Soreness after finger stick

[Bina]

Occasionally I manage to stick my finger pad in a place that is more sensitive and it hurts to type on it for a day or two, but that is the extent of it. Using your guitar strumming hand
should be a good idea as well as spreading out your testing--- if you are consistently in range..... I test every 2 or 2 1/2 weeks----always in range.

 

[babshappy]

Bina do you manage your own warfarin?? I'm in Vancouver and I am in the process of trying to get them to let me do my own managing ...they're a little backwards thinking here I think ...

 

[gerrychuck]

I saw an instructional video at a medical supply company that cautioned against using fingers that had callouses, scars, or other areas of skin thickness for blood testing. I'm guessing that, as a guitar player, you've probably got the kind of surface on your fingers that would make getting a good incision (and a good drop of blood), somewhat difficult. You may want to try the least used fingers (pinky?) -- and, perhaps, the heel or side of the hand - you probably have plenty of capillary resources there, it may not be too hard to get a drop of blood from there, the wound may close fairly quickly, it may give you an accurate reading with your meter. Of course, these systems are designed for fingers - if you can find a good, usable one, this would be the best option.

Usually you only have callouses on the fingertips of your fretting hand as a guitar player. For right handed players, that is the left hand. The right is usually quite pristine, even if you play a lot of finger style, as I do. For that reason, I have been only using the fingers of my right hand for testing, and I alternate fingers from week to week.

 

[Greg a]

For soft fingers:
wash your hands in warm water, dry off with a paper towel and hold that damp paper towel until your fingers begin to look like prunes and "poke" on the side of your finger. I find the baby finger works best.

Good Luck

as a diabetic I test up to six times a DAY and had problems until I learnt the HOT WATER and SIDE of fimger tricks

 

[Bina]

Bina do you manage your own warfarin?? I'm in Vancouver and I am in the process of trying to get them to let me do my own managing ...they're a little backwards thinking here I think ...

Yes, I manage and dose myself since 2007. Previously I was going to a lab monthly and always in range, so I called Roche Diagnostics directly, and asked for a brochure to show my doc.
The group here at VR.org had persuaded me that I could do home testing and so I went to my doc armed with current information. My doc thought it was a great idea as long as I called
him with my results. These days I only need to call him 3-4 times a year and report my results from my log sheet. We are thrilled that it has worked out so well and my arm veins weren't
going to take too much abuse anyway. The lab here only does vein draws. Ouchie.

 

[Luana]

Do what most diabetics do, lance the side of the fingers, less painful. Good thing you're not a diabetic using insulin who tests 8 or more times per day.

 

[Greg a]

as a diabetic I test up to six times a DAY and had problems until I learnt the HOT WATER and SIDE of fimger tricks

Do what most diabetics do, lance the side of the fingers, less painful. Good thing you're not a diabetic using insulin who tests 8 or more times per day.

AND I inject two types of insulin for a total of 8 injections

 

[chaconne]

Update:

Have been getting the hang of home testing with my Ebay-purchased InRatio2 ($350). It does have a crack at the base where the test strips go, but doesn't seem to affect performance.

I've been testing 2 times a week for the last few week, just to get the hang of it. The drops of blood seem to come easy now, with very little squeezing. The finger soreness is very slight, and only lasts a day or so. My INR has been reading pretty consistently at 3.1 on the meter. I had a lab draw last week on the same morning I did a home test.

Home: 3.1, Lab: 2.9. Not bad!

 

[Protimenow]

In my experience (and reportedly, that of others, too), my results on the InRatio always seem to be higher than the lab tests. In fact, a few months ago, one of the forum members even posted a mathematical algorithm that seemed to convert InRatio results to lab results. Alere's tech support has been quite helpful to me -- you might consider calling them about the crack in your meter.

A 3.1 reported by your InRatio should be fine, if the low end of your range is 2.5 or so.

As far as finger sticks are concerned, I've had pretty good luck with just standard 21 gauge lancets and a Bayer lancing device, but I am switching to 21 gauge Unistik 3 Heavy in order to get a good, large drop (which, even though my Coag-Sense only wants 10 microliters, which is less than needed for the InRatio, makes it easier to collect and transfer the drop). In the grand scheme of things, not tapping into my lifetime supply (more than 1000) of 21 gauge lancets, and instead using a device that costs about a quarter each time I test my blood, may not be such a big deal. The one use lancing devices may be an option to consider -- especially if it keeps you from wasting four or five of your strips during 100 or so tests. Plus - if you test once a week (once you get the hang of it), a box of 100 should last nearly two years.

In my experience with most lancing devices, I don't have prolonged soreness after my incisions, unless I squeeze or press the area of the incision to get more blood.

I'm glad to see that you're getting the hang of it. I'm interested in learning how Alere responds to your report of a cracked meter (should you choose to call them).

 

[chaconne]

OK, I had to stick myself 4 TIMES yesterday just to get the @#*! drop of blood to land on the small circle rather than around it. When I missed I had to use a second drop of blood. On the 4th try I used my other hand and got the drop right on the circle with the first drop. Surprisingly, all measurements were about 3.3, whether it was the first or second drop of blood used.

 

[pellicle]

OK, I had to stick myself 4 TIMES yesterday just to get the @#*! drop of blood to land on the small circle rather than around it. When I missed I had to use a second drop of blood.

bugga ... well at least your pain answered a question.

have you tried my "light tourniquet" method yet?

 

[Protimenow]

That 'light tourniquette' sounds interesting.
One thing that I just learned - after years of using a 21 gauge lancet and a Bayer lancing device set to maximum depth -- is that I get a better drop when I use a Unistik 2 Heavy or Unistik 3 Heavy. These are designed to get big drops - they are 21 gauge, and they apparently go deeper than the lancing devices that I've been using. So far, I've had no problems getting a good drop (although I still had the problem of putting that drop in the CENTER of the green area on an InRatio strip. It may possibly help to get the transfer tubes that are available for InRatio -- you squeeze the thing, suck the drop into the tube, position the tube over the green light, and slowly squeeze the tube to deposit that drop onto the dot. The whole setup -- 100 Lancing devices and 50 or 100 of those little tubes is about the same as 5 or 6 wasted strips.

Although I have more than a lifetime supply of the 21 gauge lancets, I'm pretty sure that from here on, it'll be Unistik 3 for me.

 

[chaconne]

Recently, I've had good success getting a large drop to form quickly using my "Unistik-2 Extra" Lancets (21G 3.0mm depth). I do squeeze around my finger where it joins the hand to simulate a tourniquet. The problem I had the other day was not being able to get the drop to land on the circle. The soreness, even after sticking 4 of my fingers, was minimal and I could continue playing my steel-string guitar, no problem.

 

[Protimenow]

I was under the mistaken notion that a 21 gauge lancet in a lancing device that was set to maximum depth was all I needed to get a good drop. Most of the time, it worked. However, I've had more success with the Unistik 2 Heavy (I think that's what they're called) and the Unistik 3 Heavy, which DO seem to cut slightly deeper, and make it easier to get that large drop. I don't squeeze my finger that low -- usually, I squeeze around the knuckle just below the fingertip - and my finger usually fills with blood.

I've also had problems getting that drop on the InRatio strip. I'm not sure that putting glasses on helps much. If you're really concerned about getting enough blood onto the strip, small tubes that are designed for that exact purpose are available. I got mine on eBay. It was a bit of a hassle getting the blood into the tubule without putting some air into it (so I usually don't use the tubules) but those tubes have a line that indicates when you've got enough blood, and they DO make it easier to position that drop of blood directly on the strip.

If I was continuing to use my InRatio (I'll probably move over to the Coag-Sense, which seems to be more accurate and, once I've learned how to collect the blood, almost 'fun' to use), I would use the Unistik 3 (I have a box with 97 or so in it) to make the incision and will probably try to aim that drop directly over the green light below the strip. I may often miss -- but I'm not entirely sure that the tube is the best way - for me, at least - to assure that the drop hits its target every time. (I'm sure that with a bit more practice, I'd find that the tubes work great and minimize the number of wasted strips).

I don't really experience much, if any, residual soreness after lancing my finger. It could be that, over the nearly four years that I've been testing, the nerve endings in those spots on my fingertips aren't quite as sensitive as they used to be, or I've conditioned myself to realize that, in the scheme of things, a small poke in a fingertip isn't really that big a deal.

 

[pellicle]

HI

That 'light tourniquette' sounds interesting.

the method I follow now is to

* pres M on my meter to start the strip warmup procedure, this takes ~30 sec (iirc)
* towards the end of this period wrap some thread firmly (firm, not bighting in tight, not loose) around my second knuckle, within about 20 seconds the tip of the finger starts to turn more obviously red.
* lance and then bend the finger, which causes the blood to form out of the lance site almost immediately. I get a "good hanging drop" and apply this to the meter strip.
* grab a tissue and take off the torniquet while the meter digests the blood and returns a reading



I lance at a lower depth than is needed without the torniquet and within an hour wouldn't even know I'd lanced.

 

[gerrychuck]

I've missed that dratted little green target on the InRatio strip a few times too; a couple of times it meant having to do another strip, but the last couple of times I was able to get a second drop quickly and salvage the test without wasting a strip. There definitely is a learning curve to self-testing!

 

[Protimenow]

If you're using a second drop, I hope that it's from another incision -- InRatio relies on clotting factors in the first drop in order to give a (somewhat) accurate result. A second drop, with an InRatio, can possibly result in an erroneous value.

 

[pellicle]

There definitely is a learning curve to self-testing!

indeed there is. It took me a while to get familiar with the Coaguchek XS. I have read the discussions about the InRatio and wonder if its more complex to use than the Coagucheck? Pehaps its just the descriptions making it sound worse....

 

[Protimenow]

I don't have an XS, but I'll venture a bit of a guess. The InRatio wants that drop precisely on a small area on the strip. With the CoaguChek XS, the drop can be put on a spot on the strip, or the drop can be put to either side of the strip. This sounds as if it would be easier. Whether or not that drop of blood is large enough for the meter to test may be an issue (as it is with any meter).

Remembering that the InRatio and CoaguChek XS (and Coag-Sense) want that first drop - and within 15 seconds of incision - may be something that some users don't do. A second drop, or a drop that takes more than 15 seconds to get onto the strip could, potentially, result in an erroneous result.

---

FWIW -- once you're past the learning curve, testing shouldn't be that big a deal. With the exception of the CoaguChek XS, I've probably used all the meters. The ProTime and ProTime 3 probably have the biggest learning curve -- discarding that first drop, squeezing enough blood to fill a little cup on the other side of the lancing device, then transferring it to the strip -- it takes a bit of practice, but may be one of the most accurate. The CoaguChek S wasn't too big a deal - but getting a large enough drop, and putting it on that little dot within fifteen seconds was a bit of a bother.

The InRatio made it easier to do a test than it was with the ProTime meters -- first drop, small spot -- but it still took/takes a bit of practice getting an adequate drop and placing precisely where it's supposed to go.

My Coag-Sense meter also has a bit of a learning curve -- taking that drop and sucking it into a transfer tube or minipipette, then transferring it onto the strip. It takes a bit of practice, and showed me that a non-reusable lancing device is the best way to assure that I get an adequate drop. Now that I know this, it seems pretty easy.

The point is -- none of these meters can be used properly without a bit of practice. That's why most usually come with some kind of training. All have rules for dealing with a drop of blood -- some want the first drop, within fifteen seconds of incision, one says to discard that drop. BUT ALL CAN BE LEARNED FAIRLY RAPIDLY, AND IT'S A GREAT THING TO HAVE THE FREEDOM THAT SELF-TESTING GIVES US.

 

[gerrychuck]

If you're using a second drop, I hope that it's from another incision -- InRatio relies on clotting factors in the first drop in order to give a (somewhat) accurate result. A second drop, with an InRatio, can possibly result in an erroneous value.

Fortunately, test results were completely consistent with the previous week, and with this week as well. Hasn't varied more than .1 for a month now; seem to have found the sweet spot with my dosage, diet and activity By the way, received the lancets and device today; should be set for a while now! Thanks again, Mark