slipkid
Well-known member
After months of trying to get one (very very long stories) I now finally have a home testing unit (INRatio2).
Some things have come up that have me confused regarding home monitoring.
(1) I thought one of the main points of home testing was to enable more frequent testing (weekly) with less hassle (traveling to lab, waiting for results).
With the key being that WEEKLY testing with instant results (at home) provides a better picture of one's INR & allows for tighter warfarin management in response to issues than testing every 2 weeks, or just monthly, etc. Is this not the case? Is WEEKLY testing any kind of a standard or recommendation????
I ask this because now, after my first 2 home tests, to my complete surprise, my GP told me to "test every two weeks". My cardiologist was the one who originally brought up home testing to me & said he wanted to get me testing weekly via a home program with Alere (however I can't use Alere because of very entangled insurance issues). All the things I've read on-line researching this say "weekly" home testing with lab testing monthly or so to double-check things. The info at Alere mentions "weekly" testing. The company my GP set me up with (RCS) specifically mentions "weekly testing", and they even told me when I first got enrolled that I had to call in every week, and that if I didn't, I would be non-compliant and have to return the equipment (?).
Yet my GP now is telling me to reduce testing to every 2 weeks. I discussed this with him further & told him that I thought the whole point of home monitoring was so we could do weekly testing, and that since cost is not currently an issue I would like to continue doing that, plus since I am enrolled in a service which appears to require me to test weekly or have to return the unit & he said "OK" but he made a point to say that he had many patients with home units doing testing only every 2 weeks or once a month etc and that him being the Dr. the service should do what he wants not the other way around.
So what gives with this? Is WEEKLY home testing the standard (& my Dr. misinformed) or is my Dr. correct, and "weekly" is just overkill perhaps invented by the monitoring companies to make more $$/sell more supplies??
(2) I was trained in the use of the InRatio2 by a rep from RCS, but several things about what she showed me might be wrong, at least from what I have been reading lately (which I only stumbled onto by accident btw).
The trainer told me to wash my fingers in warm water (OK on that) but also to rub the fingertips to get the blood flowing before doing the finger prick. However, I just read that you should NOT rub your finger before doing a test, that this will affect the INR reading. TRUE OR FALSE?
(3) The trainer also showed me that instead of pricking a finger, squeezing some blood out, then placing that finger onto the meter (which is how it was done by the visiting nurses I had when I first got out of the hospital) to instead prick the finger (she insisted I use my thumb btw, not a finger), to squeeze/milk a big drop of blood out, then use a capillary tube to suck the blood up, then put the tube over the meter and squeeze the blood out of the tube. To not try to place the finger (actually thumb in this case) on the strip, that it was better/easier to use the tube.
But everything I've been reading on-line only mentions doing the prick then putting the finger onto the test strip/device. I haven't seen anything that mentions using these tube things. It seems to me that the use of the tubes introduces an extra delay that could affect clotting time (??). YES/NO???
Note that both of my last home tests yielded the exact same result (2.5) but that I also did a veinous puncture lab test about one hour before the last test, and the result of that lab was a "PT" of "2.35" (I think that is actually the INR, but the INR field was blank as reported by that lab and "2.35" was listed as "PT" which makes no sense actually).
Some things have come up that have me confused regarding home monitoring.
(1) I thought one of the main points of home testing was to enable more frequent testing (weekly) with less hassle (traveling to lab, waiting for results).
With the key being that WEEKLY testing with instant results (at home) provides a better picture of one's INR & allows for tighter warfarin management in response to issues than testing every 2 weeks, or just monthly, etc. Is this not the case? Is WEEKLY testing any kind of a standard or recommendation????
I ask this because now, after my first 2 home tests, to my complete surprise, my GP told me to "test every two weeks". My cardiologist was the one who originally brought up home testing to me & said he wanted to get me testing weekly via a home program with Alere (however I can't use Alere because of very entangled insurance issues). All the things I've read on-line researching this say "weekly" home testing with lab testing monthly or so to double-check things. The info at Alere mentions "weekly" testing. The company my GP set me up with (RCS) specifically mentions "weekly testing", and they even told me when I first got enrolled that I had to call in every week, and that if I didn't, I would be non-compliant and have to return the equipment (?).
Yet my GP now is telling me to reduce testing to every 2 weeks. I discussed this with him further & told him that I thought the whole point of home monitoring was so we could do weekly testing, and that since cost is not currently an issue I would like to continue doing that, plus since I am enrolled in a service which appears to require me to test weekly or have to return the unit & he said "OK" but he made a point to say that he had many patients with home units doing testing only every 2 weeks or once a month etc and that him being the Dr. the service should do what he wants not the other way around.
So what gives with this? Is WEEKLY home testing the standard (& my Dr. misinformed) or is my Dr. correct, and "weekly" is just overkill perhaps invented by the monitoring companies to make more $$/sell more supplies??
(2) I was trained in the use of the InRatio2 by a rep from RCS, but several things about what she showed me might be wrong, at least from what I have been reading lately (which I only stumbled onto by accident btw).
The trainer told me to wash my fingers in warm water (OK on that) but also to rub the fingertips to get the blood flowing before doing the finger prick. However, I just read that you should NOT rub your finger before doing a test, that this will affect the INR reading. TRUE OR FALSE?
(3) The trainer also showed me that instead of pricking a finger, squeezing some blood out, then placing that finger onto the meter (which is how it was done by the visiting nurses I had when I first got out of the hospital) to instead prick the finger (she insisted I use my thumb btw, not a finger), to squeeze/milk a big drop of blood out, then use a capillary tube to suck the blood up, then put the tube over the meter and squeeze the blood out of the tube. To not try to place the finger (actually thumb in this case) on the strip, that it was better/easier to use the tube.
But everything I've been reading on-line only mentions doing the prick then putting the finger onto the test strip/device. I haven't seen anything that mentions using these tube things. It seems to me that the use of the tubes introduces an extra delay that could affect clotting time (??). YES/NO???
Note that both of my last home tests yielded the exact same result (2.5) but that I also did a veinous puncture lab test about one hour before the last test, and the result of that lab was a "PT" of "2.35" (I think that is actually the INR, but the INR field was blank as reported by that lab and "2.35" was listed as "PT" which makes no sense actually).