I just got my new Coag-Sense meter...

[Agian]

Hi



Was it your daughter?

The girl cutting my hair.

Sorry, missed your call.

 

[tom in MO]

http://www.valvereplacement.org/for...e-of-onx-valve-and-problems-with-lowering-inr

Thanks a lot.

 

[LondonAndy]

The question I have no answer for and have yet to find is: "When do you know your meter needs to be replaced?" Can't find that in the manual anywhere, even though they give you the meter for free to get you to buy the strips Hey that could mean they won't tell you when to replace the meter since the "free" meter is actually not too cheap.

Here in the UK, generally we have to buy our INR meter and then we get the strips for free on the NHS, or at worst pay a standard prescription price of about $10. I have to go every 6 months to my anti-coagulation clinic to calibrate my meter and make sure that it is within tolerance (by simply doing a lab test blood draw there and comparing it with my self test at the same time). I have only had my machine 3.5 years, but so far no issues.

 

[tom in MO]

Here in the UK, generally we have to buy our INR meter and then we get the strips for free on the NHS, or at worst pay a standard prescription price of about $10. I have to go every 6 months to my anti-coagulation clinic to calibrate my meter and make sure that it is within tolerance (by simply doing a lab test blood draw there and comparing it with my self test at the same time). I have only had my machine 3.5 years, but so far no issues.

Thanks for the information LondonAndy. Do they actually calibrated your meter (i.e. adjust it until it reads the correct values) or is it a simple check to make sure it is comparable to the blood draw testing?

I've had a meter from two suppliers in the US and your 6-month check is not discussed by the supplier or my cardio. I'll have to ask why not. What brand of meter do you use, mine is CoaguChek.

 

[Jamey T]

OK, not to change the subject or anything but......
I got the first comparison test with a lab test, and the results were in line with what I kind of expected.
The lab test was 2.8, the Coag-Sense was 3.1, and the Coaguchek was 3.8. The lab vs. Coaguchek difference was in line with previous tests.

I also asked about the reagent the lab uses, and they use Neoplastin.
Again, like I said, I think there is some part of my blood chemistry that messes with the Coaguchek, as it has shown those errors with several different lot numbers of test strips. And yes, I am using the correct chip. (I checked to make sure ).

OK, carry on!

 

[pellicle]

Hi

firstly are you on any medications at the moment?

OK, not to change the subject or anything but......
I got the first comparison test with a lab test, and the results were in line with what I kind of expected.
The lab test was 2.8, the Coag-Sense was 3.1, and the Coaguchek was 3.8. The lab vs. Coaguchek difference was in line with previous tests.

Seems to match the sorts of variance in that chart I posted

This also casts a bit of light on neoplastin

https://www.ncbi.nlm.nih.gov/m/pubmed/12495900/

 

[Jamey T]

No I am not doing anything different. I have been self testing/dosing for nearly seven years, so I know what I am doing. (I have typed this out three different times trying not to sound cranky, but it just isn't working for me. Sorry, I'm really not. )

Anyway, one problem I have with the chart showing the different reagents, it makes the Coaguchek look like the standard. I have never read anything that says to trust a meter over a lab test. I do understand the difference between the reagents, which could vary from lab to lab.

If I am mistaken, heck, I am here to learn, as much as anything.

 

[pellicle]

Hi
well firstly I (at least) didn't take any "emotional tone" from your content, and always assume that people aren't angry (or ask if they are if I am suspecting that).

No I am not doing anything different.

actually I'm more concerned the Lab is doing something different. Even just changing their sampling tubes can make a difference.

I have been self testing/dosing for nearly seven years, so I know what I am doing.

understood ... I'm sorry if my "going through a checklist" of items makes you feel like I was pointing at you in particular, but that's not the case. To me its just important to go through each variable and examine it where possible ...

Anyway, one problem I have with the chart showing the different reagents, it makes the Coaguchek look like the standard.

yes, that is perhaps an artifact of who made that chart (assuming you mean the one comparing reagents above) of who compiled it (Roche in this case).

I have never read anything that says to trust a meter over a lab test.

equally I've never read anything to suggest all lab tests (and all labs) are "gold" and given that the test is filled with places where mistakes can be made (and I mean repeated mistakes which are perhaps even a failure to actually properly follow the ISI procedures for normalisation). To me there is less that can be done wrong with a finger stick but I have called them into question on myself and requested a lab draw when I was suspicious.

If I am mistaken, heck, I am here to learn, as much as anything.

I believe we all are .. I am too

Not knowing what your level of experience in reading graphs and charts is , I suggest you read those charts again. Also look at this chart, and take a single vertical line and note the range of readings.

[IMG2=JSON]{"data-align":"none","data-size":"full","src":"https:\/\/c2.staticflickr.com\/4\/3671\/14252522582_6df5733536_b.jpg"}[/IMG2]

INR measurement is not like working with steel.

Again review that data I posted earlier and I believe it indicates that the variations you see are not outside of other gathered expience. Meaning you need to decide which one you'll shoot for (which is why I always advocate against picking an INR of 1.7 even if On-X says its OK)

Let me dig around and see if I can find to support a few of the statements I made above.

Also did you read that link I posted above? (Discrepant Sensitivity ...)?
What did you make of that?

 

[pellicle]

Jamey T
some bits of reading which should help build a picture of variations that can be expected. The bottom line for me is that a process which has less steps and less opportunity for variance in preparation the better (Note the code chips which ship with Coagucheck are related to calibration data for that batch thus providing for that) , it is at least less open to "unexplained" variance.

https://resultlaboratorium.nl/wp-content/uploads/2015/06/2014-1-artikel-iris-tromp-met-leiden.pdf

 

[LondonAndy]

Thanks for the information LondonAndy. Do they actually calibrated your meter (i.e. adjust it until it reads the correct values) or is it a simple check to make sure it is comparable to the blood draw testing?

I've had a meter from two suppliers in the US and your 6-month check is not discussed by the supplier or my cardio. I'll have to ask why not. What brand of meter do you use, mine is CoaguChek.

Sorry for delay posting a response Tom. No, they don't do anything at all with my meter, just do a blood draw test and I do a finger-prick test at about the same time, and so far (3.5 years) my meter has always been within 0.2 of their blood test. It will be interesting to see what they say if ever it is much more than that. My suspicion is that they will refer me back to the manufacturer, Roche, and just say that I can no longer email in results until resolved. Home testing is very important to me, and if necessary I would buy a replacement meter. I currently have a CoaguChek XS, and would get their newer CoaguChek INRrange meter or whatever is current at that time.

PS The CoaguChek XS is currently the only test meter approved by our national 'regulator', NICE. So I am assuming that newer models will also be accepted but will need to check that as and when the need for a new meter arises.