First I guess let me ask, is a clinic different from a hospital lab for ACT monitoring? My mom has been on coumadin for 27 years and goes 1x / month to a local hospital for a blood draw. Through reading here as a result of her impending MV replacement surgery, I found out you can test at home and told my mom about it. She's interested in either that or at least finding if the hospital she goes to or even another one (she volunteers at a local hospital's hospice unit about 1x / week and thought she'd look into getting her testing done in that hospital) has the finger prick method vs the blood draw. Her veins are picky and you have to get it in just the right spot. So my question is, are these "clinics" you speak of different? Are they a place just for ACT monitoring? Once things get settled after surgery and we bring this up with her doctor, it'll be interesting to see what they say.
How to find a "clinic"?
- Thread starter watson524
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Davidr
Well-known member
Hi there,
I South Africa, most pathology labs (with blood taking facilities in hospitals or clinics around the country) will act as a coumarin clinic. If they have you on file, you simply tell them your current dosage and they will then give you any adjustments after the test results...although i have not heard of any of them doing a finger prick text for ACT management.
I have recently moved to Hong Kong, and due to the very infrequent testing done here (every 3 months, with poor dosage advice, which got me hospitalized with an INR of 1.2), i have gone for the home management approach
Now I test weekly ( at least until I feel my INR is stable), and *if* my INRgoes out of range, then I must call my cardio's office for dosage adjustment.
Every 3 months, I will get a vein draw parallel to my home kit, and this will show me where my home kit is in reference to the lab test. At the moment, my CoaguChek XS gives me a extremely reeliable 0.2 above the lab test.
If your mom can get one, (maybe a nice Christmas prezzie) get her a Home test kit, the freedom and peace of mind it gives you is unbelievable.
David
I South Africa, most pathology labs (with blood taking facilities in hospitals or clinics around the country) will act as a coumarin clinic. If they have you on file, you simply tell them your current dosage and they will then give you any adjustments after the test results...although i have not heard of any of them doing a finger prick text for ACT management.
I have recently moved to Hong Kong, and due to the very infrequent testing done here (every 3 months, with poor dosage advice, which got me hospitalized with an INR of 1.2), i have gone for the home management approach
Now I test weekly ( at least until I feel my INR is stable), and *if* my INRgoes out of range, then I must call my cardio's office for dosage adjustment.
Every 3 months, I will get a vein draw parallel to my home kit, and this will show me where my home kit is in reference to the lab test. At the moment, my CoaguChek XS gives me a extremely reeliable 0.2 above the lab test.
If your mom can get one, (maybe a nice Christmas prezzie) get her a Home test kit, the freedom and peace of mind it gives you is unbelievable.
David
ALCapshaw2
Well-known member
AntiCoagulation Clinics may be independent or associated with a Hospital or Heart Center.
Anticoagulation Clinics have a record of providing better INR control than UMC (Universal Medical Care),
i.e. independent Doctors/Nurses (google Anticoagulation Clinics for more information)
Here is a website that has listings of anticoagulation clinics by geographical area:
http://www.acforum.org/clinics_us.htm
Anticoagulation Clinics have a record of providing better INR control than UMC (Universal Medical Care),
i.e. independent Doctors/Nurses (google Anticoagulation Clinics for more information)
Here is a website that has listings of anticoagulation clinics by geographical area:
http://www.acforum.org/clinics_us.htm
Jkm7
Well-known member
I was on a short course of coumadin following my tissue valve replacement and my PCP office managed ACT in her offices with a finger stick machine. I don't know which make or model it was and I only went for 2 1/2 months before I was permitted to stop.
I knew my INR immediately and the nurse adjusted my dose as necessary before I left.
I knew my INR immediately and the nurse adjusted my dose as necessary before I left.
I used a clinic when I was on coumadin. It was located in our local heart hospital. It was a finger stick and any adjustments were made at that time. She would fax the information to my cardio but I never heard from them so I'm guessing they were OK with the results. That or they just got stuck in my file. LOL
Earline
Earline
Thanks for the link Al. Looks like one is right in the same complex my mom's cardiologist recently moved into. Further away from home so I might have to check them out and see if they do a finger prick or draw.
AgilityDog
Well-known member
Watson, since your mom is over age 65, Medicare will pay for her to have a home test machine, INRATIO or COAGUCHECK. Those are finger stick devices. I'd say your mom's veins, plus the distance to the clinic, are very good reasons for home testing.
I believe most medicare recipients find their payment is $10/month or something like that.
Ask her cardio about it. It's pretty simple to learn to self-test, or you could do it for her if she has a problem doing it herself (arthritis, or fear of needles). Her cardio would continue to manage her dosing as he/she does now. Or whoever is handling the dosing. Not everyone who home tests self-manages. That part depends on the patient and the cardio or PCP. You can also call the machine providers directly. Inratio's is Philips. Search the anticoagulation monitoring forum for the contact info on coagucheck.
Most of us on home monitoring check once per week, or once every two weeks. More frequent monitoring and home monitoring have been shown to increase the time in range.
I believe most medicare recipients find their payment is $10/month or something like that.
Ask her cardio about it. It's pretty simple to learn to self-test, or you could do it for her if she has a problem doing it herself (arthritis, or fear of needles). Her cardio would continue to manage her dosing as he/she does now. Or whoever is handling the dosing. Not everyone who home tests self-manages. That part depends on the patient and the cardio or PCP. You can also call the machine providers directly. Inratio's is Philips. Search the anticoagulation monitoring forum for the contact info on coagucheck.
Most of us on home monitoring check once per week, or once every two weeks. More frequent monitoring and home monitoring have been shown to increase the time in range.
Good to know. Her PCP actually manages her dosing (I never quite understood that actually, but I know the cardio does get a copy - it's a small local hospital so often, she has a call to stay the same dosage the same day as the test). She's been at the same dosage for a LONG time (i.e. years). I think it's 2.5mg / day and we're hoping that once some kinks are worked out after the surgery, she stays as steady. That's good to know about medicare. She has BCBS as a supplement too.
I was looking at the online dosing tool that's in the sticky here so once we get to that point, I might have some questions on that.
thanks all!
I was looking at the online dosing tool that's in the sticky here so once we get to that point, I might have some questions on that.
thanks all!
I had a cardio who wouldn't get involved in the mundane stuff like managing a patient's INR -- THAT was for PCPs to do. This makes sense -- any time taken away from their cardio patients it time that these patients don't get cardio help. PCPs, or anticoagulation clinics probably ARE the appropriate ones to manage anticoagulation.
The only thing I got from my cardio was the admonition to have my INR tested every two weeks (which I didn't do).
The only thing I got from my cardio was the admonition to have my INR tested every two weeks (which I didn't do).
I don't know how far it is from your Mom (do you live close to her?) but I'm pretty sure my Dad goes somewhere in Honesdale, if that would be closer for you let me know and I'll find out who/where/how. My Mom used to go to cardiac rehab very close to the Wayne county hospital and she loved it..kept going even when she was better.. IF that is closer than other cardiac rehabs you found I can't find out where she went too
