Chasing INR

[MarkU]

After about 2 years of being rock-steady, my INR dipped to 2.1 two weeks ago. We added 2.5mg/week and it jumped to 3.9. Decided to go back to my normal weekly dose and check again in two weeks. Looking back, I suspect that the 2.1 was bogus and should have done a re-test then.

My cardiologist has been after me to get a home test unit. Probably need to go ahead and do it.

Mark

 

[ALCapshaw2]

I find it Interesting and Encouraging that your Cardiologist is the one pushing for you to get a Home Testing Device. That is a Sign of Progress in the Medical Community !

You might want to start by calling QAS to see if they have a business relationship with your insurance company.

If not, ASK for their Best Price as a Private Buyer.

Good Luck !

'AL Capshaw'

 

[catwoman]

Mark:

I had some problems with my INR in the spring. Never could figure it out. Mentioned it to a lab tech at my doctor's office and she just shrugged her shoulders as though to say, "And so??????" (grrrrrrrrrrrrr )

I finally got back on track and have been pretty steady for about 7 months.

Do look into getting your own INR tester.

 

[Ross]

I have a new PCP that really doesn't like me self dosing. I showed her my chart where I'm on 42.5mg for the week and 23 out of 25 tests are in range. She asked me what I changed to dose to when I was too low and too high. I looked at her and smiled then said that I hadn't changed a thing.

 

[Cris N]

I have a new PCP that really doesn't like me self dosing. I showed her my chart where I'm on 42.5mg for the week and 23 out of 25 tests are in range. She asked me what I changed to dose to when I was too low and too high. I looked at her and smiled then said that I hadn't changed a thing.

Yeah, sometimes it just is.

 

[Philip B]

Monitoring & Range

Monitoring & Range

I met with my cardiologist last week. During the meeting, he asked me about my INR. I presented him with a spreadsheet of my weekly INR's over the past year.

As he reviewed my data, he commented that I had only dropped out of range on the low side twice in almost a year (and those two INR's were close). He was quite pleased.

I did point out that I had been out of range on the high side a few times as well, but he commented that he wasn't concerned about those either. He stated that my data indicated I had a pretty firm grasp on how to adjust my meds to stay in range.

As we ended the meeting, he told me to schedule a routine echo in six months and make an appointment to see him in twelve months.

Geez, I love having the ability to home test. It really allows me to stay on top of dosage adjustments.

-Philip

 

[olefin]

My cardiologist has been after me to get a home test unit. Probably need to go ahead and do it.

Sounds like you have a smart cardiologist... go for it, you'll never be sorry.

I'm sorry I didn't start home testing many years ago.
Had I listen to my wife, I would have started back in 92.

 

[Bina]

After about 2 years of being rock-steady, my INR dipped to 2.1 two weeks ago. We added 2.5mg/week and it jumped to 3.9. Decided to go back to my normal weekly dose and check again in two weeks. Looking back, I suspect that the 2.1 was bogus and should have done a re-test then.

My cardiologist has been after me to get a home test unit. Probably need to go ahead and do it.

Mark

I am gonna bet that the test of 2.1 was not bogus....sometimes we just get a little blip.

 

[MarkU]

Sounds like you have a smart cardiologist... go for it, you'll never be sorry.

I'm sorry I didn't start home testing many years ago.
Had I listen to my wife, I would have started back in 92.

Actually, my cardiologist has told me that I am one of only a few of his patients that he would recommend for home testing. He knows that I 'get it' and understand how things work.

He doesn't trust a lot of his patients to do it, either due to age, ignorance or indifference.

I know I would do okay with home testing, but I think I use the routine visits to the Coumadin lab as a bit of a security blanket. After nine years I've gotten to know the nurses very well and enjoy talking with them.

Mark

 

[lance]

Thr word is finally getting out

Thr word is finally getting out

Mark and Philip
Hats off to your doctors for being open to "new" developments in INR management. You're lucky to have them. May they increase in number.
Of the many things worth chasing, INR isn't one of them.
Happy New Year.

 

[catwoman]

Mark:

Here's a link to a presentation that Dr. Jack Ansell gave in May 2009 about selection of patients for self-testing. You may want to share it with your cardiologist.

Ansell is a big proponent of PST.

http://www.acforum.org/docs/Patient-Self-Management-Ansell.pdf

 

[dick0236]

He doesn't trust a lot of his patients to do it, either due to age, ignorance or indifference.



Mark

Unfortunately, these are common problems, according to docs I have talked with and although it may be more of a problem with age and ignorance....indifference, often by younger patients, can lead to life altering consequences.....been there done that.....and that's why I "get on a soapbox" about warfarin. So long as it is taken as prescribed and tested routinely, it interferes little with life and lifestyle....."Mess" with it and.....you LOSE.

 

[olefin]

Marsha, thanks for that interesting link!

As far as record keeping, I score on that one for I have records of PT/INR from day one. When I was discharged from the hospital they gave me a copy of Dupont's 'Patients Guide to Using Coumadin'. It included an area for recording PT/INR. I'm now on my third book. It's filling much faster since last February.

 

[ALCapshaw2]

Actually, my cardiologist has told me that I am one of only a few of his patients that he would recommend for home testing. He knows that I 'get it' and understand how things work.

He doesn't trust a lot of his patients to do it, either due to age, ignorance or indifference.

I know I would do okay with home testing, but I think I use the routine visits to the Coumadin lab as a bit of a security blanket. After nine years I've gotten to know the nurses very well and enjoy talking with them.

Mark

I can relate to your last paragraph Mark, especially the part about enjoying chatting with the CRNP's at my clinic.

 

[MarkU]

I can relate to your last paragraph Mark, especially the part about enjoying chatting with the CRNP's at my clinic.

Especially the cute redhead...

Mark

 

[dick0236]

Especially the cute redhead...

Mark

Hmmm, maybe I need to rethink this home testing thing. I also miss the interaction......but the convenience of self-testing, in my shorts, is hard to argue against.

Happy new year to all.....ain't no way that 2010 can be as screwed up as 2009.

 

[jorsarge]

I envy you all. In Ireland we do not have home testing yet. I am looking forward to the day of its arrival on our shores.

Happy new year an long and happy home testing.

J

 

[Ross]

I must be the only one that never had cuteness involved in INR management. Mine were all of the Nurse Murch variety. Lets say INR management FAIL.

 

[Bina]

For the first year I had a cute single Mom as my vampire nurse...she was real chatty and a bit loud in the early morning, but she was darn good--Hit the vein perfectly every time.

 

[Marty]

Years ago there was a study in Holland that found most of their patients loved going to the clinic, schmoozing, drinking cocoa. and incidentally getting blood drawn. No interest in a home monitor in that group.