Coughed and split blood, I am ALS patient, on medicine, oxygen, warfarin 5.5mg, INR done. Recommendations?
Patient: This morning I coughed up a small amount of blood,i'm an A L S patient , on a number of medicines,also on oxygen 24 hours a day at 4.5 liters.  i'm on warafin 5.5 mg a day,checked my INR today which is 1.9. informed my family doctor and waiting for a return call. yesterday morning and the afternoon I coughed and spit up blood.  I'm not able to walk.Could I possible have a blood clot forming the warafin is breaking it up? Doctor: Hi,Thank you for posting your query.Yes, the most likely cause of coughing small amounts of blood in your cases, could be warfarin-related. Warfarin makes the blood thin, which results in bleeding at times. The reason for your warfarin use in not clear from your description. The dose of warfarin depends on the indication for using warfarin.I feel the dose may have to be reduced for a few days, after which you should recheck the PT, INR; and then adjust the dose of warfarin appropriately.I hope it helps.Please get back if you require any additional information.Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,My personal URL on this website:  http://bit.ly/Dr-Sudhir-kumar My blog: http://bestneurodoctor.blogspot.com/