I'm concerned about Dad's Warfrin dose. Any advice?

ok well I will mention it but I wont worry..Thank you for all the help I feel way better now.

Don't play games with warfarin. If it is coming up, even slowly, let the MD handle it. Once you tip the balance and it is out of control, bruising, nosebleeds and brain hemorrhage occur and can kill.

Under the circumstances, why don't you simply ask the clinic why they didn't do this time what they've done in the past? Seems like a reasonable question to me.

Is your FIL at risk for falling? For my husband the wafarin question eventually became which is the greater risk ... a stroke, or a brain bleed from a fall? We stopped the wafarin in what turned out to be his last year.

I actually attend his appointments at this point. I go in and give updates weekly to the doctor and he comes by the house once a month. I'm his medical representative and have full knowledge of everything that goes on with any nurse/doc involved in his care. In fact right now I have more say then my FIL by his choice.

Babalou the office called me directly didnt speak to dad at all about it so know this to be fact. but in the past they would always give him a bit more...there was talk with dad about backing off or even stopping his medication as part of his end of life care and maybe thats why but we didnt make that choice yet

As Jeanne asks, were YOU at this appointment, or was this reported to you? Does FIL self test or go to a lab? What are his general written instructions about what action to take at what INR level? When is his next test?

If you don't trust what the doctor is doing, find another doctor.

At our clinic there is a nurse who does the INR testing and dosage adjustments. After the initial script the doctor doesn't get involved unless the nurse decides to consult him. This works ideally, in my opinion. The nurse has in-depth knowledge of adjustments and diet and dosage and isn't responsible for hundreds of other things for each patient.

I think it would be OK to say something like, "Oh, with that reading I sort of expected to need a higher dose for a few days. Isn't that how it works?" assuming you attend your FIL's appointments. This would give you another chance to judge his competency.