B
Braveheart
Hi Friends
It's been a while since I last posted here regarding my INR management. As some of you may recall, in November 2001 I was presented with a new CoaguChek 'S' INR monitoring system by the BCPA (British Cardiac Patient's Association).
I am one of those patients who wants to get to the point where I can not only monitor my INR, but also self-manage my doses. My local doctors at the hospital have been very apprehensive. I spoke to my cardiologist 3 weeks ago at my check-up and he said he would write to the haematologist. He is very supportive of home monitoring/management as he has several patients doing this. In fact he recently put one of his young patients who is using the system, in contact with me and we've become good friends.
Anyway, last Wednesday the Consultant Haematologist and her assistant medical doctor saw me at the hospital. They were very helpful. A Roche nurse was also there. They watched to see I was using the CoaguChek correctly. They took a venous blood sample and then I did a finger prick test on the CoaguChek. The finger prick test was: 2.7, they put a sample of venous blood on a strip in my CoaguChek and that was: 2.8, finally they took me to the hospital lab and gave me a tour and showed me how they obtain my INR from my venous blood. They put the test tube in a centrifuge and showed me the tube after it had been spun. I could clearly see the seperation of red blood cells and plasma. They then placed the tube in a special lab machine. We then went for a coffee. 20mins later the results were ready. My INR was: 3.0 Everyone was very happy with the results. They said they were very close indeed.
We had a long discussion about my desire to self-manage. They said they have over 600 patients on Coumadin (Warfarin) in my town and that I am the first patient ever in the town to be using the machine. It's quite exciting. The haematologist said she is waiting for a protocol to come through from St. George's Hospital in London (our main cardiac center). They will eventually get me to the point where I can self-dose. In the meantime the plan is for me to test myself using my CoaguChek in 2 weeks time and come back to the hospital for a venous test in 1 month. If my INR is within my range: 2.5 - 3.5. then carry on taking same dose: 6mg/7mg on alternate days. If the INR has moved outside therapeutic range phone the hospital and the haematologist will advise me what dose to take.
I am happy that I am finally getting somewhere. I can understand their being cautious and not wanting to rush. I am their first patient using this. But, I am very determined to self-manage. In the 3 years since my valve replacement, I have had to attend the hospital every 1 or 2 weeks for venous blood tests. This can be very frustrating and time consuming with my job etc. To have one of these machines will provide me greater independance and thus improve my quality of life.
Thank you to everyone on this forum who has helped, advised and encouraged me.
Take care,
Jonathan (West Sussex, Grt. Britain)
------------------------------------
Complex Congenital Heart Disease:
Coarctaion of Aorta Repair - 1985 (age 17)
Aortic Valve & Root Replacement - 1998 (age 30)
'CarboMedics 27mm CarboSeal valved/conduit'
Resection Aortic Arch Aneurysm - 1999 (age 31)
Several cardiac catheters!
It's been a while since I last posted here regarding my INR management. As some of you may recall, in November 2001 I was presented with a new CoaguChek 'S' INR monitoring system by the BCPA (British Cardiac Patient's Association).
I am one of those patients who wants to get to the point where I can not only monitor my INR, but also self-manage my doses. My local doctors at the hospital have been very apprehensive. I spoke to my cardiologist 3 weeks ago at my check-up and he said he would write to the haematologist. He is very supportive of home monitoring/management as he has several patients doing this. In fact he recently put one of his young patients who is using the system, in contact with me and we've become good friends.
Anyway, last Wednesday the Consultant Haematologist and her assistant medical doctor saw me at the hospital. They were very helpful. A Roche nurse was also there. They watched to see I was using the CoaguChek correctly. They took a venous blood sample and then I did a finger prick test on the CoaguChek. The finger prick test was: 2.7, they put a sample of venous blood on a strip in my CoaguChek and that was: 2.8, finally they took me to the hospital lab and gave me a tour and showed me how they obtain my INR from my venous blood. They put the test tube in a centrifuge and showed me the tube after it had been spun. I could clearly see the seperation of red blood cells and plasma. They then placed the tube in a special lab machine. We then went for a coffee. 20mins later the results were ready. My INR was: 3.0 Everyone was very happy with the results. They said they were very close indeed.
We had a long discussion about my desire to self-manage. They said they have over 600 patients on Coumadin (Warfarin) in my town and that I am the first patient ever in the town to be using the machine. It's quite exciting. The haematologist said she is waiting for a protocol to come through from St. George's Hospital in London (our main cardiac center). They will eventually get me to the point where I can self-dose. In the meantime the plan is for me to test myself using my CoaguChek in 2 weeks time and come back to the hospital for a venous test in 1 month. If my INR is within my range: 2.5 - 3.5. then carry on taking same dose: 6mg/7mg on alternate days. If the INR has moved outside therapeutic range phone the hospital and the haematologist will advise me what dose to take.
I am happy that I am finally getting somewhere. I can understand their being cautious and not wanting to rush. I am their first patient using this. But, I am very determined to self-manage. In the 3 years since my valve replacement, I have had to attend the hospital every 1 or 2 weeks for venous blood tests. This can be very frustrating and time consuming with my job etc. To have one of these machines will provide me greater independance and thus improve my quality of life.
Thank you to everyone on this forum who has helped, advised and encouraged me.
Take care,
Jonathan (West Sussex, Grt. Britain)
------------------------------------
Complex Congenital Heart Disease:
Coarctaion of Aorta Repair - 1985 (age 17)
Aortic Valve & Root Replacement - 1998 (age 30)
'CarboMedics 27mm CarboSeal valved/conduit'
Resection Aortic Arch Aneurysm - 1999 (age 31)
Several cardiac catheters!
