You might want to find out a little more, since home testing is the "standard of care" once your INR stabilizes (e.g. 4-8 weeks post-op.) Maybe they just mean for right now, but later you can home test. If they don't support home testing at all, you can get it from other providers such as your GP.
New Coag-Sense meter
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You might want to find out a little more, since home testing is the "standard of care" once your INR stabilizes (e.g. 4-8 weeks post-op.) Maybe they just mean for right now, but later you can home test. If they don't support home testing at all, you can get it from other providers such as your GP.
Chris
Well-known member
The medical group that I belong to has a 'Medical Management' division that manages folks that are on Warfarin. I asked them and was told that they don't allow home testing. It's quite likely that at some point, after everything is stabilized, that I'll find a group that does allow/support home testing and switch, since that is what I am interested in.
That's interesting. Makes one wonder what the driver is to not allow home testing. Good luck.
From what others on this site have said, providers of INR management charge A LOT of money for testing and management. If they insist that a person doesn't self-test, it's likely that a) they don't want to give up the lucrative business that this provides to them, b) the amount of money that they get for 'interpreting' the INR values that patients call in isn't enough for them, or c) they honestly doubt that you can perform a test on your own. (There ARE people who aren't able to successfully test, but if a person interested in self-testing, he or she is probably capable of doing it and can probably tell pretty quickly if it can't be done).
As others have noted, it takes a while for dosing and INR to stabilize. Many insurers don't consider giving the patients a meter until after 90 days or so, to allow the dosing to stabilize.
As others have noted, it takes a while for dosing and INR to stabilize. Many insurers don't consider giving the patients a meter until after 90 days or so, to allow the dosing to stabilize.
Chris
Well-known member
That's what I imagine the reason(s) is likely to be.
I just ordered a meter, lancets, and test strips. I want to keep and eye on what they're doing.
I went to the ER last night to have a vein checked out (swollen & painful). It turned out to be a non-issue, but they drew blood and checked my INR while I was there. It was 1.2, so they gave me a shot of Lovinox (?) and told me to take 4 mg of warfarin when I got home, which I did.
1.2 is worrisome. Lovenox is a fast working anticoagulant. 4 mg at night won't raise your INR right away. I'm surprised they didn't send you home with Lovenox or a prescription for it.
Do you have any idea how long your INR has been so low? When was your last INR taken? You don't want to go too long with an INR that low.
Having your own meter will free you up to test at home (or wherever you are). It'll help you get a fast answer to any questions about your current INR.
Personally, I'd be concerned with an INR that low (and I've had it a few times over the years, occasionally used Lovenox twice daily to raise the INR, and used warfarin to raise the INR). Over the years, I've had procedures that requires lower INR. I was usually okay just increasing the dose once, then going to regular dose - within a few days, my INR was back in range.
Do you have any idea how long your INR has been so low? When was your last INR taken? You don't want to go too long with an INR that low.
Having your own meter will free you up to test at home (or wherever you are). It'll help you get a fast answer to any questions about your current INR.
Personally, I'd be concerned with an INR that low (and I've had it a few times over the years, occasionally used Lovenox twice daily to raise the INR, and used warfarin to raise the INR). Over the years, I've had procedures that requires lower INR. I was usually okay just increasing the dose once, then going to regular dose - within a few days, my INR was back in range.
vivekd
Well-known member
As per Chris signature, he has Tissue valve, so INR 1.2 may not be that big of a deal.
Chris
Well-known member
They're still trying to get my INR into range. I think it was low for about two days. I had a blood draw yesterday, but haven't heard the results yet. I'm very new to this (ten days post-op), but I'm not thrilled with how the warfarin/INR stuff is being managed. Hopefully that meter will ship on Monday and I'll have it sometime next week.
And thanks Vivek. I hadn't realized that I my signature needed updating. It now reflects my current (mechanical) valve.
vivekd
Well-known member
IMHO, it's always good to have 4 Lovenox injections at home with expiration 12 months in future and test at home. That way, you can always administer lovenox, if INR goes sub-therapeutic.
marvsehn
Active member
I carry a lovenox shot also but the $25 per is a bit expensive especially if you dont use it. My answer is to weekly selftest. And then if i am a bit low, under 2, i take a 2.5 mg warfarin immediately and continue the normal dose (maybe increased due to the situation). For me the 2.5 mg means about a 0.5 increase in inr over 3 days or so. I self test again in 24 hrs to make sure things are on track. Always talk with your Dr.
vivekd
Well-known member
Thats true, most of the people will not need it, if they test weekly. I keep loveneox at home, because even with weekly testing, my INR fluctuates drastically in 2-3 days. I'd situations where my INR has gone down from 2.9 to 1.4 in 2 days (1 missed INR dosage)
Your INR will probably fluctuate for a few months after OHS. Some insurances (from what I've read here) won't approve self testing for at least 90 days after surgery, because it's hard to get a grip on the INR before that.
You may be 'dissatisfied' with how your INR is managed the first weeks or month after surgery - but it may be a moving target for a while.
Now on the issue of a 1.4 with a tissue valve. I'm not aware that anticoagulation is needed for tissue valves (but may be necessary if you have AFib).
You may be 'dissatisfied' with how your INR is managed the first weeks or month after surgery - but it may be a moving target for a while.
Now on the issue of a 1.4 with a tissue valve. I'm not aware that anticoagulation is needed for tissue valves (but may be necessary if you have AFib).
I am lucky my insurance approved home testing right away. My old cardiologist was a pain he wanted me clinic testing 6 months before he would order home testing, my new cardiologist was fine since I seem fairly stable. I am sure I will have some swings, but so far so good. Been 2.5 - 2.9 now for a few weeks. The beauty of having the machine is being able to test at will. I have some supplements that will likely impact my INR so I can phase them in and get quicker feedback while lowering risk of going outside my range.
vivekd
Well-known member
my cardiologist approved home testing after 90 days. I think that restriction was placed by the insurance company
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Mine was about the same. The restriction was the insurance company.
Chris
Well-known member
So the meter arrived yesterday and I tried it out this morning. Easy peasy.
I have my next blood draw scheduled for Monday, so I'll self-test again, Monday morning, that so I can compare results.
I have my next blood draw scheduled for Monday, so I'll self-test again, Monday morning, that so I can compare results.
CThrock
Well-known member
I love my INR machine..I do the testing every morning and report it to the Doctor. As long as I'm in range there's no problem. Out of range might need adjusting. Better then going to the lab every week..Best machine invented. 
CThrock
Well-known member
Every Monday morning sorry.
I am testing twice a week, but need to get it done right after work out when my BP is a bit high so I can get good blood sample, I am having issues with 21G 1.8mm lancets on occasion not getting enough blood, wasted a strip today due to that. I am ordering a 21G 2.0mm set of lancets to hopefully help. That is the one dislike I have with CoagCheck XS you get 180 seconds to get the blood on the strip. With the CoagSense if I get a bad blood draw I see it and can prpe and draw another finger without worrying the timer will expire. I really like the CoagSense PT2, awesome meter.
Agreed. It's harder to waste a strip with the Coag-Sense because, unless you put blood or another lilquid into the well on the strip, the strip remains usable. Although the Coag-Sense meter has a timer on it, you can ignore that and continue using the strip until you DO put blood onto the strip. And, because the blood is drawn into a transfer tube, you know whether or not you have enough blood. (As you know, once you put a CoaguChek XS strip into the meter, you've got a limited amount of time to get the blood onto it - if you don't, the strip is wasted because you can't try to use it again).
Like you, I also really like my PT2.
Like you, I also really like my PT2.
