Did I sell out? Not exactly

[carolinemc]

When my old HMO REQUIRED me to go to an anticoagulation clinic, I had some long arguments with this idiot pharmacist about my dosing, and that I'd been self managing for years and didn't need him.

I finally agreed to go to the 'clinic,' where he tried to dictate my dosage - WITHOUT KNOWING, OR ASKING, WHY I TOOK WARFARIN. Idiot.

I never returned.

Screw the HMO - I know better what I was doing than this idiot, egocentric, self-proclaimed warfarin god.

I never had a cardio manage my warfarin. The lab I go to does great.

 

[carolinemc]

Yes, my current waste of space "Dr" (he is a Nurse Practitioner) does not even want to know what my INR results are (he said something like unless my results are way out of range then there is no reason to contact him). I've painfully learned that anything taking 1 minute of his time outside of an office visit is not something he wishes to be involved with. It is damn near impossible to get him to follow up on things which require his attention so I have to basically fend for myself....

That is dangerous, for you need either a good lab to go to, or a home meter. Doing without anything is a danger to you cause you cannot dose with a meter.

 

[slipkid]

That is dangerous, for you need either a good lab to go to, or a home meter. Doing without anything is a danger to you cause you cannot dose with a meter.

I have a meter. Bought one last June when I terminated my service through Cardionet/Biotel/Philips/etc.

Interestingly I've been stable for about 10 years now after the 1st couple months of needing doseage finetuning. Last time I had to make a change was about 1-2 years ago when I had covid & on an antibiotic for sinus infection which made my INR go up around a point or so. After a brief adjustment was back on my usual dose in about 5-6 days IIRC.

 

[ATHENS1964]

My cardiologist from day one suggested I self-administer INR
the only thing he asked me was that he wanted me to do some tests in a lab for a short period of time, the reason he wanted it was to check that I can handle the INR CoaguChek correctly.
After 3-4 visits to the LAB he told me to use only the INR CoaguChek and once a year to check it with the LAB.
Fortunately here in Greece, although we have issues with the public health system, patients with mechanical valves pay about 8-10 euros for 24 INR tapes every 4 months, that is, we have 3 boxes a year.

 

[LondonAndy]

My cardiologist from day one suggested I self-administer INR
the only thing he asked me was that he wanted me to do some tests in a lab for a short period of time, the reason he wanted it was to check that I can handle the INR CoaguChek correctly.
After 3-4 visits to the LAB he told me to use only the INR CoaguChek and once a year to check it with the LAB.
Fortunately here in Greece, although we have issues with the public health system, patients with mechanical valves pay about 8-10 euros for 24 INR tapes every 4 months, that is, we have 3 boxes a year.

The attitude of the medical profession seems somewhat different in Europe to the Americans: self-testing is seen as better for patient outcomes and supported, rather than trying to push patients to a cumbersome and expensive monitoring industry.

 

[Jennifer Dotson]

The attitude of the medical profession seems somewhat different in Europe to the Americans: self-testing is seen as better for patient outcomes and supported, rather than trying to push patients to a cumbersome and expensive monitoring industry.

Clarity: that’s the Medical-Industrial Complex (cf Eisenhower).
Actual *medical* professionals are often very supportive of self testing etc.
I had to switch from my cardiologist to my family doctor to be able to self test (that is, as soon as insurance will pay for the machine 3mo post surgery) because the corporate system the cardiology office is in has a rule against home testing for liability reasons. So there’s two different organizations with dumb rules getting in the way. Neither actually medical.

 

[Protimenow]

The push to an expensive and cumbersome system seems to caused by Roche - the manufacturer of the InRange and CoaguChek meters.

They don't sell directly to consumers, requiring that they use a service to get their meters. It makes the services a LOT of money. Perhaps Roche wants to avoid liability by providing meters and supplies to consumers.

HOWEVER, consumers should know that there's no prescription required for meter OR strips, and that both can be purchased. I'm currently getting strips from Reliaston. If I ever have a reason to get an InRange, if my insurance won't pay for it (and even if they do), I'll probably get it from Reliaston - unless I find a better price somewhere else.

The American system is expensive and cumbersome - but there are ways around it, if people would only look for them.

 

[Protimenow]

Reliastaon has the InRange for $549 with no strips. They also sell the meter with 24 or 48 strips. If you're a first time buyer, you get 10% off your first purchase. If you have the money, you might consider using the discount for meter and strips -- I am NOT affiliated with Reliaston. I just remember that I ordered 48 strips from them and paid something like $209.

I used the following discount code: SaveWithRELIASTON. I'm not sure if it will still work, but I wouldn't be surprised if it does. (They're selling XS 'kits,' but you're probably better off with the InRange.)