is my inr tracking ok? is it stable?

[Eva]

Eva, my machine also mentions a possible variance of .2 and I bet the labs have a hard time to compete with that.
If you aim to keep your INR around 2.7----3.3 any small variances would allow you to still be in range.
Most of us don't even think about it anymore.

Thanks, Bina. At cardio's office using his machine, my INR was 2.6 on Monday. I mentioned I preferred it to be a bit higher to be on the safe side (because of that variance), but the assistant there ignored me! thus I was not sure whether in reality I am 2.4 ...but I assume I should not worry.

I hope I am not looked at as hijacking this threa ... I am hoping we all are learning from it.

 

[Ross]

Thanks, Bina. At cardio's office using his machine, my INR was 2.6 on Monday. I mentioned I preferred it to be a bit higher to be on the safe side (because of that variance), but the assistant there ignored me! thus I was not sure whether in reality I am 2.4 ...but I assume I should not worry.

I hope I am not looked at as hijacking this threa ... I am hoping we all are learning from it.

She ignored you because she's ignorant! If I had a dollar for all the stupidity I see in these clinics, I'd be a very rich man.

My PCP, who just so happens to be the head of the lab, was telling me how inaccurate home monitors are. I challenged him to a little contest. I told him to have his lab check my inr back to back in 2 tests at the same time and tell me he got the same result. He denied my challenge.

 

[Freddie]

So, are lab tests that accurate? or can they be out a point or two also?

 

[Bina]

Freddie, the labs and monitors are as accurate as they can possibly be.

 

[Ross]

Put it this way, when I went to the ER with my gum bleeding after surgery. I tested at home before going so that they couldn't say it was the Coumadin causing the bleed. I got 1.8. There lab got 1.8. Any questions?

 

[Freddie]

Yes.
It has been said to me the lower the reading the more accurate a home monitor is.
Higher levels of INR can be out .2 as Bina has mentioned.
So, a lab draw could have a reading 3.2 and a home monitor could read 3.4 or 3.0 OR your own monitor could read 3.4 when a lab draw could read 3.6 - at least this is what I have told from my doctor and the reason why I don't have a monitor.....yet.

Ob Boy......think I just opened a can of worms and totally have hijacked this thread - sorry

 

[Bina]

Freddie....we have already determined that your doc is full of ----
3.4 is just fine and so is 3.6 and so is 4.0
If your home monitor gave you a very high reading, like over 5.0 then you may want to double check what was going on.

 

[Freddie]

So, take the lab draw with a "grain of salt" only because we can never be sure if the lab is totally accurate.....correct?

 

[Bina]

Nope.....
The tests are accurate....as accurate as they can possibly be at this time.
It's like when you get on the scale to weigh yourself.....are you really 130 pounds or are you 130.2 pounds.....??
no big deal. Capiche?

 

[Ross]

I wanna be 130 pounds!

 

[Bina]

Me too.....send me another 25 pounds of curves please

 

[Eva]

She ignored you because she's ignorant! If I had a dollar for all the stupidity I see in these clinics, I'd be a very rich man.

My PCP, who just so happens to be the head of the lab, was telling me how inaccurate home monitors are. I challenged him to a little contest. I told him to have his lab check my inr back to back in 2 tests at the same time and tell me he got the same result. He denied my challenge.

Thanks, Ross. I feel better now...you lifted up my spirits I agree she did not have an answer to me and I did not persist because I knew I would find the answer here...but I wanted to test her Does your machine mention any variance ratio like the Coagucheck?!

.....
......are you really 130 pounds or are you 130.2 pounds.....??
no big deal. Capiche?

a very thin woman comes to rehab and her cardio wants her to put on weight...she wonders how she could with all the exercise he wants her to do I offered to give her 15 lbs from me
Yesterday she came with a big smile...she gained 8 ozs
I shared her happiness.

Sorry, Westie!

 

[Bina]

Eva, I believe the other brands of home monitors also have a possible variation of .2
It is not regarded as a glitch, more like "reality".

 

[Eva]

Thanks, Bina.

It is good to know that..I am getting the coagucheck xs.

 

[Ross]

There are varations even in labs. INR is not an exact constant. People need to stop thinking it is.

 

[westie]

old school

old school

Westie,

Sorry that you are the worst patient your surgeon had?! Was this because you are smart and questioned him?! or he has high ego?!

Anyhow, to stay within your main concern about INR even though I like to know why he said that, I have question about these home machines and their variance from labs:

If Westie's INR has to be between 2 and 4 and his home machine gives a result of 2.

What is the real number at the lab? will it be 2.2 (which is ok) or 1.8 (which is below range)?!

eva
it is just that the surgeon is very old school, he is from the time when no one second guessed the doctor; a very blunt and direct man. i like that. a friend of mine also went to him and said he did not know why he was having a by pass because he felt great. the surgeon told him that the first symptom he would have was when he dropped dead on the floor!

a nurse told me he was "a pig of a man" because of how he treats nurses, they fear and respect him, but he is the best there is.

he is a great advocate of home testing and self dosing and said the range of 3 to 4 was necessary for safe anti coagulation, this stipulation is NOT due to any concerns as to the accuracy of home testing.

my understanding is the diference in simultaneous lab and home testing is about .02 to .03, so what.

the danger with lab testing is that it will never be frequent enough in the long term to pick up unexpected spikes soon enough to prevent disasters. with home testing you can test anytime.

weekly lab testing over say 10 years would leave you with junkies veins!

i 100% home test, i never go to diagnostic medlab.

 

[westie]

hijack alert

hijack alert

.
hello every one

i really enjoyed the discourse re home testing, but i would love it if someone could tell me if high inr levels, long term warfarin doseage screw our arteries and veins or is it just old age itself that increases bleeding problems when we are older???

hi

last night (28-01-09) i tested at 3.6 inr, being the same as my last test on 21-01-09.

i guess i should stay on 8 gms daily.

some of you have posted my range of 3 to 4 inr is too high and have suggested 2.5 to 3.5 is more appropriate to a mitral valve patient like myself. but the surgeon said 3 to 4 was indicated (his word) for a mitral valve and told me to make sure i did not accept advice of a lower doseage as the risk of clotting would increase significantly.

given that at my age of 55, that the risk of clotting is much higher than the risk of bleeding??????, i am inclined to follow that advice.

question - would running a slightly inr target at my age result in vein/artery damage that would show up when i am older??

in other words, does the increased risk of bleeding etc in old age arise from simply old age or can that be exacerbated (spelling probably wrong) by prior long term anti coagulation therapy and hightened by a higher ongoing inr level .

do big inr spikes, like 5 and 6 etc, have a long term on vein/artery condition??

 

[Ross]

As we age, our veins become weaker. Next time you see an 80 or 85 year old man or woman, take a look at the veins in their hands. Almost always you'll see black and blue in certain spots where the smaller capillaries just burst with little effort.

 

[Bina]

Westie, I've never heard that long term ACT will mess with your veins.....an older person is just showing normal signs of aging when their veins and skin become more fragile. Perhaps they are taking some meds that accelerate this process, but my understanding is that warfarin would not be one of them.

 

[SHEEPDOG]

Now I have a question?

Now I have a question?

I am a ROOKIE at this stuff still (7 months tomorrow) and I DO have a home monitor. (INRatio) I was given a range of 2.0 to 2.5. I have been checking at least every 2 weeks but have not been to the Cardio to let them check. I have been 2.2, 2.3 for most of my tests but missed a dose and got to 1.2 at the lowest. that was back up in a day or so as I made up what I missed and added 1/2 a pill. I guess I should know this but... 1)How long does it take to show results when you do take a pill? 2) Should I be worried about using Lovenox if I fall that low or is that something my doc should tell me to use?(I have some from a RX that I never used.) 3) Are variations down to 1.8 or 1.9 that big a deal? 4) Why do some "posters" prefer to be at the upper end of the range?
I too hope i'm not taking over the post but I don't know and I think I should.
Thanks!!!