Frustrated!!!!

[aussiemember]

I just can't believe sometimes how annoying the Warfarin clinics are!! I self test but my surgeon wants me to get pathology checks every 6 weeks just to correlate the accuracy of my machine. Which is all fine as the tests are free and there's usually no waiting time. Anyway, I was supposed to have a test on Monday but I had had a stomach bug so did a home test on Sunday night to find a reading of 4.9. So I halved my dose on Sunday night and tested again last night to get a perfect reading of 3.3 (range 2.5 - 3.5). Anyway, I went for a test this morning but made the mistake of telling the nurse I had had a stomach bug. They just rang then and told me I had to reduce my dose by .5 a day and retest on Saturday. So, I asked what my INR had been. She said it was 3.3. BUT I said - that means I am within range so why are we changing the dose. The reason apparently is that my stomach bug MIGHT increase my reading a bit. !!

So I refused to do it and she got snooty and said she would discuss it with the haemotologist and ring me back. I'm not reducing anyway, no matter what they tell me to do - BUT how annoying is that - obviously I had better not mention anything next time to the nurse....

 

[witzkeyman]

I've learned to keep my mouth shut when I go to the doctor's office. I do the same on here sometimes. you know what is best for you and how your body is affected by the Coumadin. I love having my own machine.

 

[Ross]

Not suggesting to anyone to do it, but most of us do the same thing.

 

[catwoman]

aussiemember:

I'd ignore the nurse and just keep on keepin' on.

Can you switch your anticoagulation management to another doctor other than your surgeon? My PCP "manages" mine; i.e., he writes the Rxes, but I self-test and self-dose. My cardiologist is impressed that I've been doing it for 6 years.

Having to go every 6 weeks for another INR test just to show them that your machine is accurate is ludicrous. Even if the pathology tests -- I assume it's a draw, rather than POC, or finger stick, test -- are free and there's usually no waiting. That's nearly 9 times a year you have to make time in YOUR schedule, drive somewhere and then deal with a potentially "snooty" nurse.

Food for thought: Would this same surgeon expect a diabetic to go to an endocrinologist or family doctor to get regular pathology reports to determine if his/her glucometer was accurate????

 

[aussiemember]

Thanks everyone for listening - sometimes I just need to vent

And yes - I'll definitely have to learn to keep my mouth shut and just do what I want anyway

Catwoman - totally agree with what yóu've said - the problem here in Australia is that INR home testing isn't even heard of, let alone accepted by most of the medical profession - I am fortunate that my surgeon is so progressive. So there's no option to "switch" to anyone else - I'll just have to be very careful not to tell the nurse anything!!!

 

[Bina]

Aussie, congrats on knowing what to do, and what not to do.

 

[catwoman]

aussiemember:

What algorithm chart are you using for adjusting dosages? If you're using one, have you given your doctor a copy of it?
I've shown mine to my family doctor. Even gave him a photocopy of it. I was wanting to make sure his staff knew I was basing changes on proven figures.

 

[Cris N]

Sometimes it's a good idea to tell them what they want to hear

 

[Ross]

Sometimes it's a good idea to tell them what they want to hear

Yeah, something like, "You know what, I didn't listen to you and did this and now I'm in range".

 

[netmiff]

Sometimes it's a good idea to tell them what they want to hear

been there, done that! Only thing is, next time she called, when she asked for confirmation of my dosage, I couldn't agree with her as I had not been taking what she said I should, and got a tongue-lashing on a long-distance phone call!

 

[Blanche]

I like Chris N's response. Tell them what they want to hear. I also like the responses such as," I'm not sure I remember," "I think I forgot it."

I have had more difficulty with our anticoagulation coming from "medical assistants??" than from the physicians. One person told me that she had one heck of a problem with people like me who don't listen to her. After all, she said she was "a medical professional." Turns out that the only experience she had before her present JOB was answering the phone.

In another incident, I took on the Uruologist's Nurse. She made such a fuss over the Coumadin that I thought we might have to get a different doctor. THen, I found out that the "Nurse" had a high school education, which is very good. But she has no "schoolin' in nursing or medicine. She learned whatever she could pick-up!!!

Sorry you are having these difficulties.

Blanche

 

[Cris N]

My favorite was when I was a newbie and still being managed by cardio's office. My INR was trending down but the latest result was still in range. Nurse tells me to hold one dose and then reduce the daily amount. I told her I was not comfortable with that and maybe she should verify it with someone else. She called back with a dosage increase.

 

[Mimi]

My surgeon gave me a home testing INR kit, however when I approached my local GP to assist me she refused and told me to continue with pathology. I told my surgeon and he just laughed and said, 'that's typical of a GP'. He told me to read the instruction book and work it out for myself, however the stripes are very expensive, so it's best I attend pathology. When I told pathology they were annoyed that I had been given a machine and the girl said, 'what makes you so special'. So I said, 'well I'm in my 30's and I have to test for the rest of my life'. Now days I just get my reading and keep quiet.

 

[Ross]

My surgeon gave me a home testing INR kit, however when I approached my local GP to assist me she refused and told me to continue with pathology. I told my surgeon and he just laughed and said, 'that's typical of a GP'. He told me to read the instruction book and work it out for myself, however the stripes are very expensive, so it's best I attend pathology. When I told pathology they were annoyed that I had been given a machine and the girl said, 'what makes you so special'. So I said, 'well I'm in my 30's and I have to test for the rest of my life'. Now days I just get my reading and keep quiet.

Oh Oh Oh, I have a very clever response to that smart aleck, but I'll keep it to myself.

 

[catwoman]

My surgeon gave me a home testing INR kit, however when I approached my local GP to assist me she refused and told me to continue with pathology. I told my surgeon and he just laughed and said, 'that's typical of a GP'. He told me to read the instruction book and work it out for myself, however the stripes are very expensive, so it's best I attend pathology. When I told pathology they were annoyed that I had been given a machine and the girl said, 'what makes you so special'. So I said, 'well I'm in my 30's and I have to test for the rest of my life'. Now days I just get my reading and keep quiet.

My thought: "What makes you think I'm not?"

I would have reported that employee's comment. Totally unprofessional for her to voice her personal opinion about a patient's needs.

JERK!

I have reported a whiny employee's comment to my PCP. When I was on short-term disability after my MVR, my PCP had to sign paperwork to be faxed to the STD insurance carrier. One employee didn't know I was in the next room and whined about having to take care of the paperwork, enough that I was embarrassed about the comments.
My PCP apologized and said he would talk to the employee.

 

[aussiemember]

Great advice from you all - I think the tell them what they want to hear idea is what I'll do from now on. The attitude that Mimi got from the pathology nurse is exactly what the opinion of home testing still is here in Australia - it makes you wonder how many are wandering around way out of range

BTW: I didn't hear anything else from pathology but my pathology letter arrived yesterday (they always send a follow up letter with your dose and the date of your next test) - and I was amazed to find that they actually did listen to me - the instructions were to keep my dose the same and retest again in two weeks - seems the haematologist must have had some common sense after all

 

[catwoman]

Good for you!!! Sounds like the hematologist is pretty smart.