Costs and other Basics?

[kimcdougc]

I have finally been home testing for a month. 1st week I used one lancet and 1 test strip, 2nd week I had to use 3 (still learning), today I only used 2. Today I went to the clinic and tested 2.6. Came home and tested with my cougacheck XS and my INR was 2.9. Both ok with me. The Dr. at the clinic said for me to bring in my machine next month and we can compare the machines right there on the spot. (I thought that was pretty cool of her). My insurance pays for the machine, 6 lancets, 6 test strips per month. Needless to say I went over my lancets the 2nd week. I ordered 48 test strips ($238), 200 lancets ($49.95) from Ebay. Paid for out of pocket for the purchases on Ebay. I also paid $95 out of pocket at the clinic today because the insurance won't pay for home testing and clinic testing. The clinic did tell me that if I pay for the INR test on the same day I get my INR testing done at half price. Go figure.

What I have noticed by home testing is that one week I tested 4.1 and lowered my coumadin from 5.0 mg to 1.25 mg for that date. The inr clinic told me I did the right dosage. Also, no wine with dinner that day. I feel much more educated by testing once a week and in better control of my INR range. I took 2.5mg (5) days a week and 5 mg (2) days a week. The Dr. at the clinic looked at my results and said I should now take 2.5 mg (6) days a week and 5 mg (1) day a week. She look looked at my graph that I made in Excel to compare my results.

I will continue to do the clinic for about 3 months then maybe change it up to going there every three months or so. I think my Dr. feels better with me going to the clinic once a month but he will just have to get over that one. I am giving him the chance to "get use to" me home testing. I don't think he currently has any patients doing this.

Generic coumadin no problem. Like others here have said, you do bruise easier.

 

[pellicle]

Hi

I have finally been home testing for a month. 1st week I used one lancet and 1 test strip, 2nd week I had to use 3 (still learning), today I only used 2. Today I went to the clinic and tested 2.6. Came home and tested with my cougacheck XS and my INR was 2.9. Both ok with me.

I don't know if this is helpful or not, but when I first started with my XS I had similar problems and results. Particularly good old error 5 ... drove me batty and I was wasting strips. Given all other inputs (from my wife for instance) I was clearly suffering from pump head (which seemed to last about 4 months for me) and I just couldn't think clearly.

Back to the Coaguchek when I restarted I took the approach of what I had found worked well for me in biochem labs during my degree (and working with sampling machines there too)):
* getting more than enough sample
* doing everything consistently
* follow the 15 second rule (and preferably keep time between beep and application of blood consistent too)

Soon my incidence of variance between the lab and my tests were consistently down to INR within 0.1

I found that getting the blood samples was harder in winter than in summer and (interestingly) harder when I was anxioius about getting enough blood (probably vaso-constriction). Annoyingly the prick would often bleed more

My method now is 100% and I haven't wasted a strip in ages.

1) when the machine goes beep I wind on a rubber band (square section about 5 inches in diameter) starting at the first joint out from the knuckle and working towards the fingertip. I do not apply massive strech to the rubber-band but it is not loose either. You will soon see blood gathering in the fingertip. (you can practice this without lancing too)

2) when I lance I prick the side of the finger (and so far I have been reusing my lancelets for at least 3 months)

3) a gentle squeeze of the finger (often bending it even is enough) with the rubber band still in place gets the blood out in a matter of one or two seconds.

this also has meant that I do not need to lance as deeply, which hurts less in the following day.

Lastly I notice that the latest PDF version of the userguide from Roche now is less cautious about "milking" the finger than my printed copy was. Further it has now included instructions on obtaining vein blood and using the coaguchek. So clearly their testing has revealed that the meter is less sensitive to the tissue factors that lay under the skin that some users have commented make a big difference. It seems they do not with the Coaguchek.

Give it a go.

 

[Protimenow]

The issue of comparing your meter to the lab results may be a question of what you're comparing YOUR meter to. If you bring YOUR CoaguChek XS to your clinic and THEY check with a CoaguChek XS, the results should be the same - or awfully close. The question is, of course, how do you know that the CLINIC's meter is any more accurate than your meter? If the clinic uses an XS Pro, I think that some clinics may have some reference samples that they can use to test accuracy (these would also probably work with a regular XS), but even blood draws may vary from lab to lab.

I don't think that it's necessarily a mistake to take different doses on different days, but keep in mind that, depending on the day that you test, your INR will be different, based on your dosage for the previous few days. (If you're crazy enough, like some of us have been, to test daily, you'll probably see this).

 

[Gail in Ca]

I remembered to ask at Costco about the Coaguchek XS strips and she looked it up. They are available, but she thought they would be about $400 for 48 strips, but wouldn't know the exact price until they were ordered. So, that is more than what I've been paying on Ebay, about $225 for 48 strips.
I test once a week and rarely go to the lab anymore. I got my Coaguchek XS meter and it was covered by my insurance at that time, I only paid $100 copay. I have been using a meter since my 2nd surgery in '00, and they have really changed them for the better! I now use a smaller needle to poke myself and I can test very quickly. I'm almost always in range. Managing warfarin is really very easy. I've always taken the generic, with no problems.

 

[Protimenow]

A few thoughts about lancets and lancing. I use the Unistik 3 Extra because I want to be sure that my incision is deep and large enough to (usually) get enough blood to run a test. That said, I used to do quite well with 21 gauge lancets (and I have a LIFETIME SUPPLY if anyone is interested in a box or two). Pellicle -- you've mentioned a few times that you reuse your lancets(?). Am I interpreting this correctly?

Pellicle's instructions for getting a good drop (another post) are really good. I'll give the 'rubber band' method a try.