could use some info for home testing

[evelyn2]

Hi everyone, Hope everyone's day is a good one!
I have the paperwork from QAS for purchasing a home monitor and have given them preliminary info. My cardio appt. is Nov27 at which point I hope to convince her that it would be a good idea for me to home test.
I use the Coumadin clinic at the hospital, this is what the surgeon set up, and have been going there since June, 05. I see the cardio every 6 - 9 months for a checkup and to have an echo or followup CT, but she has never been involved with the coumadin dosing or results. Also, I only saw the surgeon once after surgery to remove the sutures so he also is not involved with the coumadin dosing.
I talked with the nurse practioner at the clinic to see about who would monitor results and dosing if I am able to home test. She said they have talked about having this service but presently do not have anyone home testing. She didn't seem opposed to the idea, but she doesn't have control over what they do. I get my coumadin prescription from the nurse practioner.I have self-dosed a couple of times when I thought they were wrong. How do you handle getting your prescriptions, who decides the cost and what is the cost if you just phone in results. I really want to make a go of home testing and sure could use help figuring out how you manage. I have already bought the algorithm chart from Al Lodwick. Thanks for any input.

 

[EVELYN]

Hi Evelyn

It's Evelyn here.....nice to meet another kindred spirit.

As far as your question goes, I would go into the cardio's appt with as much information as possible re home testing. You can find it here on the site and I'm sure many will be coming on with information that will help you. You might ask QAS to fax you some info they have regarding home testing, monitoring, training, etc. I would also bring Al's dosing chart into the appointment.

We were lucky, our cardio was absolutely in favor of home testing for Tyce once his INR was stable....about 6 months post op. However, I do have to tell you, we are the only home testers in his entire practice.....I have no idea why, because it's sooo convenient. We began home testing by faxing our weekly results to their office so they could see for themselves what Tyce's INR was. If an adjustment was to be made, they would call us.....not that we always listened, but.... We've been home testing for about 5 years now and absolutely love it.

I think as far as your cardio, an informed consumer is the best thing. Try to impress on him/her the fact that you can monitor yourself weekly, when traveling, when changing meds, etc....let them know you understand that if anything is out of range you'll contact them immediately, not that you're going off totally on your own.

Hope it helps, and Nice meeting you.

EVELYN

 

[geebee]

My cardio's NP takes care of calling me when I do lab test (about twice a year to keep my cardio content). They do not charge me for these calls nor did they charge me when they had to call me 20 or so times a year when I was lab testing. It is my belief that they are happy about home testers that are competent because they spend less time on them. I do self dosing and only call if I feel there is something wrong (which is very, very rare). I do not call in my results.

My cardio still prescribes my coumadin.

 

[lance]

Professional acceptance of home monitoring

Professional acceptance of home monitoring

Good morning Evelyn, I trust all is well with you.

Have you thought about contacting the hospitals performing heart surgery?

When I met with resistance from my Primary Care Physician in 2003 when I wanted to home test I contacted the Hematology Departments at hospitals performing cardiac surgeries requesting information about self-testing. When a hospital in Toronto offered training and the services of their anti-coagulation clinic my PCP came on board and supported my decision. Ontarioans need a doctor's prescription to purchase monitors.

Home monitoring is such a vastly superior method of managing INR's I'm surprised cardiac hospitals do not promote their use. The percentage of patients compliant with in-range INR's is much, much higher than patients using a lab.

In the EU monitors have been in use for 10+ years with thousands and thousands of successful users. Maybe you could Google for ISMAAP and print the info for your cardio.

It would be surprising if your cardio doesn't know about home testing. Let us know what happens.

 

[Kathleen]

When I spoke to my internal med dr he did not say anything for or against home testing. When I got my machine with the total help and blessing of my cardiologist my internal med dr said no way I will have no part of this you need to go through cardiology to do this. I really felt the cardiologist did not need to be called with results. I changed internal med doctors and surprisingly did get a call from the nurse at the coumadin clinic asking me if I had all the arrangements made with the cardiologists and I said no and she asked what I was going to do and I said I switched doctors. I feel if a doctor who will not even begin to work with you on something that is a positive in your life, they are not the one to take care of me. Doctors can learn by working with you. You could offer to let them learn with you.
Kathleen

 

[EVELYN]

Hi Evelyn

I forgot to add that we no longer call our cardio. We stopped that a very long time ago, nor do we still fax our results. Once they're sure you know what you're doing, they're confident you'll call if you need them.

Evelyn

 

[maggiemay]

hometestin

hometestin

Evelyn2, I just received my hometester 3weeks ago.I had my 7month cardio check-up and told him I had a hometester and he was surprised, and wanted to know what I had to do to get it. This the same dr. that did not want to manage my inr to begin with. Thanks to internal medicine dr. who encourages me to self dose and trust my judgement on when to contact him. I just a keep a journal on inr levels and my meter records the levels also. It was not easy to get the ins. to pick up the cost, but I think my clinical results showed them the great control we can have if you are well informed on a weekly scale. I say get all the info you can and have the dr. back you up! Good luck Maggiemay