P
Patrick
Main part of my reply.
Main part of my reply.
Karlynn you fail to understand me on several levels. You also appear to have difficulty accepting advice for what it is, simply helpful advice based on reproducible results. There are many points I want to address and will post twice the first is the most relevant point for Joe Cool.
Point 1 You wrote:
I stand by my assertion for Joe Cool that, without the ……….concurrently, the easiest way to set his mind at ease is to check his machine on a person or people who do not use Coumadin.
Please Karlynn read this carefully as you are offering a lot of advice to lots of people whom at times can be vulnerable and nervous.
If Joe’s INR was reading low in his range a “normal” INR test would be very useful in checking the accuracy of his monitor. Unfortunately Joe’s INR was reading high therefore it would be of no value to him.
If Joe had run a normal INR and then believed his monitor was working correctly he could have changed his dose and put himself at risk of dropping below his therapeutic range. This is exactly what I am trying to get across to you.
However if Joe had been dual testing over a period of time and had worked out the relative value of both systems he would have no difficulty. Joe’s single dual test as he stated was, self-test 3.4 versus hospital test 2.6. No need to change dose!
Now Karlynn, what exactly is your difficulty with my logic on this? Can you see how your advice that you stand over so fervently could get him into trouble?
Point 2 You wrote:
Patrick, I think all you need to do is ……………..the next time they still waited a week to call her with her INR and dose.
Hospital turn around time??? I accept totally your point but fail to understand why you choose to introduce this now as it is irrelevant to Joe’s discussion points. If your cardiologist had been raising hell about the accuracy of the lab result, this would have been relevant.
Point 3 You wrote:
I'm not assuming you are naive. Most people do not have the ability to oversee their hospital testing. It sounds like you may be in a position to do this.
I am not in a position to oversee my hospital testing. I pay to have my blood taken at my GP surgery and the testing is done independently in a large Dublin based general hospital.
Point 4 You wrote:
Nor do most people have the time to extensively oversee and monitor their testing as you do.
My self-testing takes less than five minutes from getting my monitor out to putting it away again. I then write my result in a book. I fail to see what you talking about?
Point 5 You wrote:
A few recent papers……….that those who home test and even self dose…………………needed continual comparison with lab tests.
I am well aware of this opinion Karlynn and I am a passionate supporter of self-testing and when medically appropriate self-dosing. The trust-worthiness of monitors is not in question, it is all about getting to know YOUR OWN monitor and calibrating it. I am not aware of any home monitor manufacturers who claim the reagents used in their testing systems are exactly those which are used in routine hospital testing systems, hence the discrepancy in results. Therefore because of this discrepancy some calibration is necessary, this is a very fundamental but important point!
Point 6 You wrote:
Twice a year comparison with labs has been sufficient enough for both machines that I've had.
You are a very fortunate woman but I think even you might be surprised if you dual tested a bit more.
Patrick
Main part of my reply.
Karlynn you fail to understand me on several levels. You also appear to have difficulty accepting advice for what it is, simply helpful advice based on reproducible results. There are many points I want to address and will post twice the first is the most relevant point for Joe Cool.
Point 1 You wrote:
I stand by my assertion for Joe Cool that, without the ……….concurrently, the easiest way to set his mind at ease is to check his machine on a person or people who do not use Coumadin.
Please Karlynn read this carefully as you are offering a lot of advice to lots of people whom at times can be vulnerable and nervous.
If Joe’s INR was reading low in his range a “normal” INR test would be very useful in checking the accuracy of his monitor. Unfortunately Joe’s INR was reading high therefore it would be of no value to him.
If Joe had run a normal INR and then believed his monitor was working correctly he could have changed his dose and put himself at risk of dropping below his therapeutic range. This is exactly what I am trying to get across to you.
However if Joe had been dual testing over a period of time and had worked out the relative value of both systems he would have no difficulty. Joe’s single dual test as he stated was, self-test 3.4 versus hospital test 2.6. No need to change dose!
Now Karlynn, what exactly is your difficulty with my logic on this? Can you see how your advice that you stand over so fervently could get him into trouble?
Point 2 You wrote:
Patrick, I think all you need to do is ……………..the next time they still waited a week to call her with her INR and dose.
Hospital turn around time??? I accept totally your point but fail to understand why you choose to introduce this now as it is irrelevant to Joe’s discussion points. If your cardiologist had been raising hell about the accuracy of the lab result, this would have been relevant.
Point 3 You wrote:
I'm not assuming you are naive. Most people do not have the ability to oversee their hospital testing. It sounds like you may be in a position to do this.
I am not in a position to oversee my hospital testing. I pay to have my blood taken at my GP surgery and the testing is done independently in a large Dublin based general hospital.
Point 4 You wrote:
Nor do most people have the time to extensively oversee and monitor their testing as you do.
My self-testing takes less than five minutes from getting my monitor out to putting it away again. I then write my result in a book. I fail to see what you talking about?
Point 5 You wrote:
A few recent papers……….that those who home test and even self dose…………………needed continual comparison with lab tests.
I am well aware of this opinion Karlynn and I am a passionate supporter of self-testing and when medically appropriate self-dosing. The trust-worthiness of monitors is not in question, it is all about getting to know YOUR OWN monitor and calibrating it. I am not aware of any home monitor manufacturers who claim the reagents used in their testing systems are exactly those which are used in routine hospital testing systems, hence the discrepancy in results. Therefore because of this discrepancy some calibration is necessary, this is a very fundamental but important point!
Point 6 You wrote:
Twice a year comparison with labs has been sufficient enough for both machines that I've had.
You are a very fortunate woman but I think even you might be surprised if you dual tested a bit more.
Patrick