Anti-coagulant therapy has come a long way.....

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dick0236

Eat the elephant one bite at a time
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louisville, KY USA
A dozen, or more, years ago my Cardiologist would not permit home INR testing. It is a large 20+ cardiologist group. Now they not only permit home testing they have opened a "drive-thru" where you drive up and stick your finger out of your car window and they stick your finger......and off you go.....ain't technology wunnerfull! LOL.
 
that's fantastic news.

I look forward to reading next:
  • how a large group of cardiologists are behind the 20 year old established best practice of management of bridging therapy
  • how a large group of cardiologists are pushing proper education about self management and support training for it in the same way that diabetics are supported in self administration and dosing of insulin based on their readings from their blood glucose monitoring tools.
 
I went to my cardiologist on Friday. I was prescribed an antibiotic. I mentioned that it affects my INR. I said that I self test.

"And then you call it in to us?" I was asked.

I said 'no. I self manage. I've been doing it for more than 12 years.' I was told 'I believe you.'

Some cardiologists (and other professionals still don't believe that patients can self test and self manage.
 
I went to my cardiologist on Friday. I was prescribed an antibiotic. I mentioned that it affects my INR. I said that I self test.

"And then you call it in to us?" I was asked.

I said 'no. I self manage. I've been doing it for more than 12 years.' I was told 'I believe you.'

Some cardiologists (and other professionals still don't believe that patients can self test and self manage.
I use the lab that uses the same machine as you all. It is easier for someone else to help manange my dosing, for we do it all in the lab.
 
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I said 'no. I self manage. I've been doing it for more than 12 years.' I was told 'I believe you.'

Some cardiologists (and other professionals still don't believe that patients can self test and self manage.
My new Family doctor (saw once and won’t see again) didn’t even like it! He recommended going to Coumadin clinic, though I told him I have been doing this for 15 years!
 
My new Family doctor (saw once and won’t see again) didn’t even like it! He recommended going to Coumadin clinic
sadly so common ... even here my (old school) friend who's a pharmacist isn't in favour of self testing... you can imagine our conversations ;-)

He doesn't disagree with me doing it though.
 
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My new Family doctor (saw once and won’t see again) didn’t even like it! He recommended going to Coumadin clinic, though I told him I have been doing this for 15 years!
It has to do with the hospital and contracts with the big Pharma. And the insurance companies have a high stake in testing. I had problems with one coumadin lab and will never go there again.
 
There’s a method to get INR testing similar to glucose testing on the phone - we do not have a large enough population to warrant the investment in the protocols etc. Plus what would they do with all the test strips.
 
There’s a method to get INR testing similar to glucose testing on the phone
Is this the INR testing method using a smartphone you are referring to (uses a plastic device that connects to your phone and vibrates a single drop of blood to obtain INR)?

Micro-mechanical blood clot testing using smartphones - Nature Communications

Or are you referring to something like continuous glucose monitoring (e.g. MyFreeStyle Libra CGM) that can be placed on different parts of your body and does not require a lancet to obtain a drop of blood?
 
The paper you provided a link to was very interesting. Maybe in a few years, we'll be self testing using the adapter described in the paper, instead of our trusty meters.

Although the Coag-Sense meter was tested against the results of the XS, my tests over the last few years showed a large difference between the two meters. This study made comparisons to the Coag-Sense (which uses a testing methodology that may be more accurate than the XS, after all)

It would have been good to have also compared results with the XS, which is the standard used in much of the world.

However, this is promising -- especially in locations where testing is needed, but the cost of testing would be prohibitive (third world countries, for example). If it could be made even easier to use (and this is already pretty simple), perhaps we'll be seeing a system based on this some time in the nearish future if another company tries to bury it to maintain their competitive edges (I'm not naming any specific company here, and there are a handful of companies already selling home testing products and, of course, NONE of these would try to block this type of product, would they?)
 
interesting ... and what's more interesting than the method is how the bloody hell they connected it up to the smartphone without putting the drop directly on the phone mixed with reagent. Do they use the phone vibrator (the one used for silent alerting you of a call) or something that plugs in?

1690575778283.png

(and why is it black?)

going back to that article, everyone except clinics and the medical clinicians seems to get this:

Time spent in the therapeutic window benefits patients with non-valvular atrial fibrillation on warfarin, since the risk of bleeding is five times higher with overly aggressive anticoagulation and the risk of ischemic events is three times higher with insufficient anticoagulation compared to levels in the therapeutic range

but again, apparently us valvers don't exist.

¯\_(ツ)_/¯
 
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