Announcement

Announcement Module
Collapse

Welcome to the New VR.org!

Self Registrations have now been re-enabled. Due to the wonderful world of Spammers, those registering will be required to answer every question in the form..
See more
See less

A Protime/Coagucheck question

Page Title Module
Move Remove Collapse
X
Conversation Detail Module
Collapse
  • Time
  • Show
Clear All
new posts

  • A Protime/Coagucheck question

    Ok, back to the old INR (It's never right!!)

    Today Tyce had to go to our cardio for an INR test.....His nurse checked him on 2 Coagucheck machines....their old and their new one. Both machines registered 5.0. When he came home, I checked him on our Protime....2.9. Of course they want him to withold for 2 days, which isn't going to happen, but I am beginning to doubt our Protime now. I have requested ITC to send me the plug which would reprogram our machine to an ISI of 2, which I believe is the standard used for the Coagucheck. Hopefully, that will solve the problem. What do ya'll think???

    Evelyn

  • #2
    The saga continues. Our cardio's office just called and wants Tyce to go to our hospital for a lab draw stat. Maybe that way we'll know which one is closer!!! Will keep everyone posted on the third factor in the equation.

    Evelyn

    Comment


    • #3
      Evelyn:

      What is an ISI? I've applied to insurance for a ProTime but do want numbers to be as close to what they are on CoaguChek, which my PCP uses.
      Marsha (7-28-50), MVP 1990/MVR (St. Jude) & ASD repair 6/24/03 Baylor University Medical Center, Dallas Texas. Hometesting since 11/03, first with ProTime 3, now with INRatio.
      John (3-13-46), MV repair 5/10/07, Dallas Presbyterian, port-access incision, Dr. William Ryan. Chordae ruptured 12/05 in car crash.

      Comment


      • #4
        Evelyn,

        Gosh, what a dilema! Been there. Had a three way check with the home test, coumadin clinic and local lab. I hate to tell you, but we never really got to the bottom of it.

        But.........I was struggling a bit to transfer that drop of blood from my fat finger to that tiny little spot on the test strip. Whoever designed that procedure needs to be loaded up with rat poison and shot. The Roche rep got me some capillary tubes like they use at the clinic, Since then I have had no problem.

        I'm also more diligent about cleaning the machine and my finger. Also use the control vials every time.

        I have gotten to know the nurses in the cardios' office (also my coumadin clinic) pretty well. They indicated a couple of things. My lab test has a lot af variables due to transporting the blood miles in a vehicle to the lab. (Your hospital test shouldn't have that variable.) Using the capillary tube may give a slightly lower INR due to delay in transfering the boold to the strip. This should be minimal - it's what they do a the clinic.

        Keep us posted.
        [COLOR="blue"]Tom [/COLOR]
        [COLOR="red"]BicuspidAV. BactEndocard. AorticVR. PlantarFasc. IngHernias. Crohns. [/COLOR] [COLOR="green"]From couch to 26.2 in 53 weeks! Love to "Tri"[/COLOR]
        [COLOR="purple"]'Tis Grace that taught my heart to fear and Grace my fears relieved.'[/COLOR]

        Comment


        • #5
          INR LOW

          HI, EVELYN,last week I had my INR level check at a local lab and the dr recieved his office called me back a week later right before he was closing ,the nurse said it was good I said well what are the numbers oh she said its 1.6 contuine to take the doses tht he has told you to take, but I know for a fact its too low I dont know what to do should I be my own dr and requalte my own doses I believe he is very inex perenced with coumadin therpy Im in the process of looking for a dr.who will accept government medi-cal I cant take this much more Im at my wits end this is my life they are dealing with i could have a stroke if its too low I was in the hospital in sept for having it too thin i ended up having 5 pints of blood to counter act the problem well thank you ,chris

          Comment


          • #6
            Hello Catwoman
            This is how I understand ISI to the best of my knowledge:

            An ISI is the International Sensitivity Index which is assigned by the manufacturer of the reagent the particular machine uses. For example, Protime has an ISI of 1, Coaguchek, an ISI of 2. . I believe the ISI's range from 1-3, and the lower the reagent, the higher it's sensitivity to vitamin k dependent clotting factors. Mr. Al is the resident expert and can expand upon this, but that is what I understand from the manual Protime supplies.

            Haven't heard from our cardio's office yet, but will keep you posted.

            Ev

            Comment


            • #7
              Back again



              Just got a call from our cardio....the hospital lab draw was 4.9.....it looks as though our Protime is wrong and the coaguchek and hospital lab is right.....scary when it's your life that you're dealing with, isn't it!!!

              I do have the plug being sent to me to reprogram our Protime. If it's not any better next Friday, I guess I'll have to start complaining to QAS....There's a big difference, in my opinion, from 2.9 and 5!!!Maybe I'm in the same boat as Rain was with her machine, who knows!!!

              Evelyn

              Comment


              • #8
                Chris....you have to be proactive when it's your life your dealing with!!!That's the bottom line as far as I'm concerned! Evelyn

                Comment


                • #9
                  Wow - and I was on the verge of getting a Protime machine.
                  Evelyn writes:
                  >>>>
                  I do have the plug being sent to me to reprogram our Protime. If it's not any better next Friday, I guess I'll have to start complaining to QAS....There's a big difference, in my opinion, from 2.9 and 5!!!Maybe I'm in the same boat as Rain was with her machine, who knows!!!
                  >>>>>
                  What is this plug? If they reprogram the Protime does that mean the ISI of 1 was in error? I wonder if a different batch of cuvettes would yield a different result?

                  Comment


                  • #10
                    Hi Jim

                    Yes, the plug is for professionals and just reprograms the Protime to be in line with an ISI of 2, which is what the Coagucheck uses. The isi of 1 is NOT an error, just what Protime uses. Coaguchek uses materials with an ISI of 2. I did call ITC and Tyce will retest this afternoon again with our Protime. If it's still way off, it is either the machine or the cuvettes. However, these are replacement cuvettes because we were called to send back our other set because they were faulty.....so who knows!

                    Confused and a bit irritated as this was a big investment monetarily and we thought we were buying the right brand. I don't think a quality machine should break after about 15 months of use weekly!!!

                    Evelyn

                    Comment


                    • #11
                      Coaguchek or Protime?

                      catwoman, my advice is get the same monitor your PCP uses, in this case Coaguchek.
                      Marty
                      Mitral valve replacement
                      September 17, 1998
                      Mechanical St. Jude
                      Inova Fairfax, Falls Church VA
                      Dr. Ed Lefrak

                      Comment


                      • #12
                        Thank you Lance and ITC

                        I just got off the phone with both Lance from Qas and ITC in Jersey. ITC is sending me out both a new loaner unit and new cuvettes because they have no idea why the machine is doing this. Of course, I did mention that we were using NEW cuvettes that were sent to us because our last batch was defective and recalled. The new ones were NOT left out in the heat and went right into the refrig when they were delivered, so personally I don't think it's the cuvettes

                        We are to test both machines on Wednesday and record results and both machines with our cardio's office on Friday and do the same. Lakeesha from ITC is reprogramming the new unit with an ISI of 2 so it will be more in line with the Coaguchek, which our cardio uses.

                        I do hope we get to the bottom of this, and I thank God that Tyce didn't have any problems because of it. It certainly has made me feel very untrusting of this product. I would encourage everyone who has a machine to have it checked against a clinic or hospital draw routinely---I know we will from now on.

                        Evelyn

                        Comment


                        • #13
                          Thanks fo keeping us posted Evelyn.

                          My math is a bit rusty but as far as I can see if 2.9 is based on an ISI of 1 - then to get it to read 5 instead would mean an ISI of 1.5 (since the ISI number is the exponent in the INR equation. If the 2.9 is based on an ISI of 1 when 2.9 is raised by an ISI of 2 it would be 2.9 times 2.9 = 8.41.

                          I looked for some articles on the web about the ISI and they say the basic formula is:

                          INR = (PT time/mean PT time) ^ ISI (where ISI is the exponent)

                          The ISI is supposed to be established based on the different characteristics of the testing reagents so that the INR is a standard measure across all the different testing variables.

                          One question I would have is do both the coaguchek and Protime give both the INR and the PT time itself. If so you could at least see if both machines are reporting the same PT time to see if the diifference is all in the ISI number.

                          Comment


                          • #14
                            Jim
                            The protime does give both the INR and PT, which is very nice. I don't know about the Coaguchek.....Marty? do you know the answer to that? If not, I'll let you know next Friday when we check both machines with the cardio's coaguchek.

                            Ev

                            Comment


                            • #15
                              I know the Coaguchek at my Coumadin Clinic gives both.

                              Comment

                              Working...
                              X