I am a 77 year-old heart patient with a mechanical artificial valve, on Coumadin for 19 years now. An RN at a hospital monitors my INR levels once in 1 or 2 weeks, and asks me to adjust the Coumadin dose. In the past, if my INR level went low, she was asking me to increase the Coumadin dosage on the following day of of the result. Now, she has started asking me to spread the increase over 5 days of the following week. I am finding it difficult now to stick to this schedule of taking different dosage every day, and I am making mistakes. Is this spreading over really necessary and effective, and recommended by you?