? for Pro Time users

[Gisele]

I have had my unit now for approx 1 month. Today I went to my cardiologist where I demonstrated (required by Quality Assurance) that I knew how to use my unit. My INR reading was 3.6 I also had my blood drawn through traditional methods in order to compare the two. My lab results were 4.45. That is a big discrepency. Because the blood is refridgerated for several hours prior to being transferred to hospital my doc recommended that I go directly to the hospital with my unit. so tomorrow after work I will go and have them draw my blood, then immediately analyze it while I test with my ProTime unit. If the two results are still off by this wide a margin, I know my MD won't consider any further test readings from my unit. I did notice that I was getting what I thought were low readings, as I usually have a tendency to run a bit high. I have had several dose increases based on the results I obtained from my unit. This is very dissapointing. I hope that all goes well tomorrow. Anyone else have a similar incident? (PS-had the Avocet unit prior to Protime and checked it three times against the lab and it came in pretty close)
Thanks. Gisele

 

[DickV]

To Gisele

To Gisele

I self test too but before I did, I always had a stable INR then one month it was way off so the Dr. started moving my Coumadin levels up and down to try to get it back to 3.0. About 6 weeks after this roller coaster started I got an invoice from a lab I had never heard of. I went by the Dr's office to find out that on one occasion only they sent my blood to a different lab. The results were so far off my normal levels that by adjusting the medication then testing on my regular lab, I was all over the place and on and on it went. Finally I decided it was a fluke and just went back to taking my regular 8mg daily and in a few weeks I was back to normal.

Moral of the story is that I believe if you were to test your INR with two different lab companies on the same day, you would get differences. Dr's are quick to blame our smaller machines but I am not so sure after having my experience. with the variance in the two labs' test results. If in doubt, either retest at the same lab or have it tested elsewhere even it is on your own nickle. Don't let the Dr. assume any differences have to be your machine.

A certain lab here in Houston trucks the blood to Austin, about 200 miles away to test. Now how exact can that be?

Good luck and don't give up, you have a good machine. (yes Lance, I like your machine too)

 

[Gisele]

Thanks Dick, but........

Thanks Dick, but........

My MD send my blood to the local hospital. I will be going to that same hospital tomorrow. My blood was drawn about 10:30 AM, and the courrier does the pick up around 11:00 or so. Of course I am not sure how long it sat around at the hosp. The office called me around 2:00 or so with the results. I just hope that tomorrow my results are closer than today's results. Thanks for the imput. Gisele

 

[RobThatsMe]

Hi,

I went to my doctors office, preformed my own test on my ProTime unit, then he drew blood and sent to the lab.

My results were only .1 off. MY unit read 2.3 and the lab was 2.4

Rob

 

[Marty]

Lab vs.Protime?

Lab vs.Protime?

Gisele, Email your problem to Dr. Jack Ansell at Boston U.He will answer right back. He is the national anticoagulation guru.
[email protected] . When I had a similar problem starting off with my Coaguchek he said in his experience these little self fingerstick monitors were as good as most hospital labs and sometimes better! I've stuck with my Coaguchek ever since and had no problem.

 

[Hank]

Protime Accuracy

Protime Accuracy

Due to the way the protime tests itself and then double checks the sample, I would be willing to bet quite a bit that the Protime is much more accurate than a lab test.

I worked in one of these labs for years and I would trust the ProTime WAY before I would trust the lab.

 

[Gisele]

Thanks

Thanks

Thanks for your replies. I went to the hospital for a stat INR on Wed. The lab got 4.5 where I got 3.6! I spoke with Sue at Quality Ass. and faxed over all the information she requested from me so that she can get to the bottom of this. I am hoping that it can be determined why there is such a difference between results. My Avocet unit was right on target (had it checked against lab 3 times). For now I must continue going to the lab and checking against my machine. I will keep you posted when I hear anything. Thanks. Gisele

 

[Gail in Ca]

Interestingly, I had an avosure unit and it was always off from the lab, but it and the coagucheck were always closer. I just decided to take its' measurement and adjust from that.
So, now that I have my pro time I am not going thru the hassle of testing 3 different ways to see if they are all within .2 or something.
I am trusting that it is a good product and will go with it's results. I didn't know you had to go in an test it against the lab?
Gail

 

[Blanche]

Discrepancies between ProTime and Lab

Discrepancies between ProTime and Lab

My husband Al has been having these same problems with comparing the ProTime and lab results since May, and we've made about 15 comparisons. The differences between the machine and the lab runs from .01 to 1.2. The doctor even changed labs, but the discrepancies continued.

QAS arranged for the company, Technydine, to send us a second ProTime machine. We have been testing on both machines, one right after the other, and then testing at the lab. It hasn't seemed to help. And, the add to this concern, the two ProTime machines get different results. One time the first machine read 3.1 and the second 3.7. They say that a difference of .06 is acceptable. Another time, the first machine was 4.0 and the second one was 3.3. (Lab results were 3.0 and 3.1) What I wonder about is that on one test the first machine was lower than the second one, but on the next test the reverse was true...the first machine was higher than the second. I'm wondering if the tolerance of .06 is plus or minus .06, which could mean a possible difference of 1.2.

All of the data we have has been sent to the company by QAS. Although it's been about 2 weeks, we have yet to hear back. I'm sure they have experts there who can interpret the data from the many tests we have done. The last pair of tests that we tried with the ProTime machines both failed. On the first we got an error that isn't even in the book. Still waiting to find out what that was. The test of the second machine gave and INR of .08, which of course was in error. We repeated one test later and got a reading of 4.0. The corresponding lab score was 3.l.

I will let you know what the company reports when we hear from them. I know the ProTime works well for so many people here, so I hope we can resolve this and successfully use the machine instead of the lab. Time will tell.

Regards to all,
Blanche, spouse of Albert
mitral valve replaced with St Jude October, 1990

 

[Gisele]

Update

Update

Another trip to the lab, and more to come. I went yesterday to the hospital to have an INR drawn. My ProTime unit obtained an INR of 2.2 (below my optimum range of 2.5 to 3.5). The hospital got 2.46.
My cardiologist is thinking that my monitor can handle lower INR values, but when it starts to climb it cannot process that information. My other discrepencies were when my unit was giving me a reading of 3.6 and the hospital was at 4.5 (ish). Unfortunately I will have to continue testing at home, and comparing with hospital results until some sort of conclusion can be made. My doc wasn't too keen on me purchasing this unit, so he isn't about to ignore this.
I am curious to know what type of high readings other patients have achieved, and have they been compared to labs to verify accuracy.
All I can say is that it is frustrating. I was so happy to get away from going to the hospital.
Hoping to hear from QA on what they think it may be.
Thanks for all your imput...........Gisele

 

[Hank]

ProTime verses CoaguChek

ProTime verses CoaguChek

Last night I went to my Doctors office and took my ProTime. We tested from the same hole in my finger. Their CoaguChek got an INR of 3.1 and my ProTime was 3.5. Then we repeated the tests from the other side of the same finger immediately. This time their CoaguChek was 3.6 and my ProTime was 3.5. I don't know about you but this tells me two things. One, my machine is consistent. Two, theirs isn't. Thats about it, but I thought you would be interested.

 

[Gisele]

Thanks Janie

Thanks Janie

But, my problem is when my unit was giving me readings of 3.6 the lab was consistent in giving me readings of 4.5 and 4.6 respectably. (difference of .9 and 1.0)
This week my unit gave me 2.2 and the lab was 2.4 difference of only .2
The differences between the two methods vary. The constant factor is I am using the same lab at the hospital with a veni-puncture vs a finger stick. It would be fine if both methods used to analyze were constant in their different readings so I could adjust accordingly, but that is not the problem here.
I will continue monitoring the differences in hopes of finding a solution to this problem. Too bad though, I thought it would go more smoothly than this.
Gisele

 

[Hank]

Yes Janie

Yes Janie

Of course the first drop goes to the CoaguChek everytime. I read up on that many moons ago. My little test means nothing really except that it reaffirms my trust in my machine. I have no idea what controls they run on their CoaguChek or if they put in a dishwasher at night for that matter.

I do know one thing. Home INR testing is not only convenient, but also a vital part in accurate anticoagulant therapy dosing. No matter if using a CoaguChek or a ProTime. Develop faith in your machine and in your methods, confirm your results often, and you will be better off because of it.

 

[Guest]

I had a request on my website about who sells Pro Time in the UK. Does anyone know.

I told them to contact hometestmed, but that wasn't a direct answer.

 

[arlice]

Someone correct me if I am wrong, but I believe that the test reagents used in the labs to check protime are not an exact science and it changes from batch to batch and maybe even bottle to bottle. If a lab changes vendors then it might be even more of a change. There is something (a number perhaps that is provided by the maker of the reagent) that the lab has to do with each control reagent to make sure that the protime is as accurate as possible. INR is supposed to make this more accurate since it's a ratio. I think this is what happened in Pennsylvania-they forgot to make that correction with a brand change and it gave them low readings so patients were overmedicated with coumadin and then some died.

So if you are using the test Cuvettes from ProTime they should all be the same (at least from one batch). I would think this might be more accurate than a lab which might buy a cheaper brand next week or just have a new batch of the old. My husband really feels comfortable with his unit (it checked .6 off the lab when he did his proficiency test at the doctor's office) because of this. He often did not trust the readings from the lab. His protime has remained much more constant with his ProTime unit.

Did I just confuse the issue? I hope not. I hope that Gisele will get hers straightened out soon.

Arlice

 

[Hank]

ProTime Accuracy

ProTime Accuracy

Hello There,

I have a ProTime machine. I also have ten years experience working in a clinical laboratory where I was in charge of running the controls that you spoke of in your previous message. All that being said,

I would trust the ProTime and/or CoaguChek results LONG before I would trust a labs results.

 

[Guest]

Arlice,
You are 100% correct.

I am not a valve recipient, I have run an anticoagulation clinic for four years as of next week.

 

[Gisele]

Lastest update

Lastest update

Another trip to the lab. My INR today was 2.9 with my ProTime unit and the lab at the hospital was 3.74. Word is, my cardiologist no longer wants me to use my unit. I am under orders to use the hospital lab only. Now I must rely on QA to find an answer to my problem, and to present my cardiologist with that information. I do not intend to continue using the lab forever but I am afraid for now I am doomed to driving there, signing papers, waiting, waiting, and waiting some more for my name to be called etc.......I am sure we all know the routine. I am totally frustrated.

 

[Guest]

Whether your INR was 2.9 or 3.7, you would get the same advice at my clinic - continue the same warfarin dose. There is essentially no difference between the two. I allow 0.2 units outside the range to be considered in the range. You should challenge your cardiologist to give you one example of someone who was harmed by an INR of 3.7.
I had a statistician analyze 2,500 patient visits for one year. There was no statistically significant increase in minor bleeding events, no matter what your INR was as long as it was below 5.0. I also presented this as a poster presentation at the Anticoagulation Forum meeting in Washington DC during May 2001. Hundreds of people who specialize in anticoagulation discussed my findings with me and nobody seriously disagreed with me.
Essentially what your doctor is saying is that if he were trying to drive between 25 and 35 MPH and he looked at the speedometer and saw that he was doing 37, he would slam on the brakes.
I believe that your location was "north of Boston". Well one of the leading advocates for patient self-testing is Jack Ansell, MD at tehj Department of Medicine at Boston University Medical Center. I am 100% certain that Dr. Ansell would consult with your doctor on this. If I knew his phone number, I would give it to you, but you can get it by calling the medical center. Then have it to give to your doctor. Dr. Martin Thomas (MATXR) has written on this website that Dr. Ansell responds to all of his messages. I have also talked with Dr. Ansell several times and am certain that this is true.
"Illegitimi non-carborundum" loosely translated Don't let the *******s wear you down!!!

 

[Christina]

Hi Gisele,

INR testing is not an exact science and it can differ from lab to lab. I bet if you tested at 5 different labs, they all would have different readings.
Learn to trust your machine more than the lab, and find a doctor/cardiologist who is willing to work with you.
I finally found one after one year. I had almost given up and felt so depressed, because my previous doctor would not accept the Protime results, because one time not too long ago he instructed me to go to the lab and the results that day were 4.9. My Protime was 3.2. He told me to HOLD the Coumadin for TWO WHOLE DAYS (can you believe that one?) which I did not listen to.
I believe firmly that the lab made a mistake that day because it had never happened before. I usually am on the low side.
The only time when I have had a high INR was because the pharmacy gave me the synthetic form of Coumadin and I did not know the difference. I learned fast, and will never ever accept Warfarin again because you don't know how much is in it. The pharmacist told me it was the exact same thing and I believed him. Now I know better!

Hope you find relief soon. I know about the stress this can cause.

Christina