Coaguchek Rep

[big_L]

I guess I must have filled out a form on the Internet awhile back and forgot about it. Anyway, the Roche rep called me about the Coaguchek and I received my packet in the mail yesterday. Looks good, except they won't do anything until you're on warfarin for three months. Wow, I want to start testing the first day I'm home. I guess it's off to EBay, then 'play dumb' and get a backup meter three months later.

I asked Mayo (Rochester) about it (getting a meter) and they said I was the first to ask. Unbelievable.

Before I go off and buy a meter on EBay, I'd like to know if anyone was 'given' a meter at Mayo when they left the hospital. Based on my conversation, I'd say the answer is no.

 

[Protimenow]

I have no experience with Mayo, so I can't comment on that, but judging from their response to your question, it must be a definite no.

I can sort of understand the Roche misgivings about the three month wait - they want to make sure that the patient is somewhat stabilized post-op and not relying on a meter instead of these more frequent doctor visits.

I haven't had any good experiences with Roche reps. I'm a bit curious -- you list the AVR date as 12 days in the future -- are you trying to get a meter BEFORE surgery, so that you have one on hand when you want to start testing?

With the exception of an InRatio 2 that was sent to me by Alere, I have acquired all my meters on eBay, and the only ones that seemed to not work were the ones that were 'As Is' or that the listing SAID didn't work. (I got these for the charger and case).

The post-op period is an important one for regulating your INR, so you probably SHOULD leave it up to the doctor or clinic to manage this brief period. HOWEVER, it may be helpful, too, to be able to do occasional tests with your meter on the same day that you are tested at the lab. It'll be good to know how closely their readings correspond to each other. (FWIW - The CoaguChek XS is not the ONLY meter available, although it's got a large group of users and reportedly gives results that are within 30% of lab results. I'm still testing with a few different meters, searching for 'the truth')

 

[big_L]

Yes - I'm maybe 10 days from surgery. Working on all these 'things' helps me prepare mentally. And yes, I'd like to have a meter at home right away. Not to preclude any clinical testing, but to run in parallel.

 

[Protimenow]

Your clinic may decide to only run one test a month, once they consider your INR to be 'stable.' They may even go to once every two months.

Having your OWN meter, and testing weekly is the best way to REALLY be in control of your INR.

 

[big_L]

I did confirm with Mayo that they do NOT send you home with a meter. Their preference is that you manage your warfarin with your local cardio/lab. Regardless, I'll be buying a meter. I'm not waiting 3 months.

 

[Protimenow]

There's the probably correct assumption that not everyone is capable of running an accurate self-test. It doesn't take a lot of imagination to see what types of patients may not be capable of self-testing -- and this is probably a reason why Mayo and many physicians don't routinely provide meters, and don't support the use of self-testing for certain patients. Saying 'No' to all patients, and perhaps making exceptions for the patients who appear to be able to self-test and who ASK about it, is probably a lot easier for the medical professionals to handle.

Just remember that, post-op, your INR may not stabilize for a while. Micromanaging the dosing at this point is probably not a very good idea.

 

[marc_kowal]

Most insurance companies will not allow you to get a meter (and have the insurance pay for it) until you've been on Coumadin for 3 months. I'm sure there's legal and monetary issues behind these issues. One being that they probably don't want people only temporarily on Coumadin to be issued meters . Another is there's probably some legal issues with making sure your INR is stable and under a doctors care while this is happening. I waited 3 months (which went by quick) and then I got my InRatio2.

 

[big_L]

I got my eBay meter yesterday. Took me four strips to get the first reading. I see now, I need a big drop of blood rather quickly. result = 1.0, but I'm pre-surgery/warfarin.

 

[pellicle]

I got my eBay meter yesterday. Took me four strips to get the first reading. I see now, I need a big drop of blood rather quickly. result = 1.0, but I'm pre-surgery/warfarin.

Might want to try my method. Say 10 seconds before lancing wrap a little cotton thread or dental floss above the second knuckle. Then when you lance you'll get a good sample in short order without needing to milk the finger

Especially handy in winter

 

[Protimenow]

A 1.0 for a non-anticoagulated person is just right.

You didn't say which meter you got. Pellicle's method of getting the blood to collect in the fingertip is a good one -- it may not always be necessary if you run warm water on your finger, then squeeze just below the knuckle while the meter is warming up.