As one who home tests, do you ever go the lab for testing?

[yotphix]

I get a lab draw once a year just for kicks. The first one disagreed with my Coaguchek result by more than .5. I thought about it and decided that I trusted my machine, and more particularly, the operator of my machine, more than the people who drew my blood, those who delivered it, those who tested it, and those who recorded and reported the results. The following year, the lab was within .1 of my coaguchek (both times I did the stick immediately after the draw), so I figured the lab had done a better job that day.

The reason I bought the machine (all out of my own pocket, including strips) is that my PCP, or Family Doctor to we Canadians, wasn't really a star at ACT management. I found my way to a very well regarded ACT clinic, and saw that they were using the machine there. Then I saw how easy it was to manage ACT, and didn't really like the way they did it. I prefer to take the same dose each day, which for me means taking two different pills (11mg/day now, back then it was less). They wanted me to take 5mg certain days, and 7.5 others. I don't know how anyone keeps that straight!

Another Canadian noted that his doc likes him to have a draw, and have the results sent back to the office. That is most certainly about billing. If you manage yourself, there is nothing to bill. My own doc, upon seeing, and playing with my machine, investigated purchasing one for his office, but found that although he can charge to draw blood and send it to the lab, then interpret the result, he doesn't have a billing code for using the coaguchek, and thus can't bill for it!

 

[lance]

I attend the lab as few times as possible and trust my XS. Your doctor prescribing warfarin may feel differently though. I think Roche wants a comparison test every 6 months. The last time I went to the lab specifically for a comparison test it took them 3 days to send the results to my PCP resulting in the worst comparison test, ever. BAH HUMBUG! I don't mind them running an INR in conjunction with other tests though. Other than that, no thanks.

 

[catwoman]

The reason I bought the machine (all out of my own pocket, including strips) is that my PCP, or Family Doctor to we Canadians, wasn't really a star at ACT management.

FWIW:

I believe that PCP is basically an insurance term in the U.S.
PCPs are family doctors, family physicians. Some are board-certified internists, and most if not all insurance companies accept iternists as PCPs.
My previous insurance carrier required that I designate a doctor as my PCP. I could change after that, as long as the doctor was in network.

Getting back to the thread:
When I took my first monitor in to my PCP's office to demonstrate I could run a test, it was about 0.4 different from the office's CoaguChek. The tech threw up her hands and said, "Just go by your monitor's results." I don't believe I ever brought it back in.
When I got my 2nd monitor 4 years ago, I took it in for a comparison. I've taken it back in once since then and won't do that again. The lab tech blew a couple of food test strips. Should have let ME run the test on my own monitor -- I would not have wasted the strips. If there ever is a comparison test again, I'll insist on playing Dracula myself.

 

[Protimenow]

A few things: When we consider the idea of a test machine needing to be recalibrated, it's probably worthwhile to consider that, even if we test once a week, we're only running that test 52 times a year. Compare this to an anticoagulation clinic that probably runs that many tests in a day or so -- these meters were made to be accurate and to stay accurate. I don't see a reason for concerning myself about the consistent accuracy of the tests.
Also -- the XS uses a chip that calibrates the strips with the reagent on the strips. The InRatio uses a code on the strip's foil wrapper that does basically the same thing -- with both machines, the strips are calibrated to the machine. The Protime machine has this information coded right onto the cuvette (what they call their strips). All three run quality controls for each test. Unless the machine reports an INR above 4 or so, it probably makes little sense to run a lab test.

I've had a blood draw only once since I started self-testing. I had a concussion, went to the emergency room, and the ER doc was concerned about proper anticoagulation and a brain bleed. The lab's test was 2.92 -- my test, using a Protime meter the day before, was 2.9. FWIW--I went to the ER a few weeks ago for a pulled calf muscle. The doc asked when I last tested - I told him that I did my own test the day before, and he didn't order a blood draw. I think that the medical community may be getting a bit more trusting of these 'new' meters, and may even begin to trust the ability of some people to manage their own anticoagulation.

(My doctor writes my warfarin prescription and I manage the dosing myself. I've recently started using Quercetin - which increases the effectiveness of warfarin and made a minor dosage adjustment to compensate - but self-management is pretty easy once you get the hang of it. I keep a spreadsheet of the results, time, date, meter used, and any notes for each test I take. This helps me maintain an anticoagulation history and also gives me something I can use to demonstrate to my doctor that a) I'm able to self-manage and b) I'm testing often enough)

Also -- FWIW -- I got my meters from vendors on eBay. With all but a $1 'as is' meter that I bought primarily for the charger and case, I've been very pleased with the meters I've bought. You might consider eBay as a possible source for a meter or strips, although this forum discourages purchase from any other than medical supply companies.