ten months as a result of my INR’s inability to stabilize, making it increasingly difficult for my body to transition to an oral anticoagulant such as warfarin. When my doctor did try to switch me to the warfarin, I became immensely confused with all of the different dosages and blood draws – not to mention remembering to take my pill – in part because I was also battling slight loss of cognitive function and memory as a result of my illness and trauma. While I was told this was a normal side effect, it was difficult because when the nurse called to give me my dosages for the week, they literally went in one ear and out the other before I even had a chance to write them down. So, I would guess (and get it wrong) and my INR suffered greatly in terms of highs and lows, forcing me to go back on the injection each time.

I came off the injection again at the beginning of April of this year and have remained mostly stable since then. Warfarin is more practical for many because it is cheaper, has been a part of long-term safety and side effects research and is much easier to administer. People have been on it for life and have done okay, if not well – people have not been on Arixtra for life to date. It is reversible if I were to be severely hurt or injured, which takes a big worry off my mind.

What’s different this time? Well, it is true that my cognitive abilities and memory have grown much stronger, and I am better now than I was ten, six or even three months ago, but the transition to oral anticoagulation therapy would not have been possible this time without the OATBook. The OATBook is a mobile phone app that helps you track, monitor and store your complete INR history in one place; keep your dosage times consistent and never miss a dose; and stores your appointments and reminders.

I literally could not manage my INR without it and it has become a crucial part of my Oral Anticoagulation Therapy, as the name OATBook suggests.

The OATBook took a little time for me to get used to, but once I did, I quickly found it was essential to managing my warfarin dosages, INR levels and blood draws. Plus, it lets me know via an alarm when to take my medication daily (11:32 p.m.) and will continue to go off until I check that I have done it. It also reminds me when I need to get a prescription refill-

SS medication is almost out on home screen

It is invaluable to me that I can also set a reminder to get my INR checked (I have a standing order at the hospital clinic so I choose when I want to go, as long as it is the same time each week) and the app charts my levels-

SS graph of INR range

I can also send or save it if I need to take it to a doctor (who is not my hematologist)-

SS email your graph

You can see, for May 1, how I got my INR checked, had an appointment and checked off that I took my pill that night-

SS options screen with notes, meds, inr

You can customize OATBook to remember the important things like what your therapeutic INR level is and there is also a place on each day to record notes-

SS settings where you can set your INR range

If you are are like me and your dosage changes daily, you can set each day to be different in OATBook or you can have it auto-fill the same dosage each day for the month-

SS entering your dosage

 

You can download OATBook for iPhone and you can also find a user guide and answers to frequently asked questions. I found the customer service was very helpful and prompt when I didn’t realize you swipe right to left on the days to make the options appear (it took a minute to get used to, but I have no problems now).

Share your story. How do you keep track of your INR? Was it or is it a struggle for you? Have you heard of or used OATBook?

In healing there is hope and you are not alone,