5.7 How did that happen? Help !

[Karlynn]

Ann, QAS will require an Rx from your doctor (and your insurance may too, mine doesn't). The doctor will need to state a reason for home testing for your insurance company. Something along the lines of - INR hard to manage, must test frequently - or some such thing would probably work. (It did for me!)

QAS is the only company right now that I know definitly sells the machines outright. Raytel told me they no longer do that. They just offer their testing program where you rent the machine, buy the supplies and call in your INR weekly to them.

Right now you only have 2 choices in machines in the US, ProTime or INRatio. The INRatio is the new, smaller machine. It's strips don't require refrigeration. I'm in the process of replacing my ProTime (in need of refurbishment after 4 years) with an INRatio. The results of my ProTime have been accurate, but I've always had battery issues with it. Plus it's twice the size of the INRatio and it's test strips (or "cuvettes" as they are called) require refrigeration, but can be out of the refrigerator for 30 days.

Don't feel silly about being concerned about whether you should go out with Tim's INR being high. You are new to this stuff, there's lots of misinformation around, and it takes a while to adjust to the whole thing. You're doing fine. The most comfortable I've felt with being on Coumadin is the last 3 years here. This is the best site to learn how to live well with Coumadin. We are so blessed to have Al around to guide us.

 

[Ross]

If I had a dime for every piece of misinformation on Coumadin I've seen come through here in the last 4 years, I'd be a very rich man. It's absolutely mind boggling at the garbage people are told.

Ann here is the link to downloadable forms that you'll need to get the wheels turning on your Hemosense INRatio Machine:

http://www.ptinratio.com/patient_how_to_get.asp

 

[geebee]

Most insurance companies require an additional reason for home testing than just (JUST ) a mechanical valve. When my doctor filled out my prescription, he mentioned the mechanical valve, the fact that I need to test weekly (I didn't always need to but, if my dosage changed, I did), and my traveling because, at the time, I was traveling a lot for business. Finding a lab on the road was a pain and going to an ER for a blood test is overkill.
When I first started the research for a home monitor, I was on Cobra with UHC. UHC approved the purchase but took a little while. In the meantime, my Cobra ran out and I started with Anthem BC/BS. QAS resubmitted all the paperwork to Anthem and they approved it as well.
I have had my INRatio machine for almost 2 years. It is wonderful. The only current hiccup is my test strips fall under the new deductible my company started to keep premium prices down. Since I haven't used all of my deductible for 2005 or 2006 (yet), I am paying for test strips out of pocket. Therefore I now only test every couple of weeks.
Hope things work out for you getting a tester.

 

[Guest]

I'm giving a talk to a group of Nurse Practitioners and Physician Assistants Tuesday, "Don't Eat Green Jelly Beans and other ridiculous pieces of warfarin-related advice". It should be fun, I know a lot of them already.

 

[Ross]

I'm giving a talk to a group of Nurse Practitioners and Physician Assistants Tuesday, "Don't Eat Green Jelly Beans and other ridiculous pieces of warfarin-related advice". It should be fun, I know a lot of them already.

I wish you'd tape it and convert to a mp3 and let us sit in on it.

 

[Guest]

I'm not that technologically advanced.

 

[Sherry]

Sherry, did you retest when you got the 6.7? Was it a venous draw or a finger stick? I'm suspecting that it could have been a bogus test. What had your previous INRs been?

Karlynn, actually, that was the second finger stick: the first was higher. I don't know, I'm so frustrated by the whole thing. The second check, Thursday morning when I had my TEE done, was a standard lab draw, which gave me the 1.6. Hopefully, Monday will yield a better result.

 

[Karlynn]

I'm not that technologically advanced.

Can you post the text of your talk on your web site?????? Pretty please???

 

[Guest]

I'm not that technologically advanced.

However, it is taken from the stuff on my webpage http://warfarinfo.com/outrageous.htm
so you can get the idea by looking there.

 

[Ann]

Tim went in yesterday for his Protime draw. They called in PM to say it was a short draw?? they wanted him to come in today. The coumadin clinic pharmacist got quite huffy with Tim when he told them he did not discontinue the coumadin for three days. Even told him if he is not going to do as they direct they will discontinue providing his coumadin. Yeh right.

Today he went back in, had them draw two vials just to be on the safe side. It came back at 2.2. Thank you all for your help. Just imagine where his number would have been if he had skipped three day. Now, they want him to take 7.5 a day for the next week then retest.

Thank you Ross for the link. We are working on that as quickly as possible.

Sherry, how are you doing?

Ann

 

[Sherry]

Hi, Ann. I'm glad to hear he trusted his instincts and didn't hold three doses. That's just bad advice on the part of that clinic nurse to ask him to do that --definitely not standard.

My nurse gave me some sample ones and twos, so I'm playing around with six and seven mg. doses per day (rather than 7.5) to try to inch my INR back to a consistent range. It's been really wacky here lately. After five days of that, I tested 2.8 the other day, so I'm going to keep my fingers crossed.

 

[Ross]

Short draw--They botched the test. Didn't have enough sample in the vial.

Let that Coumadin person get huffy and the next time they say something so stupid about discontinuing the drug, tell them sure, and when he strokes out, you'll see that persons butt in court. Same could be said for telling you to hold for 3 days as that would certainly have put him in danger. Sorry, but I get very irrate with these ones that think they know what their doing and are more lost then anyone else.

 

[Karlynn]

I'm glad he's at 2.2.

Make sure Tim is keeping a record of his dosing and INR test. Until he can home test, he'll have a record to shove up, er I mean, show the pharmacist or nurse that their advice is irresponsible. Also have him make notes on the chart like "held dose for 1 day, continued at...."

Some people do understand. The nurse I worked with at BC/BS in getting my approval for a new machine was like "Of course you would want to home test." and "Of course you know how to dose..., look how long you've been on the drug."

 

[catwoman]

I'm giving a talk to a group of Nurse Practitioners and Physician Assistants Tuesday, "Don't Eat Green Jelly Beans and other ridiculous pieces of warfarin-related advice". It should be fun, I know a lot of them already.

Al:

Which have a higher INR value: lime-flavored jelly beans, green apple jelly beans or jalapeno ones?

 

[Guest]

Living in Pueblo where they put jalapenos in their breakfast oatmeal, it is probably that flavor.