Dr. Leitch and I are still working to arrive at a Coumadin dose that will keep my INR in the 2.5 to 3.0 range. Today my dose increased from 3.5 mg to 4.5 mg, yesterday's INR was 1.5. I am wondering if my body is fighting to keep my INR down, that even as my dosage increases, it fights harder to stay down. I had INRs of 3.3 and 3.2 on consecutive days on 4.0 mg. Now on nearly the same dose, I am down at 1.5. We will continue working at raising my INR through increased Coumadin doses.
I stopped taking Morphine right after my last post on June 21st. I had another seizure on June 30th. My neurologist Dr. Fiol and I believe that the major contributing factor was the decrease in my use of Morphine or that I wasn't taking any at all that lead to my last seizure and the winter seizures as well. My pain manager Dr. Schakel put me back on Morphine, 30 mg three times daily, but we are tapering my current use down at a MUCH slower rate. Last fall it was a 15 mg taper twice weekly. Now it will be a 15 mg decrease every 2-3 weeks. I will still be taking Morphine, just at a lower dose, maybe 45 mg total daily.
During the week or so I was off Morphine, some of my major side effects ceased: I could urinate without stream interruption, my constipation went away, and I could ejaculate for the first time since August. I was like a new man! That was a huge boost to my self esteem and mood in general. My overall outlook on life improved dramatically.
Once I started taking it again, the side effects came right back. We are hopeful that the decreased dose will minimize the side effects so I can be that confident man again. I will be working closely with Dr. Schakel to get a workable plan not only for pain management, but also managing the side effects. I am no longer willing to live with these to the degree with which I have been.
