Dr. Are useless

[SHerrin Hutt]

I think most Doctors don't have a clue how to control INR. I have had three and they were terrible at it. I have been the low of .9-6.5 and this have been going on for almost two & half yrs. Well. this week was the best of all, my primary Dr. went on vacation for a week. Sso his office told me that a different Dr. was taking his calls every day. So I called in my pt on wed. 3.0 which was great. Was told on tues. by cardiologist to stop Avapro because of my leg cramps. And to retest on Fri. did that it was 3.7 (a little high)
called the Dr. again but I have never got a call back from either day. I guess they are going to wait two weeks till he comes back to give him the messages. Got to stop the lovenox shots that was great. I can't believe they gave a script. for 32 preloaded needles. Thank God for insurance! The good news is the leg cramps are gone. Have to wait another month to get a echo to see if the new meds are working for the caridiomyopathy.

 

[terryj]

When my husband was sent home from the hospital after his AVR I had to give him Lovenex shots until his INR got up high enough. Insurance would not pay for them because I was giving them to him and not a nurse. They cost over 300.00 for a box of 10 prefilled syringes. The pharmacy would not split the box. After 3 shots at home his INR went to 6.5 so we had 7 syringes left. Of course the pharmacy would not take them back. I guess the insurance company would rather pay for more days in the hospital just trying to get his INR up. He was in there 7 days. The last four just because his INR was so low.

 

[Shine_on_Syd]

Amen,
That is why I am so happy to have this board as a resource. Lets face it most of us on this board don't have simple problems that doctors have snappy answers for.
I know for myself I have complex set of circumstances that mystifies the cardios. Most docs just don't take the time to put the pieces of the puzzle together. Just order some more tests or tell you there is nothing wrong.
The only doctor I trust is my surgeon, he has been "under the hood" and knows what's going on. Anytime I have any other consult with a cardio or PCP thank goodness my surgeon is happy to stay in touch and give his feed back.
James

 

[LUVMyBirman]

Hi Sherrin,


Just want to say that you have the upper hand. Home testing is a blessing. Sounds like you should figure out what works for you dosage wise and go for it. You will be able to tell them better! Been there.

Take care.

 

[Birky]

Drs.

Drs.

I went to see my primary care Dr. and on the wall was a sign which stated that you should expect to wait 3 days for your protime results. I have my done in a coumadin clinic where I had my surgery and get the results back the same day. That is why I went to the clinic. You could bleed to death in 3 days or spit up a clot. I swear I only do what I have to in this area.

 

[LUVMyBirman]

"I went to see my primary care Dr. and on the wall was a sign which stated that you should expect to wait 3 days for your protime results"

That is insane! I will tell you this......it took me 4 short days to hemmorage from every vital organ. Including my brain. And yes.....I was spitting up the blood. I am a walking talking miracle! Levels were being watched. Though...they left me at 4.0 with a fresh surgical site. Went from 4.0 -14.0 in that short time. Fully transfused. Your doctors should be giving you an answer within the same day..before you take your next dose.

Otherwise..why should they have prescribing rights to such a potentially dangerous medication! These are the same doctors that are so hyper about bleeding while having an invasive proceedure. They should pay more attention on a day to day basis!

 

[Ross]

I went to see my primary care Dr. and on the wall was a sign which stated that you should expect to wait 3 days for your protime results. I have my done in a coumadin clinic where I had my surgery and get the results back the same day. That is why I went to the clinic. You could bleed to death in 3 days or spit up a clot. I swear I only do what I have to in this area.

The is an open invitation to a malpractice suit right there. Perhaps you should use the opportunity to do just that!

 

[Nancy]

Marcia-

Wow! Talk of being clueless about Coumadin! I would be worried that there would be the same low level of care with other things in that medical office. You'd better watch, like a hawk, each and every thing they do. I wonder how many people they have put in danger.

It's outrageous.

 

[terryj]

My doctors office was taking three days to get my husbands INR results back to us. I had a talk with the doctor and he put in BIG BOLD letters on my husbands chart to call me with results. Now if he gets it checked at 4 P.M. we get a call first thing the next morning with the results. So,I think they can get the results back faster if you insist. We still have to adjust his coumadin ourselves because we don't always agree with the doctors recommendations. Once he realized how much we knew about this(thanks to this site) he now asks me how I think it should be adjusted and goes along with my recommendations. So, far I have been right everytime and saved us a lot of unnecessary adjusting.

 

[Ross]

Even next day results are unacceptable. Anyone on Coumadin needs the results stat, same day, now, immediately, not tomorrow, next week, three days later, etc,. Why have your INR checked if it's going to be like that?

 

[tommy]

The key is to be able to get results before the next dose. This is so obvious.

Franky if it takes special attention to get standard results, I'd change practitioners.

 

[Susan BAV]

I only had to take Coumadin for three months post-op and it was just one big mess nearly the entire time! There was a big fight between my local doctor's office and the cardiologist's office (which is two hours away) regarding who was "managing" it and eventually my local doctor started sending me down to the nearest hospital (half an hour away) for the draws because I wanted the cardiologist's office to do the managing and the INR was very low most of the time and out of range and the results didn't get forwarded to the correct office(s) following my testings and my veins were all dried up and hard to find and it was just a lot of nonsense! The medical people kept telling me that the Protime tests were prioritized and the results were forwarded promptly but that wasn't the case for me and one week I had to wait four days for the results (and I called everywhere several times trying to chase down the results)!

If I ever have to have a mechanical valve, I hope to home-test.

 

[Georgia]

Marcia, I suggest you get another doctor. Any doctor who things 3 days are needed to relay inr results is courting problems. Furthermore, until you get another doc, take a camera into that waiting room and get a picture of the sign; when asked why, just tell them you're preparing a case just in case . . .

 

[SHerrin Hutt]

Hi All,
Well. I tested my PT on tues and it 4.4. Told to hold for one day retest. On WED. it 4.4 and then the Dr. on for my Dr. told me to tae 12mg. on MWFS and 10 on TTSS. This the same office that did not call back for two days. Told be to retest in 7-10 days. Started yesterday on a new B/p med to replace the one that caused my legs to drive me crazy. Now I am on my own theses Dr's are crazy!
I need to have some oral surgery and this is going yo be a mess. I have to go in the hosp. because of being high risk of strokes and blood clots. The last tooth I had pulled, I was in there for 5 days. That was longer than my ohs.

 

[tommy]

Sherrin,

You seem to be getting nowhere fast, huh? To hold one dose and expect a result change the next day is not realistic. Retesting 7-10 days after changing medicine sounds like a long time to me.

It's like putting one foot in a bucket of scalding hot water and the other in a bucket of ice water. On average, you are not comfortable.

I suggest a "heart ot heart" with the doc, explaining your concern. Also explain what happens when he takes vacation. He may not know that his staff dropped the ball on you.

 

[SHerrin Hutt]

Thanks for yor input. I have an app. with him next month and I am going to tell him how I feel.I also haad some tests last week at the hosp. I guess I am going to have to wait till he gets back to get the results. I love my Dr. but I hate how the offfice operates.

 

[Harpoon]

I suspect the "delay" in results is only if the result is within normal specified parameters...

Though that might not be true for all clinics, all doctors, all labs...


I used to get protime checked through a blood draw. The clinic that drew my blood shipped it to a hospital's lab and the results were available the next day (the same day if I did it early enough in the morning)

I only got a call right away if there was a problem and that only happened once.


Now, I go to my primary physician's office and a nurse asks me a few questions, pokes my finger, then squeezes out a drop of blood onto a Coagucheck machine. We sit and watch the machine think then a number pops up. Two weeks in a row I scored a 2.5.

if your insurance won't let you do at home monitoring, Maybe it can be done through your doctor's office or maybe a clinic that has the capability of testing protimes with a finger prick like what Coagucheck does.

I get results only moments after the blood has been drawn from my flesh, and a doctor is in the office that can make a recommendation on med changes if my protime is too high or too low. All of the results and changes in treatment are faxed to my cardiologist so he always knows what's going on and can interviene if he sees fit.


Granted, it's still a half hour drive to my doctor's office, but that seems like a small price to pay for near instant feedback.

 

[Guest]

In a country that is advanced enough to have internet access a three-day wait for INR results is unacceptable. Doesn't that doctor have a telephone? A sign like that does not relieve the doctor of liability. GET ANOTHER DOCTOR BEFORE YOUR NEXT APPOINTMENT IS DUE

 

[Gemma]

Blimey, and I thought the way the INR results are relayed here in England were dodgy. Jim has a record book which is sent with his blood sample to the hospital lab. If there's a dosage change they phone the same day, if not the book is returned in the post a couple of days later. Except that twice they've changed the dosage and sent the book back without phoning (only a change from 8mg to 9mg twice weekly, or something like that, and he was only slightly out of range, but still...).
He's got a coaguchek monitor which has so far been within 0.3 of the lab results every time, a couple of times only 0.1 difference. Wants to go to home-testing, other hospitals in the UK do this quite happily I believe but we're still working on convincing ours...

 

[Guest]

There is a doctor in Wolverhampton named Rhys Lodwick (no relation that we can figure out) who might be able to help you get started on self-testing.