I worship my Pill Box, by the way.
Warfarin Protocol Initiated!
- Thread starter Seaton
- Start date
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I worship my Pill Box, by the way.
pellicle
Professional Dingbat, Guru and Merkintologist
nice photoshop there, I both applaud and approve ;-)
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- Dec 5, 2020
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It's on! Although, we'll need to get you some Near Beer, as I know you don't drink alcohol anymore.
pellicle
Professional Dingbat, Guru and Merkintologist
Finally, back in range... just.
Dalteparin injections stopped.
Clinic blood draw today (Monday): INR 2
An increase from last Friday's 1.7
New dosage schedule given:
Coagucheck INRange shipping from warehouse tomorrow, apparently.
Dalteparin injections stopped.
Clinic blood draw today (Monday): INR 2
An increase from last Friday's 1.7
New dosage schedule given:
- 8mg tonight
- 8mg Tuesday
- 8mg Wednesday
- Clinic INR test Thursday
Coagucheck INRange shipping from warehouse tomorrow, apparently.
Yay! A consistent dose at last! A good news post all-round 
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That's great news!
With Sunday's 8mg dose, by the time you test on Thursday it will represent 4 days in a row of dosing at 8mg. That should provide some very good data.
As I indicated in an earlier post, continuing at 8mg is exactly what they should have done earlier on when they had you at 2.0, rather that oddly dropping you down to 5mg. Apparently your clinic is reading these threads, lol.
pellicle
Professional Dingbat, Guru and Merkintologist
Great, bottom of the threshold.
Glad to see this, hopefully your stopping the heparin.
Glad to see this, hopefully your stopping the heparin.
Clinic venous blood draw today (Thursday): INR 2
No movement from last Monday's INR 2
New dosage schedule given:
- 8mg tonight
- 8mg Friday
- 9mg Saturday
- 9mg Sunday
- 8mg Monday
- Clinic INR test Tuesday
).Result: INR 2.1
I was expecting the same result today from my clinic venous draw. But alas, it was INR 2.
Arriving home from my clinic visit this morning, I again tested my new Coagucheck*. Same result as last night: INR 2.1.
The clinic's self-testing consultant remarked during our phone consultation the other day that when I eventually am “introduced to self-testing” with them, they will test my machine against theirs. They want my INR stabilised before they will consider me for self-testing.
If I remember correctly, he said they will only allow a .05 difference in INR readings between our machines, otherwise they want me to get the machine checked or replaced. Eek.
I'm now wondering whose machine is the more accurate?
I'm hoping when I eventually sit and compare readings between our machines, the results are sufficiently similar to be given the go ahead to self-test. The clinic will then supply me with Coaguchek test strips.*I won't keep checking my INR daily on the Coagucheck. These are just (new toy) practice manoeuvres.
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I suspect we all "waste" a strip or two as we get familiar with the machine - I still do, occasionally, even after 10 years!
I am sure they wouldn't have said a difference of 0.05 - the machines only measure to one decimal place, so I suspect he said 0.5. It is fine if there is a difference of +/- 0.2 or so, and usually I find a small difference when I go twice a year for my machine's "calibration". You will find various threads about discrepancies between a clinic's result and our own, particularly if against a blood draw. I think we have concluded the machine is more likely to be the "accurate" one as there's more that can go wrong in a lab procedure.
Welcome to the world of self-testing!
I am sure they wouldn't have said a difference of 0.05 - the machines only measure to one decimal place, so I suspect he said 0.5. It is fine if there is a difference of +/- 0.2 or so, and usually I find a small difference when I go twice a year for my machine's "calibration". You will find various threads about discrepancies between a clinic's result and our own, particularly if against a blood draw. I think we have concluded the machine is more likely to be the "accurate" one as there's more that can go wrong in a lab procedure.
Welcome to the world of self-testing!
Thanks Andy! That's reassuring and good to know.
I suspected my half-a-brain state had completely misheard him.
I got 6 "freebie" strips with the CoaguChek package. Am down to the last two already. Haha.
If at first you don't succeed...
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That's great news Seaton! Sorry about the strips, but that seems about par for the course. I think we all burn a few in the first couple months.My CoaguChek INRange arrived yesterday. In my impatience, I tested last night (I initially ruined two strips
Result: INR 2.1
I would agree with Andy. In that the lab said 2.0 and your value a little later in the day was 2.1, I would say that should be totally acceptible- in fact very good.
Perhaps I'm getting a little ahead of myself, but I'm already thinking about that beer
I've been testing with XS meters on and off since 2014 (there were a few years when I used the Coag-Sense), and I STILL waste strips.
The results on meters can't always be expected to match other meters. If your meter is new, I'm sure that it went through QC testing before it was shipped. I wouldn't worry about its accuracy.
The results on meters can't always be expected to match other meters. If your meter is new, I'm sure that it went through QC testing before it was shipped. I wouldn't worry about its accuracy.
Perhaps I'm getting a little ahead of myself, but I'm already thinking about that beer
I read in a Roche document that they consider a difference of 0.3 between 2 meters to be acceptable.
Still on the INR roller coaster.
Clinic venous blood draw today (Tuesday): INR 1.7
A drop from last Thursday’s INR 2
So out of my 2 - 3 target range again.
New dosage schedule given:
CoaguChek INR 1.7. So exactly the same.
The clinician grilled me on my diet and things since last Thursday. Had I missed any doses? Whether anything had changed: illness or diet? Plus, whether I drank alcohol? It’s in my notes they have, but I reiterated I haven’t drunk alcohol since the late 90s.
Afterwards, I wondered if it was the broccoli (and mixed veg) stir-fries or steamed broccoli (and carrots) I’ve been having this week? Broccoli has always been a regular part of my diet, so I imagined dosage would stabilise around my fairly consistent intake of that (particular) brassica.
I’d also been brutally gobbling dried fruits a fair bit the preceding days… dates and figs and dried apricots. But I considered those would be OK?
Anyway, that’s where I am.
I asked about the need to go on heparin again and was told only if my INR dipped to 1.5 and lower.
Next blood draw in 7 days (next Tuesday).
Onwards.
Clinic venous blood draw today (Tuesday): INR 1.7
A drop from last Thursday’s INR 2
So out of my 2 - 3 target range again.
New dosage schedule given:
- 10mg tonight
- 9mg Wednesday
- 8mg Thursday
- 8mg Friday
- 9mg Saturday
- 9mg Sunday
- 8mg Monday
- Clinic INR test Tuesday
CoaguChek INR 1.7. So exactly the same.
The clinician grilled me on my diet and things since last Thursday. Had I missed any doses? Whether anything had changed: illness or diet? Plus, whether I drank alcohol? It’s in my notes they have, but I reiterated I haven’t drunk alcohol since the late 90s.
Afterwards, I wondered if it was the broccoli (and mixed veg) stir-fries or steamed broccoli (and carrots) I’ve been having this week? Broccoli has always been a regular part of my diet, so I imagined dosage would stabilise around my fairly consistent intake of that (particular) brassica.
I’d also been brutally gobbling dried fruits a fair bit the preceding days… dates and figs and dried apricots. But I considered those would be OK?
Anyway, that’s where I am.
I asked about the need to go on heparin again and was told only if my INR dipped to 1.5 and lower.
Next blood draw in 7 days (next Tuesday).
Onwards.
Jeff Lebowski
Well-known member
You have to think positively, you'll get through this. by the way ı liked Warfarin roller coaster image
pellicle
Professional Dingbat, Guru and Merkintologist
Still on the INR roller coaster.
I fixed your graphic
- 4 weeks
- a bunch of measurements
- few alterations in dose with evaluation of that data
Sigh
Thanks for the update
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Yes, leafy green vegetables such as broccoli do have an impact on INR, so that could well be a factor if your consumption of it has increased since last week? I'm not suggesting you should reduce the portions of broccoli - I agree with the mantra "dose the diet" - not the other way around.
It will take a while to stabilise, and it's a learning curve as to how your body reacts to changes either of diet or dose, and a degree of trial and error. It still comes back to the benefits of home monitoring - you can test yourself conveniently, and more frequently when needed, to quantify what is happening and adjust dose accordingly.
As you know, don't expect your meter to match the clinic's exactly every time - +/- 0.2 or so is fine. When I go for my six-monthly "calibration check" I do a test on my meter at the same time as the nurse does one on hers (fresh pick of blood on a finger on the other hand) so that there are no other factors at play.
It will take a while to stabilise, and it's a learning curve as to how your body reacts to changes either of diet or dose, and a degree of trial and error. It still comes back to the benefits of home monitoring - you can test yourself conveniently, and more frequently when needed, to quantify what is happening and adjust dose accordingly.
As you know, don't expect your meter to match the clinic's exactly every time - +/- 0.2 or so is fine. When I go for my six-monthly "calibration check" I do a test on my meter at the same time as the nurse does one on hers (fresh pick of blood on a finger on the other hand) so that there are no other factors at play.
