Got my home testing kit today; some questions...

[bahlvarun]

Hi all,
Today Got new kit coaguchk xs; first test was at 3.0 inr. Queries are
A. I got the kit for 20k ~ $400, this Included instrument , lancets, pricking instrument, 24stripes; since its not covered by my insurance, is it a good deal?
B. stripes came in with ice pad they said its supposed to be kept cold and in fridge all the time? Also stripes should not be exposed more than 5 minutes? Also if It is to be transported it has to be definitely be in ice pack? Do we have so many restrictions with the strips?
C. How reliable is this instrument? Since I bought it based on my doc.s recommendation?
D. Even after having this how often should I test, and when should I get it tested in lab to ensure correctness of the reading? Or is it not needed at all?

Thanks in advance...!!!

 

[TheGymGuy]

I Can only answer price question. I the device is new or in as new condition the price is great!!! I was not aware of keeping strips refrigerated part, hope others chime in.

 

[sarahsunshine]

Odd that they are kept cold...

Our coaguchek XS has strips that aren't kept in the fridge. The INR clinic says that they are shipped and sold that way, but really it doesn't matter. Store them with the machine (The machine doesn't work if it's under 15C - I know because we keep it in a cabinet next to the window and it gets cool and doesn't work).

We got our Coacucheck several years ago for $475CDN so I think that $400US is a decent price.

Our machine is very reliable - but you have to make sure that you use it properly. We had a weird situation when we got high readings (very high), likely because we were in a hurry and the alcohol from the swab hadn't dried completely yet.

Testing is dependent on your dose and diet and where you are at.
Our clinic's policy is:
1. Test immediately.
2. Test in a week. If you are within range, and within INR 0.3 of your previous test, test in another week.
3. If you are in range and within .3 for 3 weeks straight, test every 2 weeks.
4. If you are within range (or 0.3) every 2 weeks for 3 tests, test every 3 weeks.
5. If you are within range (or 0.3) every 3 weeks for 3 tests, test every 4 weeks. Don't test any less often than every 4 weeks.

VARIATION:
If you change your diet, medication, or activity level significantly, start over at weekly testing or work with the clinic to re-stabilize your INR on the new regime.
If you suspect for some reason that your INR may be out of range (bruising, nose bleed, just a feeling), test.

Luckily, most of this stuff is now covered with insurance so testing isn't a big cost, and being at home means you don't have the PITA of going to the clinic. You'll wonder why you never did it before.

Oh, and our clinic has started a web page for submitting your test results and changes so they can monitor the self-regulators (us). It's SO easy.

 

[Sarah_Louise]

Hi all,
Today Got new kit coaguchk xs; first test was at 3.0 inr. Queries are
A. I got the kit for 20k ~ $400, this Included instrument , lancets, pricking instrument, 24stripes; since its not covered by my insurance, is it a good deal?
B. stripes came in with ice pad they said its supposed to be kept cold and in fridge all the time? Also stripes should not be exposed more than 5 minutes? Also if It is to be transported it has to be definitely be in ice pack? Do we have so many restrictions with the strips?
C. How reliable is this instrument? Since I bought it based on my doc.s recommendation?
D. Even after having this how often should I test, and when should I get it tested in lab to ensure correctness of the reading? Or is it not needed at all?

Thanks in advance...!!!

A. Can't help as im not in the US so i got mine for free off the NHS
B.I never kept my strips the fridge just in my pack with the needles and machines
C. I'd say very reliable, i no for me, there was only a .2-.3 differene between the finger prick & venous test so its pretty accurate,
D. I had a venous test done ever 6-8 weeks i think it was,
Good luck to you
Love Sarah xxx

 

[Bina]

Hello Varun, glad to see that you got a monitor
The price is good, I also paid c$500.

For the modern Coaguchek XS model, the strips don't need to be cold, but they shouldn't be hot either.
It is a good idea to get all your items ready on a table before you test so that no time is wasted with a strip being
exposed to air for a long period of time. My strips are in a sealed plastic tube.

Wash your hands with soap and water, dry them well, and NO need for alcohol wipes with this machine.

The results are VERY accurate and you can test as often as you like, depending on how your INR is in range or not.
My INR is always around 3.1 and I test every 2 weeks or so.
Enjoy your new monitor !!

 

[Protimenow]

I agree entirely with Bina -- I use an InRatio, and don't refrigerate my strips (although, on some REALLY HOT days, the temperature in my house may go higher than the reported maximum for the strips -- I'm not sure about a maximum temperature for CoaguChek, but it would not be a bad idea to keep your supply of strips in a place where the temperature neither gets too hot or too cold).

As far as accuracy -- these machines are very accurate -- when they were designed, they were manufactured for use in medical offices, clinics, and hospitals. In these environments, accuracy is essential. For an active clinic, a machine may run as many tests in a day or two that you'll run in a year or two. (If I recall, the CoaguChek XS strips are available in multiples of 24 strips - I've seen them sold as two containers of 24 each--even with weekly testing, it will take nearly a year to go through the 48 strips. It may almost be challenging to use a supply of strips before their expiration date).

Personally, I would prefer to test weekly (and I would, if I had more InRatio strips) -- even if your INR is the same on two tests, there's no telling where it is BETWEEN tests. Reducing the interval between tests is, to my mind, a good thing to do, and helps to be confident that you stay within range from week (or so) to week. I take the same dose every day -- if I had different doses on different days, I may even test on different days of the week, about a week apart, to detect any changes in my INR because of the different daily doses.

FWIW -- you'll probably have to use a 21 gauge lancet -- the ones made for blood monitors are too fine and won't let you get a big enough drop of blood for your meter.

Enjoy your new meter -- and the freedom that home testing gives you.

 

[bahlvarun]

Thanks all for the information...
It's a good start, just a couple more q's
A. How often should I test at the lab? Is it necessary to even go to lab?
B. how often the instruments need to be calibrated for its correctness
Regards,
Varun

 

[sarahsunshine]

We get our machine calibrated with a blood draw INR once a year. Other than that, we are lab-free.

 

[Bina]

Thanks all for the information...
It's a good start, just a couple more q's
A. How often should I test at the lab? Is it necessary to even go to lab?
B. how often the instruments need to be calibrated for its correctness
Regards,
Varun

Regarding your questions:

A. Most doctors will still request a lab blood draw once a year, or whenever your home monitor reports a very high or very low reading,
just to be on the safe side....In these cases a double check is a very good idea.
Home monitors are not capable of entirely accurate readings when the INR reads above 5.0

B. The Coaguchek XS has a modern built-in quality control and NO need for calibration.

 

[jerseysue]

Hi!
That price sounds amazing to me. I've had a home testing INR machine for 10 yrs. now and am on my 2nd one; they billed Medicare ~$2500 for it! But it's paid for by Medicare for mechanical valve recipients. Mine arrives with the package clearly marked to refrigerate upon receipt, and I've been told to leave the strips out about 45 min. before testing. Another person said it was safe to leave it out over night, but I'm in a very warm climate so I do the 45min. rule. I've never had a problem with it not being reliable and rarely go to a lab. I test 1 X week, and those are Medicare requirements. I like that, I feel comfortable keeping tabs on where I'm at since my protime is so affected by food, weather and activity - which varies. I've met some people who take their machines to a lab once a year to make sure it's accurate, but I never have. I think that most professionals feel the machines are accurate enough to let us all have them now and nobody has questioned the results, even me. If I felt it was "off", I'd go to the lab. Enjoy your machine!! They're great!

 

[catwoman]

We get our machine calibrated with a blood draw INR once a year. Other than that, we are lab-free.

I think you mean you compare your machine against a blood draw.

To the best of my knowledge, I have only had 1 blood draw for an INR in the nearly 9 years since my surgery. That was in 2009 when I had my last TEE. Didn't know I was having an INR done until I was asked if I knew that my INR was 2.0 (and no, I didn't, it was about time for me to test but I had not).

As to storage of testing strips:
I do store the box of 48 in my fridge. I keep about 3-4 in the INRatio carrying case. So, at least one may be there 3-4 weeks at room temperature before being used.

 

[Protimenow]

Jerseysue -- if you actually are using a ProTime meter, your strips should be kept refrigerated. I used to use a ProTime meter -- and my strips were okay to use after fifteen minutes out of the refrigerator. When I got my last supply, they were sent without a cold pack, and sat in the back of a UPS truck on a summer day. The people who make the ProTime meter and cuvettes (they don't call them strips) said that they CAN be exposed to heat for a few hours, and that keeping them unrefrigerated for a few days won't hurt them -- but with ProTime cuvettes, keeping them refrigerated is a great idea.

I've moved from a ProTime to an InRatio and appreciate the InRatio because it doesn't require nearly as much blood to run a test, is quieter (the beep of the ProTime meter used to annoy my dogs), the strips don't require refrigeration, and the meter will still run properly with recently expired strips.

OTOH -- The ProTime is STILL a very good meter.