Whats the smart thing???

[Freddie]

So, what is the smart/safest thing to do?

Check ones INR (once your stable) every 2 weeks or every month?

I was taken back a bit when the doctor told me today that I would be safe to go monthly

This could be a motive of hers to discourage me from getting a home monitor - I don't know......its just a thought.....and a nasty one at that!

But really, what is best? Every 2 weeks or monthly?

 

[Magic8Ball]

Best for one is not necessarily best for another.

Thats the disclaimer over and done with but i test weekly at home and sometimes (well mostly at the moment) let it slip to fortnightly when stable.

I haven't tested at a lab for nearly 6 months now (could be more).

If your stable then any time span is safe, the problem is, if you suddenly have to change meds, or are ill, or change your exercise or eating routines significantly it can sometimes affect your INR and its nice to catch that early.

There is a possibility that something could change just after a test and by the time you get to your next monthlylab test you are way way high.

Its all a risk/benefit calculation.

Others will post links to study's that say regular home monitoring gives better results than lab based monitoring at larger time intervals.

My advice to anyone, get a home tester, take charge yourself.

 

[dick0236]

I am comfortable testing every 2 to 4 weeks if my INR has been stable (2.5-3.5). For most of my time on warfarin I have tested once per month and back in the 1980s I was so stable that the docs put me on once per quarter. In hindsite I would never do that again. I did try hometesting on a weekly basis for a time but have discontinued it. I found nothing wrong with home testing but it is less expensive and almost as convenient for me to go to my doctors office. Currently I test every 3 weeks.

 

[Karlynn]

When I lab tested it was 1/month unless the INR was way off. When I started home testing I did once a week - just 'cause I could!. I usually test every 2 weeks unless there's an issue.

Interestingly enough, my dose was probably adjusted more often when I tested 1/mo with the lab.

Print out the articles in the references section on home testing and take them to your doc. There's no reason for him to not want you to do it if he wants you to be stable.

https://www.cms.hhs.gov/mcd/viewdecisionmemo.asp?from2=viewdecisionmemo.asp&id=72&

https://www.cms.hhs.gov/mcd/viewdecisionmemo.asp?from2=viewdecisionmemo.asp&id=72&

And give him these web links for a great video series.
Pt 1 Life Expectancy and Valve Selection Criteria
http://www.onevalveforlife.com/documents/1of3.pdf

Pt 2 Anticoagulation-Use, Management and Effect On Quality Of Life
http://www.onevalveforlife.com/documents/2of3.pdf

Pt 3 The Importance of Hemodynamic Function in Valve Selection
http://www.onevalveforlife.com/documents/3of3.pdf

 

[aussigal]

I have been stable for over a year and mostly I test once a month...sometimes I forget how long since I tested,. usually its between 3-5 weeks unless I have a change in something then I will throw in another test just to be sure...that reminds me I must go test today as its been a few weeks...I usually try test on the same date every month.

 

[Bina]

I did lab testing monthly for the first 20 months; I stayed in range but I was more nervous.
Now I have been home testing every 2 weeks for the past 9 months and I'm so much more relaxed. I am still in range and I can test before the dentist, after the antibiotics, etc.

 

[Cooker]

HiHo Freddieo.....I lab test once a month for the past two years. Good or bad I don't know....My INR has been in range since three weeks post-op.......Hey, I "am" stable

 

[njean]

I have tested once a week for over a year now & still struggle with the dosing. In fact, 3 weeks ago before my cardio's appointment, I tested at home & I was 2.7. He was not a happy camper when I told him that. He said, "I want you at 3.0 or better" because of your double valves! So, I upped my dose from 45 mg to 60 mg weekly, (from Sunday thru Saturday) & I'm holding at 2.9 or 3.0. Who can figure???

 

[ALCapshaw2]

When patients are stable, my Coumadin Clinic 'usually' tests once a month (more accurately, every 4 weeks).

IF there was an out of range reading (under 5.0), they recommend 2 weeks and maybe a VERY SMALL dose adjustment. Over 5.0, do some dose adjustments and come back in a week.

For Home Testers, every 2 weeks is appealing in that IF you have a change, you will see it sooner and can adjust for it before it continues. The Down Side of course is Cost.

As you can see, "It Depends" and is also a function of an individual's 'comfort zone'.

Either 2 or 4 weeks is appropriate depending on circumstances.

How's that for being ambiguous?

'AL Capshaw'

 

[lance]

Whatever makes you comfortable

Whatever makes you comfortable

I have been testing every week or every two weeks depending on my XS readings. When I think back to the days I tested once a month at the local lab, I cringe. Testing weekly at home gives me a lot of confidence and I would never return to once monthly testing.

Everyone is different and not everyone shares my opinion of warfarin i.e it is a dangerous drug. Testing weekly makes it less so.

Lab tests, even once monthly, cause the veins to form scar tissue causing pain/discomfort at test time. That's something else to consider when one is anti-coagulated for life.

Cheers

 

[EVELYN]

Weekly for us on the INRatio. Why? One, because we can, and Two because we belive it's alot easier to monitor and/or adjust a dose. IMHO, the more you're in range, the better and too much can happen in a monthly test.

Evelyn

 

[Blanche]

Freddie:

If Al had been testing weekly, it is possible that he would have avoided the strokes that he had. He had the first two strokes because, the doctors have said, that it is likely that his INR was too low for too long. He had those 2 strokes 27 days after his p/t test. At the time of his first stroke, his INR was 1.6.

Regardless of what your doctor tells you, you will have the monitor and the strips. Test whenever you want to...that's what we did. Better safe than sorry.

Blanche

 

[njean]

Freddie:

If Al had been testing weekly, it is possible that he would have avoided the strokes that he had. He had the first two strokes because, the doctors have said, that it is likely that his INR was too low for too long. He had those 2 strokes 27 days after his p/t test. At the time of his first stroke, his INR was 1.6.

Regardless of what your doctor tells you, you will have the monitor and the strips. Test whenever you want to...that's what we did. Better safe than sorry.

Blanche

Ditto that Ms. Blanche!

 

[Freddie]

Thank you all.
Its great to know how everyone feels about this.

 

[Lisa in Katy]

Sometimes I go every month, but more often I go every other month. For instance, I went in January and got a reading of 3.4. On March 13 I got a reading of 2.9. I plan to go in mid-April, only because I would rather be higher than 2.9 and want to make sure I am. It depends on how stable you are and what you are comfortable with. I don't home test and can't really justify it because I have been stable for so long. I'm going to try to get a monitor through my insurance, but if they don't agree, I don't really have grounds to fight. After all, they only pay $1.98 when I get tested at the lab and at max $20 a year, they are getting off way cheaper than buying a monitor.

 

[Ross]

For myself, I'm not comfortable going more then 2 weeks. Preferably once a week. In two weeks time, I can wonder out of range pretty good.