Anticoag home testing chart

[Heidi511]

Does anyone know of a chart to help manage your own Coumadin levels? I just received a call from my doctor's office telling me that I cannot manage my own Coumadin because of some "legal reason." I have a Hemosense PT/INR testing monitor that I have been using for 4 months or so now. My insurance company just approved doctors to charge for Coumadin management, so now I am supposed to check my level then make a phone call to the Coumadin lab for which I later receive a bill for $20. That $20 phone call is for them to tell me, "Keep everything the same; test again in two weeks." (And then another bill for $20 two weeks later). I think NOT. I'm planning to be on Coumadin for a long, long time and do not want to be held hostage by my MD's office.

Is anyone else encountering this ridiculous problem?

 

[geebee]

Heidi,

Visit Al's website via this link. Halfway down the page is a Dosing Algorithms chart you can purchase.

http://www.warfarinfo.com/publications.htm

 

[Bina]

Heidi, I also had some legal issues with blood draws and coumadin management.
I had surgery in quebec and wanted to have bloods done in quebec with my Quebec doctor, but the hospital told me since I live in Ontario it was subject to some kind of legality problem between the provinces.
My local Ontario doc agreed to take on my coumadin management but there is never any charge.

Mind you I just found out that my husband's retiree insurance does not cover my new machine....crap. I will try to claim it on my income tax next March.

 

[Blanche]

Heidi:
Al Lodwick's chart is an excellent tool that will help you in dealing with anticoagulation. But, even if you are regulating your own Coumadin, you will still have to have a doctor to prescribe your medications. It does not sound like your current doctor would be agreeable to this. You may well have to change doctors.
Regards,
Blanche

Would you mind telling us where you are located? I don't believe that this is against the law in the US.

 

[Ross]

Make them site the specific law that you are breaking by dosing yourself. There is none that I know of, therefor find a new doctor or force him to play ball.

 

[Kathleen]

I had the same issue with the doctor I was seeing. I took the sensible route and found a new doctor. I asked the former to explain the legal ramifications and actually show me in writing. I told him I worked for a group of attorneys that I had talked to about any issues and in their combined 5 brains could not come up with any that would he viable. I have taken coumadin for 22 years and feel I know my body better than any voice on the phone reading something from a piece of paper. I assume the legal issues would be the same for a diabetic patient using insulin. I did also ask the former doctor if I would die faster from a bleed or insulin shock. I left the hospital 22 years ago taking 2.5 mgs per day and now take 3.0 mgs per day. I also think they should open the range up so people would not yoyo so. I never change if an INR is 2.0-5.0. It will always swing back and forth because your life changes from day to day.
Kathleen

 

[Hank]

What a Croc!

What a Croc!

Email Lance at QAS and tell himyou want to get enrolled in their PPM service. This service lets you phone in your results and then also sends a report to your doctor. It also phones you and reminds you when your next test is due.

Ask him about your issue and see what he can do for you.

[email protected]

Hank

 

[geebee]

How very sad that they do not want you to be safer. Right now I am "coming down" from an INR of 6.4. I expected my INR to climb because I was on a Medrol dosepack but, despite cutting back on my coumadin dose, my INR still got too high. If I were not home testing, I probably would not have found out in time to make a change quickly. Granted my INR would have come back down because of stopping the Medrol but I could have had an issue in the meantime.

Home testing can actually cause less chance for the doctor to have a patient who has problems with coumadin. However, if it were me, this doctor would be history because I would never know what other medical issues he is not up to date on.

 

[catwoman]

Heidi:
Perhaps your doctor is concerned that, should something happen to you as a result of your adjusting your own dose, you would sue the heck outta him/her. Perhaps he/she has been advised by an insurance carrier not to allow patients to adjust their own dosages.

HOWEVER --

1. Do get a copy of Al Lodwick's dosing chart and show it to your doctor. I showed my family physician the chart. He has only 3 patients with home tester machines and we adjust our own dosages (one of the other two is an M.D.). I've checked adjustments he has made in my husband's warfarin dosages, and they're about the same per Al Lodwick's chart.

2. Does your doctor have any patients who have diabetes? Are they educated on factors affecting their insulin needs and how to adjust their dosages? (This is food for thought!)

3. If all else fails, shop for a new doctor. There's got to be one amenable to your home testing and adjusting your own Rx.
After all, it's NOT really rocket science, if you have a chart. Even then, there's a heckuvalot of medical professionals who miss the boat on "managing" anticoagulation therapy. (See a separate post under Anticoagulation Forum.)

 

[TrophyWife]

Sorry to come into this thread late -
I have Hemosense INR machine. Federal BC --
PM me and let's discuss!