Reasons for self-testing?

[clay_from_nj]

Had my AVR six weeks ago and am now going in for INR every two weeks, which should eventually go up to one or two months. For me, with a pretty easy to regulate level (tested today, spot-on at 2.5, with a goal of 2.0 to 3.0), getting into home testing doesn't seem too compelling. Are there specific circumstances which make self-monitoring more attractive, or is it primarily for the convenience of not having to go to the lab every time? I would imagine that the major concerns would be if someone's level is more difficult to regulate and needs more frequent testing or if the distance they must travel for testing is prohibitive. Just wondering because the home testing thing seems to be very popular.

Clay in Colorado. ATS Open Pivot AP to replace BAV, 9/21/12, St. Joseph Hospital - Denver, Dr. Mark Ammons

 

[lance]

Good morning Clay
Reasons for home testing (mine):
Scarred veins from many repeated blood draws
Home testers stay in their range a greater percentage of time than none --research has proven this
Patients more aware of their own health
Self use fosters warfarin knowledge enabling users to identify the bad advice they will be given (I have, many times and so have many others).
Monitors are easy to use, convenient, portable, highly accurate and can be used anytime
I would never, ever be without mine
Learning how to manage INR with Point of Care monitor is the most valuable gift I have given myself enabling me to manage my spouse's INR. I reporrt to a clinic because I'm part of a study on the accuracy and usefulness of home monitoring.

 

[Freddie]

Hi Clay and Welcome.
I would say your thoughts are correct on home testing ones INR.
Lance is correct, but for me it was more for convenience.

Not sure how the labs work in the U.S.A. except that you might be charged for every lab visit. Here in Canada there is no charge but the waiting time (for me) at the lab can be up to an hour (travel time is not an issue). And when it's -13F or colder who in the heck wants to venture out in that weather to go anywhere?

 

[Fundy]

There's also studies such as the following that suggest a lower and tighter INR range is effective for frequent self-managers.
http://shvd.org/abstracts/2011/C70_71.cgi

 

[AgilityDog]

1. I leave for work, 40 minutes away, by 7 a.m. The lab opens at 8:30
2. When I went to the lab the first few months after OHS, I didn't get the !@#$ results for 3 days!!! by then they were useless!
3. When I have to go to the lab for other bloodwork, there is frequently an hour wait, AND I wind up with bruises in my elbows.

I'd rather have a finger stick, on my own schedule, with immediate results. I own my own machine, and buy my own strips because Philips is a rip off for people with high deductible plans.

Oh yeah, my cardio lets me self-manage, too.

 

[RobThatsMe]

Hi Clay,

I agree with the others comments above, and also have my own personal reason.
Not trying to scare anyone with this next sentence, but it is a fact.
Coumadin can be a very dangerous drug. One that can kill if not managed correctly.
I have been on Coumadin now for 12 years, trouble free and have home tested for 11 years.
I would never think of letting one or two months go by without testing. For me that is out of the question.
I test every other week, and sometimes weekly, if required.

Also, if you travel often, it really is convient, and provides peace of mind if you have your own testing unit to take with you on trips.
So many things effect your INR when using this drug. Including, diet, other medications, stress, to name just a few.
Home testing allows you to test often, and control any swings in INR that may, and do occur from time to time.

Rob

 

[catwoman]

Another reason:
If you have to take an RX that will affect your INR, you generally test before starting, then several days afterwards. That would throw you into another couple of visits to your doctor's office or lab.

It is sooooooooooo nice to hear my doctor say, "This (RX) may affect your INR, but since you have your own monitor, you don't have to worry -- you can test at home."

I generally test every 7-10 days.

 

[Bina]

Very soon post op I was able to go to monthly testing at a blood lab, my INR has always been rock steady....BUT, my veins would at times
not cooperate and I became concerned that too much damage was being done to them over the long term.
So, a few members here on VR got me all excited about home testing and when I suggested it to my GP he said "sure".
I have been thrilled with the accuracy and convenience of my home monitor. Love it.

 

[Protimenow]

I went for a long time between blood draws for the first fifteen or so years post-op. I had a doctor who didn't seem to care, and was fairly lucky that a consistent dose of warfarin apparently kept me fairly safe.
In 2009, I finally got my own meter. At that time, I tested every two weeks or so. I've kept a record of my INRs (and any diet, medication, dosage, or other changes) ever since I started self testing. The simple Excel spreadsheet lets me see my INR history, and can be useful for convincing prescribing doctors that I know what the heck I'm doing.

I test every week to 10 days. I like the convenience, the cost, and the ability to test more frequently if there's a reason to. (Many months ago, I started taking what I thought was a low dosage vitamin K supplement. It wasn't. I stopped taking the med, upped my dosage according to clinical guidelines, and tested every two days until I was in range. (I didn't want to overcompensate and wind up with an INR that was TOO high). Having my own meter made this more frequent monitoring easy to do.

Having a meter, and being relatively current with the latest information about anticoagulation, I can (as others have noted) tell when I am getting bad advice from a medical professional. I am very glad that there are meters available - and that I have meters (I only need one, but somehow have wound up with a bit more...), and that I am able to monitor my INR with a weekly (or so) test.

For some people, self testing isn't a good option -- but for me, it's great to have one.