INR reading

[Jackie]

I just called in my first test on the INRatio, it shows 5.0 today. Yesterday I had blood taken at the Lab and just got that reading back, INR is 3.7. Yesterday I took it when I came home from the lab so I could compare, and it was 4.4 on the InRatio. When I talked to Clinical advise from QAS I was told that the reading on the monitor is usually .7 higher than the lab. My Doc from Kaiser is going to freak when he gets the report of 5.0, I freak when it is to low, what's a person to do? I take 2.5 on Mon and Thurs. The rest of the week is 5.0. Would taking the different amounts on different days affect the result? Also I am sure that I touched the test strip when if dropped the blood.

 

[Karlynn]

Jackie, is your range 2 - 3?

Your doctor shouldn't freak over a 5.0. Don't let him do something like have you hold for 3 days and test again. As long as you aren't bleeding (which at 5 wouldn't be very likely) adjusting the dose cautiously is better. You got Al's dosing chart right? I'll let someone else weigh in on what they would do because I take a whole lot more Coumadin than you do and my body reacts differently to dose adjustments because of the amount I take.

Just to clarify - you tested at the lab yesterday - got the results today, it was 3.7. You tested on your INRatio yesterday and it was 4.4. You tested again today and it was 5.0?

Some of us have experienced disparity with our home test #'s and some have not.

It's a good thing to compare with the lab when you first get your machine. But you also need to be able to trust the lab's results. Getting your # the day after you test doesn't instill a whole lot of trust in me. You don't know how long the tube sat around before testing.

See if you can get your # within 3-5 hours after you lab test, then compare that # to your machine. Do this a 2 or 3 times and see if there's a pattern.

Another thing you could do just to see what it does is test someone you know who isn't on Coumadin and doesn't take any meds that mess with (or "thin") the blood. If this person tests out at a .9 to 1.2 it should give you a little more confidence in your machine's readings. If it doesn't and it goes higher that will give you some information too.

You'll eventually get to know your machine.

 

[Jackie]

Jackie, is your range 2 - 3?

Your doctor shouldn't freak over a 5.0. Don't let him do something like have you hold for 3 days and test again. As long as you aren't bleeding (which at 5 wouldn't be very likely) adjusting the dose cautiously is better. You got Al's dosing chart right? I'll let someone else weigh in on what they would do because I take a whole lot more Coumadin than you do and my body reacts differently to dose adjustments because of the amount I take.

Just to clarify - you tested at the lab yesterday - got the results today, it was 3.7. You tested on your INRatio yesterday and it was 4.4. You tested again today and it was 5.0?

Some of us have experienced disparity with our home test #'s and some have not.

It's a good thing to compare with the lab when you first get your machine. But you also need to be able to trust the lab's results. Getting your # the day after you test doesn't instill a whole lot of trust in me. You don't know how long the tube sat around before testing.

See if you can get your # within 3-5 hours after you lab test, then compare that # to your machine. Do this a 2 or 3 times and see if there's a pattern.

Another thing you could do just to see what it does is test someone you know who isn't on Coumadin and doesn't take any meds that mess with (or "thin") the blood. If this person tests out at a .9 to 1.2 it should give you a little more confidence in your machine's readings. If it doesn't and it goes higher that will give you some information too.

You'll eventually get to know your machine.

Thank you Karlyn

My range is 2.5 to 3.5. I have been fighting with the Anticoagulation Clinic for 6 months over not doing tests stat, in house, as they put it. They make up a list for the lab of unstable INR's and the rest are sent to a Kaiser Lab about 30miles down the road. I get the results the next day. The girl that called was almost ready to cut my dose for the 3.7 and than realized who she was speaking to. Last time I refused to cut my does when it was 4.0.
I do have Al's chart. Can see I will be using it now that I have the monitor.

I just had a call for QAS, she is going to call Kaiser and try to instruct them on the use of the machine, and suggest that I have another blood draw and do a test on the monitor at the same time. I am not scheduled until 1/23, two weeks. I hope that they will let the test be In House since the result of today was 5.0. No one wants anything to do with me because they do not know anything about the testing. I have not been able to get the form signed off because of it. I did ask HemoSence Brenten to help me out with some traing for Kaiser, but have not heard from him yet.

 

[Karlynn]

Maybe you can convince them to do it in-house so that you can accurately compare your machine with their tests. Seems like a great reason to me! Best wishes with this.

With a 2.5 - 3.5 range, you really aren't all that off at a 5. Particularly if it turns out your machine might run a little high and your INR has been fairly in range. I think even side by side lab to lab comparisons have a .5 acceptible difference. Have a nice big salad, or glass of V8. Or my fave - a big scoop of guacamole!

If your INR has been creeping up on the dose you're on, then you know you can safely lower your weekly dose without worrying about it going too low.

INR is not an exact science. This is why we don't agree with doctors that will tell their patients that their range is 2.5 - 3, or 3 - 3.5. It's just to close a range to adhere to. And that nurse wanting to adjust your dose for a 3.7, she could have run a side by side at the lab and also had a 3.3 from the same tube of blood tested at the same time.

Nice to see you're developing a reputation with them! You go girl!

 

[Jackie]

Maybe you can convince them to do it in-house so that you can accurately compare your machine with their tests. Seems like a great reason to me! Best wishes with this.

With a 2.5 - 3.5 range, you really aren't all that off at a 5. Particularly if it turns out your machine might run a little high and your INR has been fairly in range. I think even side by side lab to lab comparisons have a .5 acceptible difference. Have a nice big salad, or glass of V8. Or my fave - a big scoop of guacamole!

If your INR has been creeping up on the dose you're on, then you know you can safely lower your weekly dose without worrying about it going too low.

INR is not an exact science. This is why we don't agree with doctors that will tell their patients that their range is 2.5 - 3, or 3 - 3.5. It's just to close a range to adhere to. And that nurse wanting to adjust your dose for a 3.7, she could have run a side by side at the lab and also had a 3.3 from the same tube of blood tested at the same time.

Nice to see you're developing a reputation with them! You go girl!

I just got home from another visit to the lab. The Anticoagulation Clinic called and asked if I could come in this evening to take another test and I brought my monitor with me. The test is inhouse but the clinic closes at 5 and won't have results until morning. My INRatio recorded a 3.7 this time. Do you think I am doing something wrong? Thats a big drop with tests being run about 5 hours apart.

 

[Karlynn]

Wait and see what the lab shows when you hear tomorrow. (Hoping that the blood was tested STAT.) I'd make sure you get the # first thing in the morning. If they tell you it's not ready yet, then I'd be a bit suspicious of just when it got tested.

It's probably possible that you were 3.7. The reality is, our INR probably does go up and down and around a selected range during any given 24 hours. This is why you should test around the same time every day. As I said, you can run two tests back to back and get different numbers. You run that at different times of the day, it's even more likely.

What are you doing as far as your dose tonight? If it were me (and I'm not you) I'd take my usual.

Are you wiping your finger with alcohol before you stick it? Alcohol left on the finger can mess up a test #. To be sure it doesn't, wipe off the first drop of blood.

Try not to "milk" your finger to get the blood. If you're having a hard time getting the drop, you probably don't have an adequate stick. Try setting your lancette pen up a notch. (If that's what you got.)

I usually rub my hands together or wash them with warm water prior to a test. (I have cold extremities!) I then gently squeeze my finger to get the drop of blood.

If things continue to be screwie, I'd have QAS send you another machine.

 

[Jackie]

Thank you, Karlynn, for you input. I did take my usuall dose last night. This morning I called the lab and got my result, 3.4. InRatio result was 3.7 just minutes after the lab test. That's not to bad. I have to go back in two weeks so I will also bring my little monitor with me. Hopefully I won't have to keep going back, I really want this to work, for me and KAISER