I ordered a new tester, test strips and lances, supposed to be here on the 8th. Not cheap the tester alone $519.00 fortunately rouche has a $150.00 coupon but I feel it is worth it. 3 times in 6 weeks I have tested below 2 INR, it seems as I feel better and become more active it is taking more warfarin to stay in range of 2-3 I’m at 6mg and 5.5mg alternating. The INR clinic keep trying to bump me to testing every 2wks and up pops a low out of range result then back to weekly test, when my meter arrives I will test weekly.
Inrange is on the way
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pellicle
Professional Dingbat, Guru and Merkintologist
Hi
good investment
Treat your meter well (don't drop it, keep it in its case, change out the batteries every year as a minimum) and it'll give you thousands of tests.
I recommend you read through this and watch the video included in that (note, there is a lot of detail just presented by that which I do but don't necessarily speak of, but if I'm doing it, its for a reason).
Every time someone says "yes, I watched that, and I blew a strip" I ask a question like did you wrap up or down, did you rest your arms, did you check the fingertip was pink before lancing (heck, before you even put the strip in) and the answer is inevitably down to missed one of those steps.
https://cjeastwd.blogspot.com/2023/03/roche-coaguchek-xs.html
Best Wishes
good investment
depends, I've done a number of tests so lets go with (a bare minimum of) 52 per week over 13 years = 676 tests ... so that's about 76c per test, for reference the strips are about $5 each.
Treat your meter well (don't drop it, keep it in its case, change out the batteries every year as a minimum) and it'll give you thousands of tests.
I recommend you read through this and watch the video included in that (note, there is a lot of detail just presented by that which I do but don't necessarily speak of, but if I'm doing it, its for a reason).
Every time someone says "yes, I watched that, and I blew a strip" I ask a question like did you wrap up or down, did you rest your arms, did you check the fingertip was pink before lancing (heck, before you even put the strip in) and the answer is inevitably down to missed one of those steps.
https://cjeastwd.blogspot.com/2023/03/roche-coaguchek-xs.html
Best Wishes
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Good move in getting your own meter and good plan to test weekly.
"Conclusions: Patients steadily become less sensitive to warfarin during the first months after heart valve surgery. This leads to subtherapeutic anticoagulation"
But, I don't agree with the solution proposed by the authors, when they say this:
"A dosing algorithm that takes increasing requirements into account is proposed."
Rather than try to find such a universal algorithm, just test frequently, especially during the first few months after surgery, then adjust warfarin accordingly. But, I would say then to continue testing frequently. Testing yourself weekly, as you plan, is a good habit to keep.
https://pubmed.ncbi.nlm.nih.gov/19336266/
This is common. During the first few months out of surgery, I needed an increasing dosage of warfarin to stay in range. There are also studies supporting this occurance, see below:
"Conclusions: Patients steadily become less sensitive to warfarin during the first months after heart valve surgery. This leads to subtherapeutic anticoagulation"
But, I don't agree with the solution proposed by the authors, when they say this:
"A dosing algorithm that takes increasing requirements into account is proposed."
Rather than try to find such a universal algorithm, just test frequently, especially during the first few months after surgery, then adjust warfarin accordingly. But, I would say then to continue testing frequently. Testing yourself weekly, as you plan, is a good habit to keep.
https://pubmed.ncbi.nlm.nih.gov/19336266/
Weekly testing is important -- especially if you're only a short time post-op.
These meters are designed to do a LOT of tests - some of them are still in use by doctor's offices or anticoagulation clinics where hundreds of tests might be run each month. Roche isn't going to sell meters that fail or that start giving erroneous results, or have any performance issues. A month or so of use in a clinic may be equal to a decade of home testing.
There shouldn't be any reason why the InRange wouldn't provide the same type of life (other than the fact that the more features you add to something, the more there is for it to fail. Plus, the new technologies in the meter (WiFi, Bluetooth) may become less new and over time become unsupported). You're also future proofing your testing setup in case Roche at some time in the future makes its new strips unusable in the old XS meters.
Where did you get the $150 coupon? Where did you use it to buy your meter?
(Of course, I'm still happy with my XS meter(s) and can't justify the cost of the InRange - especially since I self manage and doubt that the updates over WiFi will really make much difference to the actual testing).
These meters are designed to do a LOT of tests - some of them are still in use by doctor's offices or anticoagulation clinics where hundreds of tests might be run each month. Roche isn't going to sell meters that fail or that start giving erroneous results, or have any performance issues. A month or so of use in a clinic may be equal to a decade of home testing.
There shouldn't be any reason why the InRange wouldn't provide the same type of life (other than the fact that the more features you add to something, the more there is for it to fail. Plus, the new technologies in the meter (WiFi, Bluetooth) may become less new and over time become unsupported). You're also future proofing your testing setup in case Roche at some time in the future makes its new strips unusable in the old XS meters.
Where did you get the $150 coupon? Where did you use it to buy your meter?
(Of course, I'm still happy with my XS meter(s) and can't justify the cost of the InRange - especially since I self manage and doubt that the updates over WiFi will really make much difference to the actual testing).
I down loaded the coupon from the coaguchek web site, and redeemed it at whitecrossdispensary.com.
Thanks.
I don't know if this will work outside of Canada. But it's likely that some of us (but not me) may give it a try.
I don't know if this will work outside of Canada. But it's likely that some of us (but not me) may give it a try.
I’m an odd one here. I test twice a week. That comes to another ~$240 per year for solely “peace of mind”. But, for me, it’s worth it right now given my financial ability to do it. Maybe one day I’ll go to once a week. But not anytime soon.
With the above said, testing twice a week means exercising the self control of not adjusting Warfarin dosage more than once a week unless something is incredibly out of whack (especially when reflecting on your week’s food intake, exercise level, health, etc)
With the above said, testing twice a week means exercising the self control of not adjusting Warfarin dosage more than once a week unless something is incredibly out of whack (especially when reflecting on your week’s food intake, exercise level, health, etc)
Not sure, maybe could order from Canadian store and use coupon. $519 Canuck bucks = $380 usd, the coupon would be worth $110 usd.
Me too, but more expensive in Canada (more than double the cost) - yeah peace of mind.
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Liborio
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Since labwork is free in canada, i do 1 week at home and 1 week in the lab and this way i keep the cost down, but in winter, since i am in ontario, i only do home testing; Just keep in mind that there will always be differences between machine at home and lab; IF anything, your home test IS more accurate; because for the lab, the blood sits x hours before it is tested, and second the machine has built in mechanism for QA; ( i got all of the above talking to Coagucheck Canada support ) and i agree; i called because one day machine gave 3.3, and lab same day 1 hour later, gave 3.0, and i thohgt there was something wrong with my machine
Interesting:
When I was using the InRatio machine and would get a different value from the labs, I was always told to 'trust the lab.'
The InRatio was a terrible machine and I'm sorry I trusted it for as long as I did.
IF I had a lab right next door, perhaps I would have tests done there more often. The points that PeterII made, about not knowing how the lab handles the sample is often valid. I've experienced tests from one lab that gave me (and another patient whose blood was drawn in the same doctor's office) a 5.1. The lab claimed that repeating the test also gave a 5.1.
My tests using my meter the same day as the doctor's blood draw was 3.4. (I usually test using my meter on the same day that I get a blood draw). The blood drawn was obviously mishandled before it got to the lab.
I've had another episode where I had a medical clinic draw my blood -- their results: 7.1. The actual result on my meter: IIRC 2.7.
The strip manufacturers go to great steps to make sure that their meters give accurate results. There's too much liability - both financial, in terms of human life, and in terms of reputation - for the strip makers to EVER issue erroneous strips. The risk for labs is insignificant in comparison.
When I was using the InRatio machine and would get a different value from the labs, I was always told to 'trust the lab.'
The InRatio was a terrible machine and I'm sorry I trusted it for as long as I did.
IF I had a lab right next door, perhaps I would have tests done there more often. The points that PeterII made, about not knowing how the lab handles the sample is often valid. I've experienced tests from one lab that gave me (and another patient whose blood was drawn in the same doctor's office) a 5.1. The lab claimed that repeating the test also gave a 5.1.
My tests using my meter the same day as the doctor's blood draw was 3.4. (I usually test using my meter on the same day that I get a blood draw). The blood drawn was obviously mishandled before it got to the lab.
I've had another episode where I had a medical clinic draw my blood -- their results: 7.1. The actual result on my meter: IIRC 2.7.
The strip manufacturers go to great steps to make sure that their meters give accurate results. There's too much liability - both financial, in terms of human life, and in terms of reputation - for the strip makers to EVER issue erroneous strips. The risk for labs is insignificant in comparison.
I did my first test today with my new meter and only managed to ruin one test strip(not enough blood) INR 2.2. The instructions says begin at 2.5 for lance depth I ended up using 4.5 trial and error.
Right after testing at home I went to have my regular blood test for INR probably about an hour later it will be interesting to get the results and compare.
Right after testing at home I went to have my regular blood test for INR probably about an hour later it will be interesting to get the results and compare.
Timmay - I test once a week - unless my INR for some reason gets near to, or below, 2.0. I'll adjust my dosage - probably by .5 or 1 mg - then test a few days later. Most of the time I rarely make dosing changes, and when I do, they're small.
If I start a new medication, and I wonder if it has any effect on my INR, I may test a bit more frequently to determine if there's any effect on my INR. (Of course, if the medication effects platelets - an effect that can't be determined by testing INR - I might take it into consideration when aiming for a target range - I don't want excess bleeding because my platelets aren't as 'sticky' as they would be without an NSAID or other medication that affects platelets).
Other than that, weekly tests are fine for me.
If I start a new medication, and I wonder if it has any effect on my INR, I may test a bit more frequently to determine if there's any effect on my INR. (Of course, if the medication effects platelets - an effect that can't be determined by testing INR - I might take it into consideration when aiming for a target range - I don't want excess bleeding because my platelets aren't as 'sticky' as they would be without an NSAID or other medication that affects platelets).
Other than that, weekly tests are fine for me.
pellicle
Professional Dingbat, Guru and Merkintologist
Lab INR results 2.2, same as Inrange meter 2.2
pellicle
Professional Dingbat, Guru and Merkintologist
its what I see ... unless its different, and then investigations usually reveal that the lab was out.
Roche stands a lot to lose from their mistakes, but an individual lab nothing...
