INR level via lab draw vs. fingerstick test

[Warrick]

well I tried this this morning and got an Error 6 but I did take the strip out of the machine. So next time I'll try just turning it off and on again.

If that works then perhaps its only good for a "retry" when close to the time limit.

yes I don't take the strip out just turn it off and then back on, and it worked fine, sorry you wasted a strip, it pisses me off enough when i get error 5,
Error 6 I've had once but I never turned off ,removed, touched or bumped the strip

 

[pellicle]

... sorry you wasted a strip, i

all good ... was gunna be burned anyway ... I was having a panic over the bacon burning and didn't get blood coming, so thought "I know, I'll try Warwicks method"

Its frustrating to burn a strip, but its still minor in the long run ... I wouldn't go back to a lab as a regular that's for sure

 

[kolyur]

I'm glad you all encouraged me to stick it out with the Coaguchek--I'm having much better luck with it now. The bulk of my problem seemed to be related to the fact that I wasn't using a proper lancing tool. I had purchased one made by Roche but I think it was meant for glucose testing because even the deepest setting wasn't deep enough. So, even if I was able to get enough blood to avoid Error 5, it took lots of squeezing and I was way past the 15 second limit. I finally bought a box of the single use Roche lancets that are meant for AC testing (white T-shaped jobbies with a blue button) and it made all the difference. They seem to use more of a slicing action rather than just a pin prick. (Sounds like it would hurt more but nope.) I've also gotten into the habit of washing my hands with hot water while massaging the finger for about 30 seconds prior to the prick. Plenty of blood now and I can get it on to the strip within 5 seconds of the prick. Now my INR comes in consistently within 0.1 or 0.2 of the lab value, always on the high side it seems. Cardio nurse said in her experience it's normal for the home machines to run a bit high and I am quite satisfied with this accuracy.

 

[pellicle]

Hi

glad its all working

...I had purchased one made by Roche but I think it was meant for glucose testing because even the deepest setting wasn't deep enough. So, even if I was able to get enough blood to avoid Error 5,

glad you got it sorted. I guess you bought it second hand and it didn't come with the lance. Well lance diameter (thickness) is usually measured in Gauge ... and you need a thicker gauge than the lances for INR than for diabetes machines.

I know you know now, but I'll put this here for others who don't get the light bulb moment ...

. Plenty of blood now and I can get it on to the strip within 5 seconds of the prick. Now my INR comes in consistently within 0.1 or 0.2 of the lab value, always on the high side it seems. Cardio nurse said in her experience it's normal for the home machines to run a bit high and I am quite satisfied with this accuracy.

its actually an interesting "feature" that ... myself I agree its a good idea as like people who set their watches a few minutes fast (rather than slow) they are never late to meetings (and you won't be under on your INR cos under hurts more than over does.

Also, as one who is used to both biology and engineering I can say that the measurements in Biology are not precise as are those in engineering. A little something for your to consider:

Best Wishes and good luck with keeping your INR on track.

Feel free to PM me if you have questions / need a hand

 

[user 15848]

Hi, during past 13 months since my AVR with OnX i have been doing lab and coagucheck tests, 95% of the time both show same value,
and if different never more than 0.1 appart. At my blood lab the take blood with the needle, but i would prefer the finger test, is less invasive
as per my perception of it, thank you

 

[Warrick]

I'm glad you all encouraged me to stick it out with the Coaguchek--I'm having much better luck with it now. The bulk of my problem seemed to be related to the fact that I wasn't using a proper lancing tool. I had purchased one made by Roche but I think it was meant for glucose testing because even the deepest setting wasn't deep enough. So, even if I was able to get enough blood to avoid Error 5, it took lots of squeezing and I was way past the 15 second limit. I finally bought a box of the single use Roche lancets that are meant for AC testing (white T-shaped jobbies with a blue button) and it made all the difference. They seem to use more of a slicing action rather than just a pin prick. (Sounds like it would hurt more but nope.) I've also gotten into the habit of washing my hands with hot water while massaging the finger for about 30 seconds prior to the prick. Plenty of blood now and I can get it on to the strip within 5 seconds of the prick. Now my INR comes in consistently within 0.1 or 0.2 of the lab value, always on the high side it seems. Cardio nurse said in her experience it's normal for the home machines to run a bit high and I am quite satisfied with this accuracy.

Thats fantastic mate glad you stuck with it and yep thats brilliant for you good stuff!!!

 

[Protimenow]

I've been away from this forum for a while, and I skipped most of the posts on the second page of this thread. A few things -- Mrs. Beasley - I don't think that it's a good idea to test every five weeks. If your INR is too low, you can get a stroke in a week. Having an INR reading that is in range every five weeks doesn't assure that your INR is safely in range between tests.

Others have indicated this, but I'll reiterate -- to do an adequate INR test, you need to get an adequate drop of blood. I use a few different lancing devices - disposable (about 25 cents each) - that are designed for INR testing. It's rare that I don't get a sufficient drop of blood.

Prepping the finger before the incision is the only way to go. Roche cautions about 'milking' the finger after you incise it, because you'll be squeezing out plasma, and could be interfering with the test results.

For myself, I've found that testing after shaving, or after doing dishes in warm water works well -- the skin is warm, the capillaries are open, and I'm more likely to get a good drop. Also - one thing that I do, in addition to the warm water, is to hold my thumb just slightly below the knuckle at the tip of my finger, while the strip is warming up. This causes the blood to pool in the fingertip. Doing it this way usually gets me a good drop of blood.

CoaguChek is NOT the only meter out there. A few years ago, I ran through testing on multiple machines - CoagChek XS, ProTime 3, InRatio, and Coag-Chek. I made comparisons to blood draws.

I found that the CoagChek XS gave me results that were nearly always higher than the lab blood draws. In a few of my tests, the CoagChek results were considerably higher - more than the standard of +/- 30% that ISO (I believe it's ISO) requires. The Coag-Sense is usually slightly lower than the blood draw. Personally, I'd rather have a meter that reported slightly lower than a lab than I would to have a meter that reported slightly higher. THIS WAY, if my meter gives me a 2.5, I can be reasonably certain that the lab result will be around 2.7 or 2.8 - and my INR is in range.

A few other things. The Coag-Sense is a physical test, actually taking the blood and physically moving it until a clot forms. It doesn't rely on electrical phenomena to get a result.

Also - unlike the CoagChek, even if a person's hematocrit is low, the meter can get an accurate result. Finally, the strips don't seem to be as sensitive to atmospheric conditions once opened, like the CoaguChek XS (which are apparently only good for a few minutes after exposure to air -- this is why they're stored in air-tight containers). I've had times when I've opened a Coag-Sense strip, but been unable to test for a day, or two, or even longer. As long as no blood is put onto the strip, the strips remain usable.

No, I don't work for Coag-Sense. I just prefer their meter over the CoaguChek XS.

Oh -- and on the subject of cost - you can occasionally find a deal on a test meter. The consumables can usually be bought on eBay, too. Over the years, I've been able to get THREE Coag-Sense meters (because the price was so good, and I expected to be able to either keep one as a backup, or help someone out with a loan or low cost sale of one or two).