Coagcheck Machine post surgery

[Gkeraney]

Twelve years so far on my XS

The new INRange seem to have a testing count limit built in.

12 years would be awesome.

 

[pellicle]

12 years would be awesome.

yep, but you know, its sort of diminishing returns anyway. Just going with 12 years.

so by about year 6 the cost of replacing the machine becomes non-significant and then it takes 6 more years before that relationship halves. *(the above is based on exactly 52 tests per year and of course the more tests you use the sooner the cost ratio of machine vs consumables is more attractive.

Just stating the obvious.

HTH

 

[David Robbins]

They'll be testing you daily in the hospital, so it probably would be overkill. You will have other opportunities to check your machine against the lab.


You would probably be ok waiting until you get home. However, personally, I would bring it and test one or two days after release. This is based on my personal experience. My surgeon had ordered that my INR be tested two days after release. The home visit nurse was unable to get enough blood for the test. For some reason he tried to draw it from a vein in my hand. He struggled to get enough- turns out that he did not fill it up to the little line in the tube and Quest rejected it when he got there. He came back the next day and was not able to get more than a couple of drops. He told me my blood was too thick. The guy was totally incompetent. I had the coumadin clinic call in to Quest, so that I could just go in myself on day 4 to get tested. My INR went from 3.1 to 9.7 during those 4 days, as I was on a medication which is known to spike INR.

If I had my own meter, I could have tested myself on day 2, and could have taken action much sooner, before my INR went so high. So, I guess I am an advocate of being able to self test very soon after release. Upon release, they will be switching you from IV fed medications to oral and this might affect your INR- it sure did for me.

I belong to a medical group called Dignity which limits the doctors you can see to those in their network. Previously, at the network of Tenet, the cardiologist would not give me a prescription for the Coagchek home testing. My primary care doctor prescribed and is monitoring the results I call in every two weeks. Apparently, Tenet doesn’t trust their patients ability to test or wants more control over the testing for lab revenue (always come down to the money, it seems). I have had the meter for over 5 years and it is still working perfectly.
The meter rental and strips costs Nedicare over $880 per 2 months, which is ridiculous since one could buy a used unit for about $1000. But, the service is required to have 3rd party reporting and for Medicare to pay for the test strips. I purchase the Safety Pros spring loaded lancets which are quick and painless for the finger prick sampling.
I like the Coagchek system for the convenience and portability if you want to take a long trip and testing is required during that time. Reporting over the phone or internet is simple.

 

[Protimenow]

Roche may try - but I suspect that government regulations may make it difficult to do this to 'old' units for many years to come, and even then, they may have to offer a replacement program (or hefty discount) on the new meters. OTOH, when they discontinued the Coaguchek S, I think they only issued a warning about the date that they'll no longer support the meter, and no offers of upgrades or compensation. I guess a long enough warning that the strips (and current XS machines) will no longer be supported may be adequate.

---

I also have extra meters, and I've been giving some away. I now have an XS pro (overkill for a single tester), an XS that I use (bought for $29 on eBay and was new when I got it) and the XS that I replaced with the 'new' one.

These should keep me going until support for the old strips is discontinued - at which point, I'll have Medicare buy me a new meter and supplies. Currently, Medicare still buys the XS, as far as I know.

I don't think the new InRange offers anything that makes it worth updating -- a color screen?

 

[Protimenow]

Aside from needing the greedy providers for warfarin prescriptions, and for making the service lots of money, it may make sense to get strips on eBay and self manage. You'll probably do a better job than this 'service' that only wants test results EVERY TWO WEEKS. This demonstrates that they're not up to date with modern protocols.

If you can prove to your PCP that you've been self testing and self managing (if you DID self manage) with a spreadsheet or other record that shows you were actively involved in testing and management, MAYBE you can convince the provider to prescribe warfarin when you run low.

The insurance thing is a ripoff of insurers, but may work well for those who are unable to self test.

 

[Chuck C]

The meter rental and strips costs Nedicare over $880 per 2 months, which is ridiculous since one could buy a used unit for about $1000.

That's insane. A total rip off to all of us, who end up paying for Medicare. You can get a used one a lot cheaper than that. I purched mine for about $230 and picked up a couple of back ups for $ 50 and $35.

So, even if you take my most expensive Coaguchek at $ 230, for $880 I own my meter still have enough left over to buy over 2 1/2 years worth of strips.

 

[pellicle]

The meter rental and strips costs Nedicare over $880 per 2 months, which is ridiculous since one could buy a used unit for about $1000

I'm pretty sure you can buy a new unit for $600 and a used one for much less, making it more ridiculous.

PS:
In Australia
https://www.medshop.com.au/products/coaguchek-xs-system-au
https://www.medshop.com.au/products/coaguchek-reg-inrange-system
amusingly the INRange is cheaper with its colour screen and additional "features" ... (speculates)

In Germany
https://www.doccheckshop.eu/laborat...re-devices/4198/roche-coaguchek-pro-ii-system
(the locations are chosen because I lived in the EU for a while and am living back in Australia now)

 

[Bionic Orange]

Thanks for everyone's input, I learned a lot.

I want to also thank Pellicle for his video showing how to use the Coaguchek machine, especially how to draw the blood using the lancet and elastic band tournique.

The elastic band tournique made all the difference in not wasting strips. Roche doesn't mention this method. They say to milk the finger after placing the finger under warm water. The elastic band tournique was pretty much fool proof.

Another of Pellicle's blogs that was very useful was on the dosing of warfarin. Everything mentioned about minimal dose changes was spot on, and the addition of vitamin K1 foods not lowering the INR dramatically was also observed when checking my INR, twice daily at the beginning, to determine the best dose for my target range. I will be checking twice a week soon.

 

[pellicle]

I want to also thank Pellicle for his video showing how to use the Coaguchek machine, especially how to draw the blood using the lancet and elastic band tournique.

totally welcome ... I'm here to help ;-)

I will be checking twice a week soon.

just make sure that you don't make adjustments twice a week, or you'll be chasing your tail