Anticoagulation Patient Self-Testing Consensus Guidelines Published

[sharky7]

Is there such a thing as too many.......

Is there such a thing as too many.......

The task of organizing and dealing with information, in this information society, is a task that I have no idea how to handle.

Sure would like some advice from those folks who know how to categorize and record these kinds of things.

Until that is forth coming, I will keep my little...or not so little...favorites at my hand. I suppose that that means we have to be our own IR folks....

Blanche

OUR OWN IR? i dont understand. I, 68yr old male, JUNE/2015-I own and am using a St.Jude Mitral valve, and recently purchased a brand new machine and now i am also self testing. I am right now at 3.5, and eating salads so I need to make sure i am 2.5-3.5, know what I mean. I have owned it now for a month or so, and now i test when i feel i need to, and am also, i think, tracking my INR much better. here is the machine i bought, it was a bit pricey, but i think i got a good deal, a tad over $500USD!
BUT those test strips are, i think, expensive. Is there a source for them online cheaper than EBAY has anyone found? i think that i am paying about $5-7usd per strip, is that about right, what are you paying for them???
I am in SOUTH FLORIDA!
I have my heart doctor currently at the VA, now what happen with the testing with the VA, i tested the same day at the VA TEST, my at home INR test was 3.5, and the VA came back 3.2.....is that about right, or what....DOES ANYONE KNOW?

{{at first the testing was hard, but i figured ot out fast enough, and now have no problem at all, is there others that are having problems testing at home? anything little or big problems, i would like to hear them.}}

 

[sharky7]

Many thanks for the updated link. It is now downloaded and I will give it to my doctor and Coumadin Clinic. They have me on self testing but do not really like it.
Walk in His Peace,
Scribe With a Stylus

Do not understand, what is it about self testing that you dont really like? and which machine do you own, or are they renting it to you? and where and how much are test strip for you, if ya dont mind me asking.>>>>this is what i own, NEW for a tad over $500USD<<<i find it not too bad, although sometimes that little prick does hurt.....LOL

 

[pellicle]

, my at home INR test was 3.5, and the VA came back 3.2.....is that about right, or what....DOES ANYONE KNOW?

we do ... and its been discussed here a fair bit actually. Bottom line is that (leaving aside the issues of their reagents, your testing method and the known variances) this is not a clinically significant value. Meaning that 0.3INR units makes no significant difference to your response.

 

[sharky7]

we do ... and its been discussed here a fair bit actually. Bottom line is that (leaving aside the issues of their reagents, your testing method and the known variances) this is not a clinically significant value. Meaning that 0.3INR units makes no significant difference to your response.

EXACTLY, this is what i was trying to get to, and have answered for those, like me are trying to figure out! thank you, i could be 0.1 over or under and some will make a big deal about it, well over in the VA that is! they seem to be under trained, i think. got to have some sort of training i would think? BUT perhaps not as much training as I would like, seems when i talk to those types, they have the BOOK that they go by, and when trying to figure out the dose I should either stay on, or change to......they be checking the stats, and the DATA in the "book". thing is with me, that darn book doesnt always cover everyone as I think it needs to, there should be something in there that also deals with us out here, as in, when we take our blood thinners, and it does its thing in days, or even hours, even though the book says ya dont see changes until at least 5-7days! I happen to know for a fact my changes show up either that next day, or 2nd day after take my dose! Today i self tested and got a 2.9.....yAAAAAA, my range is 2.5-3.5!!!! QUESTION for everyone here, is there anyone here that self tests, and is in the MIAMI FLORIDA area? 33183???

 

[tom in MO]

At 68 Medicare will cover your home testing supplies if not the VA. Medicare covered my mil machine and supplies. I am surprised the VA doesn't cover it, make sure you get all your benefits your are entitled to.

I had trouble getting a big enough drop with the SoftClix device. I now use it w/o the head and just *** it in all the way...no problem with a drop now.

My machine was free, I pay for the supplies though. I get it all through work insurance BCBS.

Testing frequency can vary depending upon the person's INR stability and the INR value. I test about every 2-3 weeks unless I need to adjust the dose. Then I test about 1/week until stable. If I take antibiotics, I test every 1-2 weeks until I am off them.

 

[pellicle]

thing is with me, that darn book doesnt always cover everyone as I think it needs to, there should be something in there that also deals with us out here

personally I think my book covers most things. However my book is written to help people who are diligent in collecting their data and are genuinely serious about taking their drugs consistently manage themselves in almost all situations.

The clinics book is written to attempt to engender fear in the patient because they think that blunt instrument will get people to do what they're told.

There is not much hard in my method but its based on this:

http://cjeastwd.blogspot.com/2015/10/managing-my-inr-example.html

and for more details
http://cjeastwd.blogspot.com/2014/09/managing-my-inr.html
Best Wishes

 

[ScribeWithALancet]

Do not understand, what is it about self testing that you dont really like? and which machine do you own, or are they renting it to you? and where and how much are test strip for you, if ya dont mind me asking.>>>>this is what i own, NEW for a tad over $500USD<<<i find it not too bad, although sometimes that little prick does hurt.....LOL

Shark7 said "... what is it about self testing that you dont really like?" Ooops, I gave you a misunderstanding. Actually, I like home testing. I test approximately once a week and have my wife help me to make sure I do it right. My INR tracks my health plan's INR tests when I check them in parallel. The statistical tracking is almost a perfect correlation.

When I first thought about statistical tracking and comparison, I looked at the internet to see if anyone had published on the subject. Sure enough, Dr. Stacey A. Johnson had published on the subject. He advises a University of Utah Anti-Coagulation clinic and has patients that have to drive over an hour to get their blood tested. He realized that this was a problem and that home test meters would help minimize it. However, he wanted accurate results and used statistics to get a strong match between the meter results and the University Medical Lab's machines. He does point out that if the patient or Lab switches types of machines or Thromboplastins that this would destroy the correlation and one would have to start over. And yes, he found out because all of the sudden his matches went away because a switch was made at the lab. However, when I communicated with him, he said his statistics were the simple Statistics 101 correlation that Microsoft Excel, Apple Numbers and Libre Office do. I set that up and verified it with both a mathematician and a biomedical engineer. They both agreed. He also noted that his patients preferred the CoagUChek because they found it easier to use. I prefer the CoagSense because I like the way it works. Pellicle likes the CoagUCheck because he can always find strips when he travels for extended periods. To each their own.

My health plan worries about legal liabilities and claims that they cannot take legal responsibility for decisions based on my own meter's readings. I preferred to purchase my Coag-Sense unit so that I do not have to report its readings to anyone other then my health plan pharmacist. Since they now have me self managing, I technically do not have to report it to them either. However, I like talking to someone else who knows as much as I do about INR testing and statistical validation. Unfortunately, that frequently means talking by posting here with Pellicle and others like him who have been self testing a long time and have a "scientific" and "statistics" background even if they are not Coumadin/Warfarin Clinic Pharmacists.

I know a biomedical engineer who originally wanted to become a doctor and said that he rarely met doctors or pharmacists who had a strong scientific or statistical background. He explained that in the crammed four years of med school it is impossible to fit the rigor of the courses in. The same is true of pharmacists but because they are crammed with fitting in four years of information on Meds. Doctors know little pharmacy and Pharmacists know little medicine and neither know much science and statistics. Dr. Stacey Johnson of the University of Utah and Dr. Paul Marik of Old Dominion University and the FLCCC being two exceptions.

I use a Thermophore hand and lower arm heating pad and almost always get enough blood on the first prick so long as I prick the 2nd to 4th fingers from my thumb on the lowest digit and on the side of the finger. (I picked up the side of the finger advice from a Diabetes Doctor as I was prediabetic). I preheat my hand on the lowest setting for two minutes, on the middle setting for two minutes and on the highest setting for two to three minutes. The blood usually flows freely except when my INR is 3.5 or above when it tends to flow faster.

I purchased my CoagSense from Wilburn Medical when it was on sale. It is made in Korea and the strips are made in California. I purchased a second unit for backup in these days of Covid and it gives identical results to the first (with +- 0.1 unit of INR)

I personally like the way it works. Since the CoagSense is statistically indistinguishable from my health plan's system, they should like it too. However, lawyers can sometimes confuse matters. I track my INR with a spreadsheet but usually do not plot in on a graph as the CoagSense meter can do graphing and I can read the numbers on the spreadsheet to look at trends. I also track my carbohydrate, K1 and K2 food consumption on a separate spreadsheet to keep them at a constant intake. I make very small adjustments in my Coumadin - on the order of 1 / 4 th of a mg per day when I see a trend downward or upward. This usually is enough for me to stay in range. I try not to obsess about it and have usually been in my very safe range of 2.5 to 3.5 and almost always in the safe range between 2.0 and 4.0. (See Pellicle's reference on safety and number of incidents at different INR ranges. A beautiful U shaped curve ! - )

The one time I went above 4.5 was because I took a "safe" medicine of Tylenol and got a call from my Coumadin Clinic that they had just found out it was NOT safe and had a journal article on it that they were going to send me. I got the phone call as I was walking OUT of my health plan's urgent care clinic with two hematomas. Perfect Timing : - )

I have been on Coumadin since my emergency heart surgery for Congestive Heart Failure, cure, a St. Jude Mitral Valve, in 2004. I consume 300 mcg of K1 and 100 mcg of k2 (note 2 ounces of Spinach is 308 mcg of K1 hence the 300). This is to keep a constant baseline on my background K vitamins. I saw an article by a Pharmacist about how most side effects of Coumadin actuallyare side effects of Vitamin K deficiency about 15 years ago and it convinced my Coumadin Clinic Pharmacist that I should eat regular amounts of Spinach. Later, we decided to change to greens plus Vitamin K1 pills to make up the difference between the greens and the Spinach. After he left to a different job so he could be a better father, my new pharmacist opposed adding Vitamin K2 and I simply told her I was going to do it anyway so she should find me a different pharmacist.

Covid has messed me up somewhat as I have decided to add the vitamins and supplements recommended by the FL-CCC doctors who are primarily Intensive Care doctors who are also professors of Intensive Care Medicine at medical schools. Virtually everything they recommend doing to minimize the chances of getting Covid or getting hospitalized with it affects the INR. Thus, I have had to gradually adjust my Coumadin/Warfarin dosage by small increments to keep my INR in range. Unfortunately, the US president and the NIH/CDC believe there is NO evidence that Ivermectin, C, D & Zinc have any beneficial effect on Covid. The FL-CCC web site has multiple pages of references and there are dedicated pages at a couple other sites that give even more references. (I was a Traffic Operations Research Engineer in my working life and know how to read research reports and with relatives in the medical field found equivalent "How to Read a Book" reports on how to read medical research - be skeptical and look to see if they provide links to the data.) Be aware that bias in medical research extends far beyond financial bias (not to say that financial bias is not real).

In the case of Statins, Cholesterol and Health studies, they don't give access to the detailed patient data and the study. drop outs. Similarly in the case of Covid, the US CDC studiously avoids collecting data on the co-morbidities of those they vaccinate and in the case of my relatives even refused to tell them which vaccine they were being given ?!? Virginia says that the federal government does not require this data so they are not going to require it. This data is critical for me as I do not know if my two immune system disorders (in the lungs and the skin) require the vaccine(s) (or Ivermectin) or prohibit the vaccine(s). I have listened to Doctors who were involved in the development of the vaccines and came away still mystified as they had inadequate information to give informed advice and said so. At least deaths and complications from Covid are going down. (One of the doctors who helped develop the concepts for the current vaccines mentioned that he had been double vaccinated and managed to get Covid and now has Long Covid for which he is taking Ivermectin regularly to minimize the problems - NOT curing it ! )

At least with Self Testing, I have all the data and can tell somewhat from my past history where it is likely to lead.

Walk in His Peace,
Scribe With A Stylus

 

[pellicle]

I know a biomedical engineer who originally wanted to become a doctor and said that he rarely met doctors or pharmacists who had a strong scientific or statistical background.

seconded, although I would speak highly of my friend who is a pharmacist, but then he's pretty experienced and well educated

Covid has messed me up somewhat

have you had covid?

irtually everything they recommend doing to minimize the chances of getting Covid or getting hospitalized with it affects the INR

ok, to me the most effective things (from the getgo, before vaccines) were

• distancing from people (eg avoiding crowds)
• wear a mask
• hand washing before touching your face

I don't see any INR related effects there

One of the doctors who helped develop the concepts for the current vaccines mentioned that he had been double vaccinated and managed to get Covid and now has Long Covid for which he is taking Ivermectin regularly to minimize the problems

err ... do you have a refernce for that? Even a name?

US CDC studiously avoids collecting data on the co-morbidities of those they vaccinate and in the case of my relatives even refused to tell them which vaccine they were being given

goes counter to my experience. Publishing may be a different story.

this however is now working its way into best practice:

I saw an article by a Pharmacist about how most side effects of Coumadin actuallyare side effects of Vitamin K deficiency about 15 years ago and it convinced my Coumadin Clinic Pharmacist that I should eat regular amounts of Spinach

agreed eat healthy and eat greens. Also consider taking K2 suppliments of MK-7
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3502319/

 

[Ebender]

Hello
I self test bi-weekly and use the same meter pictured, and my Insurance paid for it and the test stripes, I get them shipped to my home when I am down to two/ three stripes. I report my INR to a Real Time who then reports back to my Cardi.

 

[ScribeWithALancet]

seconded, although I would speak highly of my friend who is a pharmacist, but then he's pretty experienced and well educated

## I am inserting my responses with ## at the beginning of the line. I am sorry for the verbosity but you asked serious questions deserving detailed answers.

have you had covid?

## No, but that does not mean I have not been impacted. I have 7 commorbidities
## including two separate immune system dysfunctions that leave me very vulnerable.
## These "rare disease" immune system dysfunctions mean the vaccine is
## contrindicated.
## Thus, I started research on the US National Institute of Health electronic on line
## library called Pubmed very early. I found out a lot about C, D and Zinc because I had ## been researching those because of other medical impacts they have. When I heard ## about the FLCCC doctors I paid attention because it lined up with my own internal
## research.

ok, to me the most effective things (from the getgo, before vaccines) were

• distancing from people (eg avoiding crowds)
• wear a mask
• hand washing before touching your face

I don't see any INR related effects there

## The INR related effects were from the Vitamins,Minerals & Supplements
## recommended by the FLCCC doctors and by the NIH publications. Thus, you could ## not list the "Vitamins, Minerals & Supplements" & Medicines recommended by the
## FLCCC ( Front LineCovid Critical Care) doctors who are (at least in the early stages ## Professors of Intensive Care (& indirectly emergency care) medicine at medical
## schools and most of whom are also half time Intensive Care Doctors. They learned
## by reading the research literature (and "practicing" (intensive care) medicine using it.
## High dose Vitamin C, high dose Vitamin D, and Medium dose Zinc each cut the
## admission to intensive care by about 2 / 3. In their report "

An overview of the MATH+, I-MASK+ and I-RECOVER Protocols
A Guide to the Management of COVID-19

## they discuss this in detail. Paul Marik, MD (one of the co-authors) is the 2nd most
## published research doctor in the world. Dr. Marik was one of the first to use steroids ## in treating Covid but noted that timing was critical, being too early or too late could ## be fatal. The report also goes into detail on how to use Quercetin and Melatonin
## Quercetin and Melatonin have surprisingly useful effects on Covid.

err ... do you have a refernce for that? Even a name?

## Use Google to find the report and the website and read lots AND LOTS of
## references. As mentioned above, the FLCCC doctors are primarily research doctors ## and just love publishing.

Home - FLCCC | Front Line COVID-19 Critical Care Alliance

## for evidence on Ivermectin effectiveness
https://covid19criticalcare.com/ivermectin-in-covid-19/goes counter to my experience. Publishing may be a different story.

## However, you and I are not research medical professors who actually practice
## intensive care medicine in the here and now. The FLCCC doctors now mostly
## publish on their FLCCC web site as their recommendations go against the widely
## accepted grain that only masks, social distancing and vaccines are effective.
## See a generalized biographical note on the credentials of the FLCCC doctors at:

The FLCCC Physicians - FLCCC | Front Line COVID-19 Critical Care Alliance

this however is now working its way into best practice:

## evidence for "best practice" as recommended by the FLCCC intensive care doctors-
## FLCCC and Allied Publications, see URL for links:

Essential Documents - FLCCC | Front Line COVID-19 Critical Care Alliance

## text of page follows:

MATH+ protocol for the treatment of SARS-CoV-2 infection: The scientific rationale Paul E. Marik, Pierre Kory, Joseph Varon, Jose Iglesias & G. Umberto Meduri (published in the Taylor & Francis Online, August 18, 2020).
SARS-CoV-2 organising pneumonia: ‘Has there been a widespread failure to identify and treat this prevalent condition in COVID-19?’ (published in the BMJ Open Respiratory Research, September 22, 2020).
COVID-19: A Clinician’s Perspective: A master-class comprehensive review by Dr. Paul Marik of scientific insights into the origin, replication, transmission, infectivity, pathophysiology, and treatment of COVID-19. (USA, September 25, 2020).
Information about the MATH+ protocol and the medicines used can be found in our peer-reviewed paper Clinical and Scientific Rationale for the MATH+ Hospital Treatment Protocol for COVID-19 (published in the Journal of Intensive Care Medicine, December 2020).
Our review of Ivermectin: Review of the Emerging Evidence Supporting the Use of Ivermectin in the Prophylaxis and Treatment of COVID-19 – November 2020. also see our Ivermectin in COVID-19 section.
A “Summary of the Evidence for Ivermectin in COVID-19”: FLCCC Alliance Review: Ivermectin in prevention and treatment of COVID-19.
Masks! – Clearing Up the Confusion When to wear them, when not to wear them, that is the question. An essay by Dr. Pierre Kory. (published January 5, 2021).
Global trends in clinical studies of ivermectin in COVID-19: Dr. Satoshi Ōmura, co-author of the newly published paper, “Global trends in clinical studies of ivermectin in COVID-19” was one of the four researchers from Kitasato University in Tokyo, Japan who received the Nobel Prize in Physiology or Medicine in 2015 for their discovery of ivermectin. (published April 5, 2021).
Our peer-reviewed paper on Ivermectin: Review of the Emerging Evidence Demonstrating the Efficacy of Ivermectin in the Prophylaxis and Treatment of COVID-19. (published in the American Journal of Therapeutics, May 2021 ).
Bryant, Lawrie et al Meta-analysis of Ivermectin: Ivermectin for Prevention and Treatment of COVID-19 Infection: A Systematic Review, Meta-analysis, and Trial Sequential Analysis to Inform Clinical Guidelines. (American Journal of Therapeutics, June 2021). Authors’ Update
Andrew Hill, et al: Meta-analysis of ivermectin by the WHO research team: Meta-analysis of randomized trials of ivermectin to treat SARS-CoV-2 Infection. (Published by Oxford University Press on behalf of Infectious Diseases Society of America, July 2021).
Marik, Paul, et al: Researching the different clinical stages of COVID 19 and pinpointing the treatment needed for each stage: A Scoping Review of the Pathophysiology of COVID-19. (Published by The International Journal of Immunopathology & Pharmacology, September 2021).

agreed eat healthy and eat greens. Also consider taking K2 suppliments of MK-7
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3502319/
## The K1 and K2 really do affect my INR but if I read the research literature on them
## correctly, they also really do affect bone fractures. In one Japanese study moderate ## dose K2 increased bone density by 6% but reduced bone FRACTURES by 60%.
## That is quite an impact (pun intended) on impact damage.

Walk in His Peace,
Scribe With a Stylus

 

[pellicle]

Hi

you know, if you click reply you don't need to do all that ## stuff right?

## I am inserting my responses with ## at the beginning of the line. I am sorry for the verbosity but you asked serious questions deserving detailed answers.

verbose is fine

have you had covid?

## No, but that does not mean I have not been impacted. I have 7 commorbidities

I'm glad to hear that

## including two separate immune system dysfunctions that leave me very vulnerable.
## These "rare disease" immune system dysfunctions mean the vaccine is
## contrindicated.

I'm a little lost ... we're all impacted and your immune system issues make getting it probably FAR worse than the vaccine ... however I'm glad you haven't had it

ok, to me the most effective things (from the getgo, before vaccines) were

• distancing from people (eg avoiding crowds)
• wear a mask
• hand washing before touching your face

I don't see any INR related effects there

## The INR related effects were from the Vitamins,Minerals & Supplements
## recommended by the FLCCC doctors and by the NIH publications.

suggested ... I thing recommended is a bit strong.

err ... do you have a refernce for that? Even a name?

## Use Google to find the report and the website and read lots AND LOTS of
## references. As mentioned above, the FLCCC doctors are primarily research doctors ## and just love publishing.

Home - FLCCC | Front Line COVID-19 Critical Care Alliance

right

## for evidence on Ivermectin effectiveness
https://covid19criticalcare.com/ivermectin-in-covid-19/goes counter to my experience. Publishing may be a different story.

... is pretty flimsy ... but if you are happy with it then go with that

## evidence for "best practice" as recommended by the FLCCC intensive care doctors-
## FLCCC and Allied Publications, see URL for links:

err ... that's best practice for managing it, not preventing it (which was what I gave examples of

agreed eat healthy and eat greens. Also consider taking K2 suppliments of MK-7
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3502319/
## The K1 and K2 really do affect my INR but if I read the research literature on them
## correctly, they also really do affect bone fractures. In one Japanese study moderate ## dose K2 increased bone density by 6% but reduced bone FRACTURES by 60%.
## That is quite an impact (pun intended) on impact damage.

well of course K1 will depending on the amount, but K2 is shown to be not clinically significant while that may be the case if you take them regularly then surely you can measure and just dose the diet right? So therefore null sum game

I'd be very interested to see a rigorous experiment done to show how K1 effected your INR and the data too ... "one off" observations are not rigorous

Best Wishes

 

[carolinemc]

seconded, although I would speak highly of my friend who is a pharmacist, but then he's pretty experienced and well educated

## I am inserting my responses with ## at the beginning of the line. I am sorry for the verbosity but you asked serious questions deserving detailed answers.

have you had covid?

## No, but that does not mean I have not been impacted. I have 7 commorbidities
## including two separate immune system dysfunctions that leave me very vulnerable.
## These "rare disease" immune system dysfunctions mean the vaccine is
## contrindicated.
## Thus, I started research on the US National Institute of Health electronic on line
## library called Pubmed very early. I found out a lot about C, D and Zinc because I had ## been researching those because of other medical impacts they have. When I heard ## about the FLCCC doctors I paid attention because it lined up with my own internal
## research.

ok, to me the most effective things (from the getgo, before vaccines) were

• distancing from people (eg avoiding crowds)
• wear a mask
• hand washing before touching your face

I don't see any INR related effects there

## The INR related effects were from the Vitamins,Minerals & Supplements
## recommended by the FLCCC doctors and by the NIH publications. Thus, you could ## not list the "Vitamins, Minerals & Supplements" & Medicines recommended by the
## FLCCC ( Front LineCovid Critical Care) doctors who are (at least in the early stages ## Professors of Intensive Care (& indirectly emergency care) medicine at medical
## schools and most of whom are also half time Intensive Care Doctors. They learned
## by reading the research literature (and "practicing" (intensive care) medicine using it.
## High dose Vitamin C, high dose Vitamin D, and Medium dose Zinc each cut the
## admission to intensive care by about 2 / 3. In their report "

An overview of the MATH+, I-MASK+ and I-RECOVER Protocols
A Guide to the Management of COVID-19

## they discuss this in detail. Paul Marik, MD (one of the co-authors) is the 2nd most
## published research doctor in the world. Dr. Marik was one of the first to use steroids ## in treating Covid but noted that timing was critical, being too early or too late could ## be fatal. The report also goes into detail on how to use Quercetin and Melatonin
## Quercetin and Melatonin have surprisingly useful effects on Covid.

err ... do you have a refernce for that? Even a name?

## Use Google to find the report and the website and read lots AND LOTS of
## references. As mentioned above, the FLCCC doctors are primarily research doctors ## and just love publishing.

Home - FLCCC | Front Line COVID-19 Critical Care Alliance

## for evidence on Ivermectin effectiveness
https://covid19criticalcare.com/ivermectin-in-covid-19/goes counter to my experience. Publishing may be a different story.

## However, you and I are not research medical professors who actually practice
## intensive care medicine in the here and now. The FLCCC doctors now mostly
## publish on their FLCCC web site as their recommendations go against the widely
## accepted grain that only masks, social distancing and vaccines are effective.
## See a generalized biographical note on the credentials of the FLCCC doctors at:

The FLCCC Physicians - FLCCC | Front Line COVID-19 Critical Care Alliance

this however is now working its way into best practice:

## evidence for "best practice" as recommended by the FLCCC intensive care doctors-
## FLCCC and Allied Publications, see URL for links:

Essential Documents - FLCCC | Front Line COVID-19 Critical Care Alliance

## text of page follows:

MATH+ protocol for the treatment of SARS-CoV-2 infection: The scientific rationale Paul E. Marik, Pierre Kory, Joseph Varon, Jose Iglesias & G. Umberto Meduri (published in the Taylor & Francis Online, August 18, 2020).
SARS-CoV-2 organising pneumonia: ‘Has there been a widespread failure to identify and treat this prevalent condition in COVID-19?’ (published in the BMJ Open Respiratory Research, September 22, 2020).
COVID-19: A Clinician’s Perspective: A master-class comprehensive review by Dr. Paul Marik of scientific insights into the origin, replication, transmission, infectivity, pathophysiology, and treatment of COVID-19. (USA, September 25, 2020).
Information about the MATH+ protocol and the medicines used can be found in our peer-reviewed paper Clinical and Scientific Rationale for the MATH+ Hospital Treatment Protocol for COVID-19 (published in the Journal of Intensive Care Medicine, December 2020).
Our review of Ivermectin: Review of the Emerging Evidence Supporting the Use of Ivermectin in the Prophylaxis and Treatment of COVID-19 – November 2020. also see our Ivermectin in COVID-19 section.
A “Summary of the Evidence for Ivermectin in COVID-19”: FLCCC Alliance Review: Ivermectin in prevention and treatment of COVID-19.
Masks! – Clearing Up the Confusion When to wear them, when not to wear them, that is the question. An essay by Dr. Pierre Kory. (published January 5, 2021).
Global trends in clinical studies of ivermectin in COVID-19: Dr. Satoshi Ōmura, co-author of the newly published paper, “Global trends in clinical studies of ivermectin in COVID-19” was one of the four researchers from Kitasato University in Tokyo, Japan who received the Nobel Prize in Physiology or Medicine in 2015 for their discovery of ivermectin. (published April 5, 2021).
Our peer-reviewed paper on Ivermectin: Review of the Emerging Evidence Demonstrating the Efficacy of Ivermectin in the Prophylaxis and Treatment of COVID-19. (published in the American Journal of Therapeutics, May 2021 ).
Bryant, Lawrie et al Meta-analysis of Ivermectin: Ivermectin for Prevention and Treatment of COVID-19 Infection: A Systematic Review, Meta-analysis, and Trial Sequential Analysis to Inform Clinical Guidelines. (American Journal of Therapeutics, June 2021). Authors’ Update
Andrew Hill, et al: Meta-analysis of ivermectin by the WHO research team: Meta-analysis of randomized trials of ivermectin to treat SARS-CoV-2 Infection. (Published by Oxford University Press on behalf of Infectious Diseases Society of America, July 2021).
Marik, Paul, et al: Researching the different clinical stages of COVID 19 and pinpointing the treatment needed for each stage: A Scoping Review of the Pathophysiology of COVID-19. (Published by The International Journal of Immunopathology & Pharmacology, September 2021).

agreed eat healthy and eat greens. Also consider taking K2 suppliments of MK-7
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3502319/
## The K1 and K2 really do affect my INR but if I read the research literature on them
## correctly, they also really do affect bone fractures. In one Japanese study moderate ## dose K2 increased bone density by 6% but reduced bone FRACTURES by 60%.
## That is quite an impact (pun intended) on impact damage.

Walk in His Peace,
Scribe With a Stylus

WOW!

 

[Protimenow]

Now, it's my chance to chime in a bit.

I used my Coag-Sense meter for years. I trusted it with my life. I strongly suggested it to those at this website. I even had an issue with a lab, whose results were much higher than those with the Coag-Sense.,

For the last year or two, my Coag-Sense results rarely came near to the results of blood draws.

The results of my tests using Coag-Sense versus CoaguChek XS were usually not very close - well beyond the 20% difference recommended.

The XS results were usually (not always) closer to the lab results than the Coag-Sense results were.

The XS is also slightly easier to use than the Coag-Sense.

I test with the XS more frequently than with the Coag-Sense. I plan to test with both, and with a new old XS, closely followed by a blood draw, to validate my findings.

It's unlikely, but possible(?)., that there's something in my blood that causes the Coag-Sense to miscalculate my INR. I get the same results with two of my Coag-Sense meters, so the error is consistent.

I'm taking a K2 and Vitamin D supplement, and have found absolutely no effect on my INR.

I studied biostatistics and epidemiology in pursuit of a Masters Degree, and still remember a lot of what I learned in what seems like 80 years ago, but although I've been self testing and self managing, I never did statistical analysis of the results. To me, my most recent result is the one I want to go with, in terms of managing my dosing.

If I find large swings, or significant differences from blood draws, I pay more attention to the discrepancies. I've found a few labs to have major errors - occasionally ignoring the errors and trusting my meter more, or testing at another lab.

Doing correlations, in my mind, didn't seem to provide much usable data.