Freaking about my extended appointments

[Mileena46]

For the first time, my next appointment for my protime is one month! I knew eventually I would go to this, but it is scary. I have been going once a week since my surgery and now my doctor thinks I can wait a month. I have been very stable, not just for the last few visits but the whole time. (the reason for the once a week visits was because they were concerned when they dropped my amiodarone from 400mg to 100mg.)

Anyway, did you guys freak out when it went that long? The last 4 times I have been checked I have been 2.8 3.4 and then 3.3...so we are leaving my dose at the same. The 2.8 came right after the lower dose of amiodarone.

Does this sound normal to be on once a month already? My surgery was July 16.

Thanks in advance

Mileena

 

[Bina]

I was also on Coumadin for only 3 months when my tests were extended to monthly.
With a steady, in range INR that is the protocol, but I was still a bit nervous.
I made sure to keep a consistent diet, and was careful with taking any kind of new supplement or vitamin.
Over time you will get used to the routine, and become more comfortable with it.
Maybe a home monitor will be in your future and then you can test every week or two.

 

[Freddie]

I have a home monitor and I still go to the lab every 2 weeks - main reason being is that my GP doesn't know I have my Coaguchek and I'm comparing the results so I can show my doc.
Once my doc knows the truth about home monitors I will still check my INR every 2 weeks. Going monthly would have me a bit leery - but that's just me.

 

[ALCapshaw2]

Mileena -

Are you using the First Heart AntiCoagulation Center at the Heart Center in HSV to manage your anti-coagulation?

If so, you could ask your favorite CRNP if she could set you up to return in 2 weeks instead of 4, 'just to make you feel more comfortable'. I expect they would accomodate you.

'AL C'

 

[Philip B]

INR Checks

INR Checks

Personally, I like to do weekly checks. I guess that's an advantage of doing the home testing thing. I've done checks from time to time every two weeks, but always felt a little uncomfortable. I don't think I could adjust to once a month checks.

-Philip

 

[Blanche]

Better safe than sorry

Better safe than sorry

My husband tested, at the lab monthly for ten years with no problems or concerns.

But, shortly after ten years of monthly testing he suffered a stroke. His cardiologist now says, almost ten years after the stroke, that he could have avoided the stroke by testing more frequently.

My advice would be, get yourself an INR monitor, such as the ProTIme, Coagucheck, or INR monitor and take this into your hands. It is not difficult.

I sincerely think that a home monitor will help you and save you much concern. Monthly testing is not good for all (or in my opinion, anyone).

Regards,
Blanche

 

[MarkU]

I went to monthly testing about two months post-op.

My INR was always been pretty stable and they put me on a six week schedule after a year or so. Been doing that for almost nine years.

I'm considering getting a home monitor, but that means I wouldn't be able to see the cute redheaded nurse at the Coumadin lab as often.

Mark

 

[halleyg]

you could ask your favorite CRNP if she could set you up to return in 2 weeks instead of 4, 'just to make you feel more comfortable'. I expect they would accomodate you.

This is what I do, the nurse knows I won't go longer than 2 weeks w/o having a test and I haven't in two years. Sometimes another nurse will tell me come back in a month, but I always return within two weeks. The head nurse knows this about me and I've never had a problem. Just tell them you aren't comfortable and they should accomodate you, as Al said.

 

[Cooker]

I tested every week for several weeks after surgery ... I have now tested once a month and have always been in range ... everyone is different and there are many opinions on how often to test ... people have strokes for numerous reasons ... I don’t mean to minimize you concern but if your doctor is a good one I think you can go with this without putting yourself in harms way ... people have had strokes while in range ... I take my meds everyday, test once a month and don’t give it a second thought ... peace of mind comes with the experience time brings....

 

[EVELYN]

My husband tests once a week and has for 7 years. His cardio says, "Better safe than sorry." However, we do have our own INRatio. Personally, I like his checking weekly and could probably go to every other week, but NOT once monthly. I think when you go out of range it's just easier to get it back when it's monitored weekly. JMHO.

Evelyn

 

[Mileena46]

Thanks to everyone for your replies. I don't know that I feel better though.

Al, I was doing the clinic in Huntsville....which is why I was going once a week, but you know that is over an hours drive for me. They suggested I get a doctor in Scottsboro and they would be more than happy to send him my files OR to take me back if I wasnt happy with him. (They no longer accept phone patients),

My surgeon allowed me to be tested at the local hospital and I had a standing order there. They also offered to keep managaing my levels for me....but I felt I needed a local doctor.

The doctor I chose is a "blood doctor from way back", (his words) and I liked him. I also know other people who he manages for and they do very well.

After he told me to come back in a month, I started becoming concerned. I know he isn't the clinic and this isn't all he does...BUT I have such a hard time driving an hour for someone to prick my finger and I am there all of five minutes! Now I just don't know what to do!

Mileena

 

[olefin]

My first cardiologist wanted me tested monthly unless I was our of the control range of 2.5 to 3.5. Also he would retest in a week if there was a change in the dosage.

Six months after AVR we went on the road in our motorhome. I had a prescription to get my INR checked at any hospital or lab. I got tested monthly would call him the results if it was out of control. Then test weekly until in control. My INR has always been a little wild.

After a few years sold the RV and moved to another state. My new cardiologist wasn't as careful with testing and didn't like to test but once a month. Many times I would request to be tested, especially if he made a change in the dosage or was out of control limits. He never refused but could tell he didn't like it. I also tweaked his recommended dosage when I saw fit.

This year I started home testing and dosage. I feel more comfortable with weekly testing.

Maybe you should consider home testing.
Good luck.

 

[dick0236]

If you have a history of being stable, monthly testing should be OK. I lab tested (venus draws), monthly, for many years. After the "finger stick" became available, testing became less a hassle and I asked to test more frequently, bi-weekly, because that seems to make staying in range "easier". My docs never objected to my request for bi-weekly testing. Now I am "self testing" biweekly.

 

[ALCapshaw2]

Thanks to everyone for your replies. I don't know that I feel better though.

Al, I was doing the clinic in Huntsville....which is why I was going once a week, but you know that is over an hours drive for me. They suggested I get a doctor in Scottsboro and they would be more than happy to send him my files OR to take me back if I wasnt happy with him. (They no longer accept phone patients),

My surgeon allowed me to be tested at the local hospital and I had a standing order there. They also offered to keep managaing my levels for me....but I felt I needed a local doctor.

The doctor I chose is a "blood doctor from way back", (his words) and I liked him. I also know other people who he manages for and they do very well.

After he told me to come back in a month, I started becoming concerned. I know he isn't the clinic and this isn't all he does...BUT I have such a hard time driving an hour for someone to prick my finger and I am there all of five minutes! Now I just don't know what to do!

Mileena

You might start by just telling this new Doctor that you are nervous about going out to 4 weeks and would feel more comfortable testing every 2 weeks until you see that you are stabilized. Hopefully he will understand and accomodate your desire.

Another option is to see if your insurance company will pay for a Home Testing Device. QAS can help coordinate this process. If you are on Medicare, Home Testing IS a covered option and QAS can help with that also.

Option 3 would be to purchase your own Test Instrument and Test Strips. QAS and others have been known to offer 'cash discounts' to such customers.

Good Luck !

'AL Capshaw'

 

[Herb M]

I test whenever I feel like it. It usually is 4 to 6 weeks. Sometimes when I feel there may be a change in my diet I would test in 2 to 3 weeks.

I am in control of my testing, not the doctor, not the lab. I know more than the doctor or lab knows.

I use a hospital lab for the blood test.

 

[Mileena46]

Well, I have decided since I have a standing order at the local hospital that is good for 12 months, that in 2 weeks I am just going to go and get it checked and not have them send it anywhere.

I would feel better doing that and its taken a load off my mind.

Thanks everyone for your help!

Mileena