Managing Coumadin While Traveling

[Jkm7]

The thread that poster ThomasAw started re: having his INR testing while traveling aboard made me wonder about even domestic travel and testing.

Seeing as such a small percentage of people on ACT have their own machines, what do most people do who travel for a month or two or more at a time? So many RV people, people who go to Florida for a month etc..... Do all these people have to pre-arrange with their doctors/coumadin clinics for where they can be tested and dose adjusted if necessary? I see so much chance for hassle and problems.

We cruise a lot and think the ships provide testing in their infirmiries if pre-arrangment is made. I know the doctor/nurses on board have to provide that service for 107 day World Cruise. There have to be a number of folks who need to be tested and dosed. But one wonders how experienced they are or if they have specific training before getting that assignment.

 

[ThomasAw]

Jkm7,

I was wondering also how people managed their ACT while traveling domestically or overseas. I foresee problems when traveling for months especially overseas. Your INR is stable domestically but when overseas & when you are in Asia where the food intake is different, then it looks like you have to start all over to get stable again. And you need to find a quality & reliable clinic/hospital to do your INR testing. And vice versa for people from Asia traveling to US/Europe. Off course the quality side is better in US/Europe.

I hope people who have this kind of experiences will share them.

Thanks

 

[westie]

no alternative

no alternative

it seems self monitoring is essential for travelling; even if you are in a civilised and familiar country, you will spend a lot of time locating, organising and traveling to a blood testing facility. that could easily chew hours out of your day. and do we need that sort of tension on holiday?

as for extended travel to exotic or remote locations, i can see no alternative to self testing. and even if you can track down a testing facility in a third world country, could you trust it?

my nz $875.00 purchases of a coagucheck is probably my best investment ever.

 

[wes]

yeah, self testing is probably the best option. besides having to take time out to find a doctor/clinic, you have to deal with the language problems. living in Japan has been no problem because I can speak the language and I had my surgery done over here. Luckily, a lot of the terminology is the same in English and Japanese (albeit with very different pronunciations).

 

[Jkm7]

After posting my question, I e-mailed a RN friend who is currently working on a cruise ship as lead nurse and asked about INR testing. Got a quick answer and was told that they do INR testing for their guests. No problem. I am also sure they stock coumadin among their Infirmary Pharmeceuticals.


Self-testing is the ideal for normal day to day as well as travel but we read here all the time that some doctors won't agree to it or insurance companies refuse coverage. It could be very difficult on people who wish to travel for more than a week or two if they can't self test.

Just a suggestion, but perhaps for those who are having a problem getting their doctors or insurance to agree, try informing them you would like to plan a lengthy trip and it will be mandatory you be able to self-test. Might be just the little bit of influence to get them to agree??

 

[Freddie]

Just a suggestion, but perhaps for those who are having a problem getting their doctors or insurance to agree, try informing them you would like to plan a lengthy trip and it will be mandatory you be able to self-test. Might be just the little bit of influence to get them to agree??

Funny how you would mention the above statement. Nice thought but it didn't work for me .

In my case, it didn't influence my doctor when I requested a home monitor. I even told her that I had turn down a 5 week trip to Egypt due to getting my INR checked every 2 weeks. My doctors response was "you've been pretty stable for the last few months - you could go a month before you had to check your INR again "

When I heard that I came home and posted what was the norm/time frame on checking ones INR. Although everyone is different, it seems that every 2 weeks is the norm/standard.

Sorry to have high-jacked your thread.

 

[Jkm7]

Not a hi-jack at all. It is the kind of conversation I was hoping to read. I hoped it might be an idea that would work for people who couldn't get their doctors to give them the Rx. Sorry your doctor is so resistent. Any idea why?

 

[lance]

E-mails are wonderful .......................

E-mails are wonderful .......................

My "XS" travelled in carry-on luggage and while in the UK I e-mailed my test results to the clinic in Toronto and they returned the e-mail with the dose for the following week. It worked like a charm. I took enough supplies (strips, lancettes, warfarin) to last. I was staying with relatives and they have a computer.

Last year while staying in a London hotel I had to pay for internet access. Even though the e-mail address was correct the e-mail was not delivered so I managed quite nicely on my own. It was disappointing and I was still charged 8 pounds for absolutely nothing.

 

[catwoman]

After posting my question, I e-mailed a RN friend who is currently working on a cruise ship as lead nurse and asked about INR testing. Got a quick answer and was told that they do INR testing for their guests. No problem. I am also sure they stock coumadin among their Infirmary Pharmeceuticals.

Seems like I saw something from someone here in the last year or two that they did have an INR test run on board a cruise ship. But it was pricey (at least $100 US) and don't think insurance covered it.

I have emergency stashes of all my Rxes in each piece of luggage I use on a regular basis: my overnighter, my rolling TravelPro, my cat show judge's briefcase, my laptop bag and my cats' grooming supplies bag. (Need to use up a couple of tablets because they're the actual Coumadin, which I haven't bought in 2 years. Still good, though.)

 

[Freddie]

Any idea why?

Check out my thread "COAGUCHECK DENIED". The whole story is there, but I'm still working on getting a home monitor - I see my Doc on Monday - keep your fingers crossed.

 

[ThomasAw]

Funny how you would mention the above statement. Nice thought but it didn't work for me .

In my case, it didn't influence my doctor when I requested a home monitor. I even told her that I had turn down a 5 week trip to Egypt due to getting my INR checked every 2 weeks. My doctors response was "you've been pretty stable for the last few months - you could go a month before you had to check your INR again "

When I heard that I came home and posted what was the norm/time frame on checking ones INR. Although everyone is different, it seems that every 2 weeks is the norm/standard.

Sorry to have high-jacked your thread.

Hi Freddie,

It has been 10 weeks since my AVR. I am still not stable yet. Testing is once 2-weekly & if dose change weekly. Out of 9 tests so far, I was in range twice only.

I have a friend who has the same type of surgery done in 1999 & is now on quarterly testing.

I hope to get into minimum monthly testing soon. Then at less I can travel overseas & come back within a month.

Thanks

 

[Karlynn]

Funny how you would mention the above statement. Nice thought but it didn't work for me .

In my case, it didn't influence my doctor when I requested a home monitor. I even told her that I had turn down a 5 week trip to Egypt due to getting my INR checked every 2 weeks. My doctors response was "you've been pretty stable for the last few months - you could go a month before you had to check your INR again "

Freddy - I test every two weeks and had been pretty stable for a while. I took my INRatio to France with me in February - even though I rationalized that I could easily just wait to test when I got back after my 11 day trip. I tested the day I left and was nicely in-range. I tested after being in France for 5 days and my INR was 6.0. Don't really know why it was that high, but it was (all the sitting while plane and train traveling???? But I walked all over Paris. I had wine - but not too much - so who knows.)

Had I not tested and continued to take my regular dose, I would have gone even higher. Instead I held a day and took a half dose and was back in range.

Your doctor is an idiot. Even if you've been stable, the circumstances of travel can change things. I'm so sorry you had to turn down a trip to Egypt.

 

[John & Joann]

We have been in 48 states and much of Canada while Joann is on Coumadin. The process is very easy for us.

She has a standing order for testing as needed. She has a target date for the test that is not in writing. She changes as she feels appropriate. The information is faxed to our local coumadin clinic. They call Joann on the cell telephone with the results.

The only problem that we have ever had was with LabCorp. Thay forgot to fax the clinic and send the information to the physician. It got lost in the paper flow. The fax number is now highlighted. She has the test earlhy in the morning so that the results are to the doctor by noon. If she does not hear from the clinic, she will call the next morning.

Nothing to fear with internet, cell telephones, and dilligent observation. Still clicking with coumadin since 1971.

 

[ThomasAw]

Freddy - I test every two weeks and had been pretty stable for a while. I took my INRatio to France with me in February - even though I rationalized that I could easily just wait to test when I got back after my 11 day trip. I tested the day I left and was nicely in-range. I tested after being in France for 5 days and my INR was 6.0. Don't really know why it was that high, but it was (all the sitting while plane and train traveling???? But I walked all over Paris. I had wine - but not too much - so who knows.)

Had I not tested and continued to take my regular dose, I would have gone even higher. Instead I held a day and took a half dose and was back in range.

Your doctor is an idiot. Even if you've been stable, the circumstances of travel can change things. I'm so sorry you had to turn down a trip to Egypt.

Maybe it is the food that we consumed when overseas that produced very high or low INR. Off course it is impossible to take the food along that we eat regularly back home which produce consistent within range INR.

Therefore in my opinion people on ACT who are traveling domestically/overseas for months have to take along a portable test kit. If unable to contact clinic/hospital, have to self adjust dosage to the best of their ability.

Interesting to know anyone who is on ACT have climbed Mount Everest & back safely.

Thanks

 

[ThomasAw]

We have been in 48 states and much of Canada while Joann is on Coumadin. The process is very easy for us.

She has a standing order for testing as needed. She has a target date for the test that is not in writing. She changes as she feels appropriate. The information is faxed to our local coumadin clinic. They call Joann on the cell telephone with the results.

The only problem that we have ever had was with LabCorp. Thay forgot to fax the clinic and send the information to the physician. It got lost in the paper flow. The fax number is now highlighted. She has the test earlhy in the morning so that the results are to the doctor by noon. If she does not hear from the clinic, she will call the next morning.

Nothing to fear with internet, cell telephones, and dilligent observation. Still clicking with coumadin since 1971.

John & Joann,

Glad to know you have traveled much & testing is OK for you. Have you thought of travelling to Asia?

Thanks

 

[Jkm7]

John and Joann.......

It's wonderful you travel and have Joann's INR tested so easily but I am confused and hope you can help. I cannot understand from your post HOW it is that she has a place to go when on the road, knows WHERE to go and WHEN for her INR test.? Does her local ACT Manager pre-arrange for her when she knows she will be traveling? Do they set up appointments in advance for her? Do you research on your own in advanc


While I will be stopping warfarin next week, I know that I could be put back on it at any time. DH and I travrel and I am trying to figure out in advance how I would handle being tested if that becomes necessary at a future time.

Thank you for any help you can offer.