Need info on out right purchase of home test equip. and supplies.

[Noyolk]

My Physician has "OK'ed" home testing for my anticoag. He is pushing me into Alere, which I am waiting for a return call from. I was hoping to purchase my own system and shop consumables from any supplier, but this sounds as if they are a one stop shop. Can someone direct me to sources to purchase from, our how the marketing of these home use tests work? Thanks in advance.

 

[lance]

Good morning,
You will love the convenience of home testing. Who will be in charge of monitoring your INR management--may be that is why he referred you to Alere.

 

[tom in MO]

I got with Alere a couple of months ago. Alere provides the monitor, the consumables, and a 24hr reporting call-in system that notifies your health care provider of your results. Your nurse in town (not Alere) calls back with your new dose.

I don't believe Alere "sells" the monitor or consumables, just their service. Others on here have bought their own monitors on the internet and some do their own self-dosing as well.

 

[njean]

I bought my own home monitor from QAS (Quality Assured Services, Inc. - 407-563-2860) about 7 years ago. I paid a pretty hefty price for the INRatio monitor, (almost $2000) but don't regret one cent of it!

I have to call in my test results to Alere in order for Medicare to cover the cost of test strips and other supplies.

You will absolutely love the freedom of home testing!

 

[Protimenow]

Not being on Medicare, and not having medical insurance, I've been pretty much on my own in regards to INR management.

For many people, using Alere or Philips is a viable (though expensive to the insurer and possibly also to the insured) option. They'll send you the meter and supplies. They may nag you for results that they don't receive when they want to receive them (I'm sure about this), and they'll report your INR to the doctor or clinic that is managing your INR. Some on this forum have had serious billing issues with one or more of these companies.

For myself, I've gone through a few different machines - bought on eBay (with one exception). I started with a ProTime and later moved to an InRatio. (I'm now, perhaps, getting a lab quality meter that mere mortals aren't supposed to come within ten feet of, but having had a stroke, my life is a bit more important to me than making some vendor happy). I would be happy to try a CoaguChekXS, once I can get one affordably.

You should be able to get new meters on eBay -- with warranty -- from medical equipment vendors that sell on eBay. You can get meters that were 'retired' or 'upgraded' by clinics or hospitals and replaced with newer technologies. These meters are probably just fine - they worked for the clinics or hospitals that 'upgraded,' and should work for you. The move from performing possibly dozens of tests a day at a clinic to performing a test a week should be fine for the meter. I didn't fear eBay for these purchases. I still don't

DO NOT BUY A COAGUCHEK S - or any Coaguchek other than the XS - the others have been discontinued and there are no strips for them that are easily available. (There may be some, somewhere, overseas).

As N Jean said, you WILL love the freedom of home testing.

(One other thing -- you may find that your meter varies fairly consistently from a lab's results. See if you can compare your meter's results to your lab's. My meters (both the InRatio and InRatio 2) are fairly consistently .4 - .6 above the lab results - I wish I had known this in April. Once you know your meter, I recommend that you test weekly (I do). Just make the simple adjustment to bring your meter results close to where the lab results would be. In my case, if my InRatio or InRatio2 gives me anything between 3.0 and 4.0, I believe that I'm pretty close to my 2.5-3.5 range. If you get a crazy result (above 4.5 or below 1.5, retest and, possibly, go to a lab for confirmation)

 

[lance]

Hi Noyolk
I've been home testing for a long time using only Roche meters. Comparison tests were performed every 6 months. For the most part my S was within 0.2 of the lab. When my husband started using my XS three years ago his comparison tests were within 0.2 and twice were exactly the same. I also had comparison tests exactly the same as the lab. The one exception occurred when it took 3 days for the lab results and there was a significant difference which I ignored. Learn how to to use your meter and trust the results it gives you. The lab is the lab and the meter is the meter--you needn't compare apples and oranges. I suspect all meters are very accurate and life can be complicated enough.
I remember a posting by a former member of this forum now retired. He is a pharmasist and worked in a hospital where he was responsible for INR testing and managing. He tested the XS prior to its release to the public 1,000 times confirming its accuracy. He also noted a hospital lab that did not calibrate its test equipment properly resulting in over1,000 inaccurate tests resulting in I think several deaths. Just because the lab test were first on the scene doesn't make them more accurate than POC monitors.
You should be very happy with any brand you choose.
Cheers

 

[tom in MO]

"Just because the lab test were first on the scene doesn't make them more accurate than POC monitors."

Absolutely correct. Hospital labs are filled with people who can make mistakes. At least with a POC monitor, you know who made the mistake

 

[Protimenow]

After I had my stroke, and called Alere about the wide difference between my InRatio INRs and the hospital lab's, I asked them which to trust. Their answer - in three words - 'Trust the lab.'

Since then, the results on my two InRatio meters (the original, which I owned, and an InRatio 2) matched each other - within .1 or so - whenever I ran the test on both meters. When I compared to the labs (tested within an hour or so of each other), I've seen that my InRatio results are .4-.6 above those of a hospital lab.

In my experience with two different labs running tests on my blood that was taken just a few hours apart, I found significant (to me) differences -- a 2.9 at one lab, and 3.7 at another. Clearly, the way the blood is handled, the reagents used by the labs, and general lab technique can account for substantial differences.

What I'm trying to do now (for now, at least) is use my InRatio (or InRatio2) with a target of about 3.1 - 3.9 or so -- my actual target range is 2.5 - 3.5. I'd be comfortable in that range - or within a few tenths either way.

 

[Diana22]

I just recently went on Medicare. Are the home testing machines and the strips paid for by Medicare?

 

[njean]

I just recently went on Medicare. Are the home testing machines and the strips paid for by Medicare?

Yes they are but you have to get your doctor's referral. Call Medicare and ask them for the information you will need.

Good luck!

 

[tom in MO]

According to hospital lab results, I should have been dead 51 years ago. I've work in a lab. People and machines make mistakes.

 

[AgilityDog]

One word: Amazon. Though some suppliers will not sell the INRatio to a non-physician. Some will. Test strips run about $200 for 48. They are valid for 9 months or so, but I've used them for 6 months after the expiration date with no problems at all. I've had no issues getting strips.

Perhaps you have a friendly doctor (or a doctor in the family) who will order the machine for you direct from the medical supply house, at his price ($800 vs $2000 retail) and you can pay him/her.

 

[Diana22]

Yes they are but you have to get your doctor's referral. Call Medicare and ask them for the information you will need.

Good luck!

Thanks. That's good news. I'm so tired of driving a long distance to get tested. Two weeks ago my INR was 6.2, the next week it was 1.8. Then I get accused of not taking the proper dose. Grrr... Coumadin is a horrible thing to have to take. I was losing my hair, and then found out that coumadin binds iron. Started taking liquid iron in the morning, and my hair grew back. There are so many side effects. And doctors don't even know what the side effects are! :mad2:

 

[Protimenow]

It sounds like you're a great candidate for self-testing. I own my meters outright. I self test. I just recently got involved with a clinic, but their protocol is for tests once a month. I am much more comfortable with weekly testing, in the comfort of my home.

I don't make drastic changes in dosage, and my INR is usually slightly different week after week - but close enough to 'in range' that I don't worry much about it.

I don't know if I'm personally comfortable describing warfarin as a horrible thing to take. I'd much rather take it than something that gives me chronic diarrhea or something like that. With regular monitoring, you should be able to stay in range most of the time.
(I thought that the pages on the calendar that were flipping forward at an accelerated rate were the cause of my thinning hair - I'll have to see how much iron I get in my daily multivitamin packet)

I'm still a few years short of Medicare age. It'll be interesting to see what they'll want to bully me into.

 

[Noyolk]

Thanks everyone for the input. I spent a lot of time dealing with the insurance and have found that Edgepark medical is my approved supplier. They have Inratio and coaguchek xs available. It is a purchase machine, not a rental, and I will be calling my primary doc's nurse with the results. I hope to have it in my possession soon, so I can still go to the coumadin clinic to test it against the Hemochron signature elite that they use and calibrate daily.

 

[lance]

Hi Noyolk
Is instruction on use available?

 

[Protimenow]

I have a Hemochron Signature Plus (one generation below the Elite). They use electronic controls for testing the accuracy of the meter -- I wish I had those controls.

Personally, I'd much rather trust my life to the results of a Hemochron than to any of the meters. (I'm pretty sure that I can get the Prothrombin Test strips for this meter, but I'm not sure that I'll be able to use it without occasionally calibrating it).

As others have said, you will love the freedom to do self-testing. You will probably get training with the meter - if not, it isn't that difficult to read through the manual and run the test yourself. From what I've read, it may be a bit easier to get the blood onto the XS strip than it is on the InRatio -- but if you can't drop a good drop onto the InRatio strip, you can use a capillary tube to collect the blood and then squeeze it onto the strip. The most important thing to remember is to get that drop onto the strip within 15 seconds of incising your finger.

Which meter are you getting?

 

[Noyolk]

I do not think their will be hands on training as this is a medical mail order supply house. I believe I will have a choice between the INratio2 or Coaguchek XS. I have not received any pricing on the meters or the consumables, so any input on the ease of use or benefits of one over the other is helpful.

 

[Bina]

I do not think their will be hands on training as this is a medical mail order supply house. I believe I will have a choice between the INratio2 or Coaguchek XS. I have not received any pricing on the meters or the consumables, so any input on the ease of use or benefits of one over the other is helpful.

You are on the right track. I've been using the Coaguchek XS for the last 5 years with perfect, accurate results; and I have heard
others report that their INRatio2 is equally reliable.
Once you get your machine we have tons of threads on here to help you if you run into any testing issues.

 

[Protimenow]

My InRatio and InRatio 2 seem to be fairly reliable. Understand that 'reliable' is a statistical term -- it means that the results can be reproduced. A clock that doesn't work is 'reliable' -- it always shows the same time, and is accurate once or twice a day (depending on whether you're on a 12 or 24 hour schedule). My InRatio and InRatio 2 agree with each other when tests are done within minutes of each other, and the same batch of strips is used -- but the results are 'reliably' higher than a blood draw. In my case, I figure that my InRatio results are .3 - .6 (or so) higher than the lab. With a target range of 2.5 - 3.5, I'm comfortable with an InRatio result of 2.9 (or so) to 4.1.

If the Coaguchek XS is closer than the InRatio to a lab blood draw, and the price of the meter is the same as that for an InRatio, I would lean towards a CoaguChek XS.

(Not having ever used an XS, I can't speak for the accuracy, in my case, but others report good results)