Home testing questions

[charlottekaye]

Hi all - I have been on warfarin or its equivalent since 1997. Since COVID-19, I've been unwilling to go in to my location for testing. I have discouraged by my coumadin folks from getting a home- testing device. Consequently, I havent been tested since January (!!!!!!) Has anyone else been discouraged from buying a home testing g device? Also, how much should I expect to pay? Any information you can share is greatly appreciated!!

 

[dick0236]

Hi all - I have been on warfarin or its equivalent since 1997. Since COVID-19, I've been unwilling to go in to my location for testing. I have discouraged by my coumadin folks from getting a home- testing device. Consequently, I havent been tested since January (!!!!!!) Has anyone else been discouraged from buying a home testing g device? Also, how much should I expect to pay? Any information you can share is greatly appreciated!!

I was not only discouraged by my testing clinic and cardio, they refused to approve my use of self-testing. That "hard ***" position seems to be slowly changing among medical professionals. Do a search for "INR self testing labs" and they can walk you thru the procedure. I have been home testing for over 10 years with my docs blessing.

PS: You really should get and INR test......especially since it has been 7 or 8 months. Go to your lab. If they are like the labs in Kentucky, they are well equipped to handle you safely.

 

[pellicle]

I have discouraged by my coumadin folks from getting a home- testing device.

I don't know who discouraged you but they need a good swift kick.

I'd personally just buy one and start testing. Ask for advice here and here's a stater post on how to I wrote some years back:
http://cjeastwd.blogspot.com/2014/09/managing-my-inr.html
you should test weekly in my view, sure a case can be made for testing every second week, but really what does that achieve? I think even if you are stable (and only weekly testing will reveal that) that its like wearing a seat belt. You don't start to put it on when you see an accident ahead.

 

[Justmadi]

I don't know who discouraged you but they need a good swift kick.

I'd personally just buy one and start testing. Ask for advice here and here's a stater post on how to I wrote some years back:
http://cjeastwd.blogspot.com/2014/09/managing-my-inr.html
you should test weekly in my view, sure a case can be made for testing every second week, but really what does that achieve? I think even if you are stable (and only weekly testing will reveal that) that its like wearing a seat belt. You don't start to put it on when you see an accident ahead.

 

[Justmadi]

I totally agree with those who promote self testing!! i bought my meter on EBay for around $500. That’s about what I was paying a year to be tested at the doctor’s office. Fortunately my doctor was all for it and I let them do the actual monitoring if needed. And I just converse with them via email at no cost!!! I’d love to say you should get a different doctor. Also...you need to be testing way more often. I do weekly and only email doctor if I’m not in my range. Be your own advocate in this. No one else is!

 

[gkold]

Hi all - I have been on warfarin or its equivalent since 1997. Since COVID-19, I've been unwilling to go in to my location for testing. I have discouraged by my coumadin folks from getting a home- testing device. Consequently, I havent been tested since January (!!!!!!) Has anyone else been discouraged from buying a home testing g device? Also, how much should I expect to pay? Any information you can share is greatly appreciated!!

I bought one last year. Insurance paid for some of it. Well worth it.

 

[MdaPA]

I havent been tested since January (!!!!!!)

As you say you haven't had your INR tested due to COVID-19 since January, I would suggest going to the clinic/lab as soon as possible, not waiting until you complete your research into self-testing or your insurance/doctor approves. Don't let the fear or risk of catching COVID-19 jeopardized your health in other areas. There are precautions your lab is taking and you can take as well (e.g. make first appointment of the day, wait in car until called, wear gloves and mask, etc).

 

[Sheenas7]

Hi all - I have been on warfarin or its equivalent since 1997. Since COVID-19, I've been unwilling to go in to my location for testing. I have discouraged by my coumadin folks from getting a home- testing device. Consequently, I havent been tested since January (!!!!!!) Has anyone else been discouraged from buying a home testing g device? Also, how much should I expect to pay? Any information you can share is greatly appreciated!!

Hi Charlottekaye
Since Covid I began self testing this past April instead of going to my doctor’s office. This group here helped me get started. I contacted Roche patient services and they eventually delivered the machine and strips. My insurance (Medicare and Cigna) has been covering all costs so far.
it has been so much easier. Best of luck. I do agree you should go get tested ASAP.

 

[LondonAndy]

It's different here in the UK of course, where self-testing is actively encouraged for those who haven't lost their marbles or control of their fingers etc. But if helpful here is another link to my amateur summary of a health report published in 2014 that says home testing is better than going to a clinic both for the patient and for the health provider (well, those seeking to avoid future hospitalisation of patients due to strokes etc), though I realise that US healthcare operates on a different model. But perhaps it will help encourage them. (NICE is the UK's National Institute of Clinical Excellence, setting out best practice for the NHS).

 

[pellicle]

It's different here in the UK of course, where self-testing is actively encouraged for those who haven't lost their marbles or control of their fingers etc.

As an a aside, if I'd worn that someone would have reported that to the moderators as a political post and it would have been deleted

 

[LondonAndy]

As an a aside, if I'd worn that someone would have reported that to the moderators as a political post and it would have been deleted

Point taken! Have amended to take that into account

 

[ScribeWithALancet]

It's different here in the UK of course, where self-testing is actively encouraged for those who haven't lost their marbles or control of their fingers etc. But if helpful here is another link to my amateur summary of a health report published in 2014 that says home testing is better than going to a clinic both for the patient and for the health provider (well, those seeking to avoid future hospitalisation of patients due to strokes etc), though I realise that US healthcare operates on a different model. But perhaps it will help encourage them. (NICE is the UK's National Institute of Clinical Excellence, setting out best practice for the NHS).

I agree with most of your summary points except one:

• Less time spent testing (5.3 minutes per test compared with 158
  minutes)

We spend less time testing but it is more like 30 to 45 minutes. My wife helps me clean up the table, scrub it down with soap and water, scrub our hands and use a thermophore heating pad for 3 to 5 minutes prior to the prick. We also set up the spreadsheet from the previous week to show which side of which finger to prick. Then, it is a couple minutes to enter the data into two different spreadsheets (to avoid loss in the far future). The data includes what the coumadin dosage was and whether there were unusual circumstances such as medicines or painkillers such as Tylenol. After this, we methodically put away all the equipment and close the software. The extra time is still far less then the time to drive to the Coumadin Clinic which I was doing every couple months prior to the epidemic. My time in range is not as good as yours and Pellicle's but is getting better.

Thank you again for your sample report sheet. It keeps my doctor and my Coumadin Clinic Pharmacist very content. I only send it to the M.D. once every couple months to reassure him that I am fine. I send it to the Coumadin Clinic about once a month. I told my M.D. that it is as much for me as for him as it keeps me from having strokes and bleeds (I had two large hematomas from taking a medicine that was NOT supposed to interact but DID that convinced me that I needed a home meter) When I tried to get a meter thru my health insurance, the rigamarole (sp?) was so great that he wrote me a prescription to get one by paying entirely on my own. I got a Coag-Sense on a bundle sale and it has worked perfectly for me. The CoagUChek folks wanted me to use their service and I did not wish to as my health plan has a Coumadin Clinic.

Walk in His Peace,
Scribe With A Lancet

 

[LondonAndy]

I agree with most of your summary points except one:

• Less time spent testing (5.3 minutes per test compared with 158
  minutes)

We spend less time testing but it is more like 30 to 45 minutes. My wife helps me clean up the table, scrub it down with soap and water, scrub our hands and use a thermophore heating pad for 3 to 5 minutes prior to the prick. We also set up the spreadsheet from the previous week to show which side of which finger to prick. Then, it is a couple minutes to enter the data into two different spreadsheets (to avoid loss in the far future). The data includes what the coumadin dosage was and whether there were unusual circumstances such as medicines or painkillers such as Tylenol. After this, we methodically put away all the equipment and close the software. The extra time is still far less then the time to drive to the Coumadin Clinic which I was doing every couple months prior to the epidemic. My time in range is not as good as yours and Pellicle's but is getting better.

Walk in His Peace,
Scribe With A Lancet

Thanks Scribe - the time comparisons are taken from the actual report, and I think their basic point was that this is comparatively quick and easy to do at home compared with travelling to an anti-coagulation clinic, having a blood draw and going home again.

Personally, I rely on the meter memory to record my results, as it can store over 100 test results, and update my spreadsheet every couple of months or so, but as both you and Pellicle point out it can be useful to record your daily Warfarin dose so that you can look for trends. I also find no problem with getting a sufficiently large drop of blood without having to take extra measures, which I know many people have to do.

I had to buy my meter outright too, directly from Roche for £299 (US$ 382), but thereafter all the supplies are from my doctor on free prescription, and of course the freedom to travel anywhere with the meter, as well as the more frequent testing benefits, led me to conclude it was well worth the investment. My machine is now 6 years old, looks as good as new despite being well travelled, and I think I am still only on the second set of batteries!

 

[charlottekaye]

I don't know who discouraged you but they need a good swift kick.

I'd personally just buy one and start testing. Ask for advice here and here's a stater post on how to I wrote some years back:
http://cjeastwd.blogspot.com/2014/09/managing-my-inr.html
you should test weekly in my view, sure a case can be made for testing every second week, but really what does that achieve? I think even if you are stable (and only weekly testing will reveal that) that its like wearing a seat belt. You don't start to put it on when you see an accident ahead.

Thank you so much

 

[charlottekaye]

I totally agree with those who promote self testing!! i bought my meter on EBay for around $500. That’s about what I was paying a year to be tested at the doctor’s office. Fortunately my doctor was all for it and I let them do the actual monitoring if needed. And I just converse with them via email at no cost!!! I’d love to say you should get a different doctor. Also...you need to be testing way more often. I do weekly and only email doctor if I’m not in my range. Be your own advocate in this. No one else is!

Thank you so much

 

[charlottekaye]

I bought one last year. Insurance paid for some of it. Well worth it.

Thank you

 

[charlottekaye]

I agree with most of your summary points except one:

• Less time spent testing (5.3 minutes per test compared with 158
  minutes)

We spend less time testing but it is more like 30 to 45 minutes. My wife helps me clean up the table, scrub it down with soap and water, scrub our hands and use a thermophore heating pad for 3 to 5 minutes prior to the prick. We also set up the spreadsheet from the previous week to show which side of which finger to prick. Then, it is a couple minutes to enter the data into two different spreadsheets (to avoid loss in the far future). The data includes what the coumadin dosage was and whether there were unusual circumstances such as medicines or painkillers such as Tylenol. After this, we methodically put away all the equipment and close the software. The extra time is still far less then the time to drive to the Coumadin Clinic which I was doing every couple months prior to the epidemic. My time in range is not as good as yours and Pellicle's but is getting better.

Thank you again for your sample report sheet. It keeps my doctor and my Coumadin Clinic Pharmacist very content. I only send it to the M.D. once every couple months to reassure him that I am fine. I send it to the Coumadin Clinic about once a month. I told my M.D. that it is as much for me as for him as it keeps me from having strokes and bleeds (I had two large hematomas from taking a medicine that was NOT supposed to interact but DID that convinced me that I needed a home meter) When I tried to get a meter thru my health insurance, the rigamarole (sp?) was so great that he wrote me a prescription to get one by paying entirely on my own. I got a Coag-Sense on a bundle sale and it has worked perfectly for me. The CoagUChek folks wanted me to use their service and I did not wish to as my health plan has a Coumadin Clinic.

Walk in His Peace,
Scribe With A Lancet

Thank you so much for sharing this information

 

[Warrick]

I prick the same spot on the same finger every weekly test. Third on the left seems to be my best bleeding finger.

Just looking on ebay there appears to be several s/h well priced meters at the moment

 

[Poyda]

Hi all - I have been on warfarin or its equivalent since 1997. Since COVID-19, I've been unwilling to go in to my location for testing. I have discouraged by my coumadin folks from getting a home- testing device. Consequently, I havent been tested since January (!!!!!!) Has anyone else been discouraged from buying a home testing g device? Also, how much should I expect to pay? Any information you can share is greatly appreciated!!

hi there

i cannot recommend self testing enough! it honestly makes things so much easier i've been self testing for a few months now and i'm glad i made the switch

the test itself takes like 5 minutes, no more waiting around for the blood draw and the waiting for your result . with my current schedule i actually couldn't test like i used to

i've also found i've been in range more often and the few variations i've had , they've been knocked on the head pretty quickly.

make the switch, future you will be thankful

 

[Superman]

We’re all a little jaded to poor medical advice, so a little gallows humor.

If something bad should happen, is that a COVID death?

I had this fight about 10 years ago with my provider and insurance. I couldn’t have been the only one, because shortly after I started calling and emailing up the decision tree at the HMO, they finally partnered with the Coumadin Clinic and a third party for a home monitoring service. It’s worth the battle.

Honestly, short of a stroke or hemorrhage, you have no idea what your INR is and really haven’t known since about a week after your last test. Assuming you’re in the States, this is sadly not even about care. It’s about liability and who’s going to pay for it. And they’re willing to sacrifice you.