I'm an INR "consultant"

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catwoman

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near Fort Worth TX
Well, not really.
But ... my PCP considers me to be a quasi-expert on anticoagulation.
Had my annual physical today. Another doctor's nurse knocked on the door -- my PCP practices w/ 3 or 4 other physicians plus his nurse practitioner -- and consulted with him about a patient's INR. My PCP said, "What's the reason for taking Coumadin?" Nurse said it wasn't on the sheet, but the INR range was 2.0-3.0 and that this patient had been fluctuating in & out of range.
My PCP said to just recheck the INR in 2 weeks. No dosage change.
Then, turned to me and said, "What do you think?" I asked what the INR was on today's test and he said, "3.1."
I said I wouldn't change anything.
He agreed and said he was sooooooooo glad I had educated myself about warfarin and did home-testing.

I then said, "You can replace blood cells but not brain cells."
He agreed. He said he'd never heard that phrase and would have to pass it to others and that too many people worry about bleeds rather than strokes.
I have so many of y'all out there to thank for helping educate me -- Al Lodwick for starters, and Karlynn, Ross, Nancy, too many to try to remember all the names because I'll forget someone.
 
Marsha, good for you!!!! Did they discount your office visit for your consultant's fee?:D My cardio is also very thrilled that I home test and have educated myself. She is in the process of trying to get a few more of her patients into home testing.
 
Hey that's a level 1 consult, so you should charge him at least $150 for the intial consultation.
 
Everything I know, I learned from the people who take the stuff.

I saw my longest continuously participating person today. She has an aortic valve and first came to me on the Wedneday before Thanksgiving 1997. (I was completing my third month as a warfarin manager and had seen about 100 patient visits.) Her INR was greater than 9.2 (CoaguCheks used to go that high). We were going to be closed for the next 4 days. I bit my lip and told her to hold the warfarin for 4 days and see me Monday. All 4 days I kept worrying myself sick that she was going to die, I'd get my tail sued off, and have to leave town in disgrace. There was nobody ever happier to see a 2.4 than I was on Monday. She and her doc both thought I was a genius. Then I got to thinking - "Hey this is a piece of cake."

Her INR was 4.5 today. My student was in a near panic. JoAnna and I looked at each other and said, "Maybe hold one dose. No biggie"

It is great to hear that you have such a teachable doctor, Marsha (you too Karlynn).
 
Hey, and you are physically a lot closer than Al............

Hey, and you are physically a lot closer than Al............

if we have to come see you during one of our midnight Katie crises..............:D :D Congrats. HUgs. J.
 
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