Coagucheck vs Protime?

[Marty]

Giselle...Call Dr. Ansell!

Giselle...Call Dr. Ansell!

Giselle, the top hematologist clotting guru in the country is right in your backyard.He's one of the pioneers in patient self testing. He's at Boston U. Med Center. His name is Jack Ansell. Four years ago when I was just starting with my coaguchek I would Email questions and get prompt replies. Then I had a chance to meet him while at a medical meeting in DC and discussed this whole busines of central labs vs. home monitors. As Rob says don't put blind trust in your hospital lab.When I tested my Coaguchek against my own lab a few months ago there was a discrepancy that worried me. Later that day the chief lab tech came into my office and sheepishly admitted she found an error that they made because they were very busy and did not program their computer properly.I was ready to change my dose!

 

[Gisele]

I think I will do that.............

I think I will do that.............

Do you have his e-mail address? I just don't know who to believe anymore, and after having that problem on Lovenox, I wonder if I really needed it at all! Then a few weeks ago after finishing about 4 or so days of Lovenox, I had appt with new PCP. I had all kind of abnormal labs. They might not be related, but then again-who knows? My GGTP was 550 among other things. Went for repeat labs to rule our hepatitis, plus iron studies which came back normal. Haven't heard from PCP on what next step will be.
I think I am starting to fall apart, but I still have my sense of humor!
Thanks Gisele

 

[Zipper]

My post..Protime vs Lab draw experiment

My post..Protime vs Lab draw experiment

Gisele,

I don't know if you saw my post on my experiment, but maybe you could do this. It was very reassuring for me and my Lab tech checked to see if the same calibration (or something..not sure) were being used. He said it's important in order to compare readings. I'm sure Marty or Al would know what mean.

I took my Protime unit to my lab..they did a draw...from that draw he placed drops in the 'funnel'..now we had two readings..I then did the finger stick for a third reading...They were all very close..not enough difference to matter. I always use the same lab since I work at the hospital and the same lab tech, as I understand method of drawing (easy/clean, or need to 'probe/difficult) can also produce different readings.

Maybe this experiment would work for you to see exactly why your readings don't match up. I hope this is of help..I can understand your frustration!!!!

Take care, Zipper

 

[Marty]

To Giselle re: Dr. Ansell

To Giselle re: Dr. Ansell

Giselle, Dr. Ansells E-mail is: [email protected]
His office is at Boston University Medical Center
88 East Newton Street, Boston 02118-2395
I note that his latest honor was being elected President of
the ISMAA (International Self-Monitoring Association For Anticoagulant therapy) at the meeting of the International Society of Thrombosis and Hemostasis April 2001 in Bad Homburg Germany.

 

[Gisele]

Thanks Zipper and Matrx.............

Thanks Zipper and Matrx.............

#1, Zipper, I have brought my unit on one occasion to the hospital lab so I could do both at the exact same time. I think the prob. with your method is, even though if I understand you correctly, you are saying use the same draw for both tests?? BUT regardless if I stick my finger, or I have a venipucture they should both equal the same. It is unrealistic to say a venipucture draw will result in a different INR reading, and a finger stick will give a lower or higher reading. The machine is made to give an accurate Inr result.
Coincidently, yesterday QA called me to check up on how I am doing with my unit. (I have had it for nearly one year). I explained everything that was going on and she is going to try to replace the unit for me just in case there is a problem with my Protime. I guess she has to check with the "higher ups", but I might feel more comfortable making sure my unit is OK. Of course that would mean that I would have to retest against the lab again in order the verify the accuracy, but it is worth a shot.

Matrx, thanks for that e-mail address. I will try to e-mail him this weekend to see if he can shed any light on this. All I can say, is either the hospital is incorrect, or my unit is wrong. It has to be one or the other and proving which one is difficult.
Thanks for your help...........................Gisele

 

[Zipper]

Sorry Gisele..I guess I was not clear...the point was to have a three way reading...finger stick and draw used in unit and draw analyzed by lab. It worked for me to see how close the unit matched up with the lab. The other consideration was the technique of the person drawing the blood..it can make a difference from I've been told.

Your dilemma may be solved by a new unit...I sure hope so since so many of us, thankfully, have had good results with home testing! Hang in there...Wishing you good luck and answers soon!

Zipper

 

[Gisele]

Oh, OK-I get it

Oh, OK-I get it

I think I will wait to see if they ship me a new unit. Afterwards, I know my MD will make me go to the lab at least a dozen times. Hopefully, things will work out. If I see that it isn't working out, I will ask the lab if I can compare a finger stick vs venipuncture blood to see if they analyze the same. But my question is: Why would it differ?? They always put a small amt of blood in a red top first to discard, then draw the blue top. Tourniquet is never on too long prior to draw. Is there anything else I should be looking for??
Thanks, Gisele

 

[Zipper]

Gisele,

I don't know..LOL! My lab tech said technique of draw can matter so suggested this 3 way thing as a matter of testing every possible way it could vary. Yikes...you must be fit to be tied...I'm thinking your anxiety level is the culprit now..jus' kiddin' !!!

I'm with you...wait for new unit and start fresh. Hopefully, it will work out quickly and your Doc will be co-operative after a couple of tests! I'll be thinking of you when I stick my finger tomorrow!

Take care,

Zipper *~*

 

[Lorraine]

Hi Everyone,

I wrote that post and then was on vacation for four days and when I got back I was swarmed at work so I looked at the forum but didn't get any posting in.
I want to Thank eveyone for their responses. MArty, thanks for the phone number. I'll give them a call this week and see if I can get the paperwork to get a Coagucheck. If not I will get the Protime. Reading your responses, it probably won't make any difference. My cardios head nurse just suggested the same kind they use because she said with the Coagucheck, you don't need to draw as much blood. Myself, I didn't really notice much difference in the blood being drawn from the Coagucheck, and when Hank did it last fall with the Protime. Plus it sounds like the Protime is overall cheaper. My only obstacle now will be to get my Blue Cross/Blue Shield PPO to pay for it I guess. Reading the post it sounds like they may not. My cardio said he would write whatever he needed to write to convince them I need a home unit. So at least he's on my side.
I feel real nervous right now going once a month to get checked. Like I had said, my last reading was 2.7 and the cardio was happy with that. I wasn't. I rather be around 3.0 to 3.5. I have two valves replaced and I rather my blood be a little on the the thinner side.
I had another question. With summer here is the Coumadin and INR affected by hot weather and not wanting to eat as much? I know everyone says to get checked before you go on a trip and afterwards because your eating habits and dailey rituals change. Well, isn't this true with it being summer too? I don't know about everyone else but I don't care to eat much, especailly my evening meal. I may just want a yogurt. Would be too afraid to do a salad more than once a week.
Thanks again for the responses and take care!