DENIED!!!! CoaguChek XS - Part 2

[Freddie]

First of let me express my appreciation to all of you who took the time to point me in the right direction to web sites and other means of information of obtaining a home monitor. But once again I got denied.

According to my doctors findings:
- the Coagucheck XS is only 76% accurate. Meaning in her words:
"the machine can be .5 high or low when your range for INR is 2.5 to 3.5. The accuracy improves when your on the lower end of the scale"
- ".5 high or low would mean a change in dosage. If you were 3.3 with the monitor, you could actually be 3.8 and have to change or skip a dose or you could be 2.8 and be fine.

As I tried to explain all of my findings and that the FDA approved the monitor, she wouldn't except - no such luck. In fact she didn't have nothing nice to say about FDA.

I explained how it would give me the freedom and the independence of being in control.....the response "but the monitor is not accurate enough to give you any freedom".

The doctor made a suggestion about me signing a waiver that "she would not be responsible blah, blah and that I would be responsible.......it would be like me prescribing the use of home marijuana." Guess she doesn't believe in that either.

She could tell that my French temper was beginning to show.

She return all my papers I had printed out and on a closing note she said, "the coagucheck XS is better than the coagucheck S, maybe the next generation will be better. We'll just have to wait and see."

So, there you have it. Stuck on going to the lab. There was nothing more I could do or say......in fact I think I said to much..........she now wants me to go to lab once month not comfortable about that.

 

[catwoman]

Freddie:

I'm so very sorry. You did try, though.
You just can't teach an old dog, er, doc new tricks, I guess.

 

[lance]

AHHHHH--banging my head on the table

AHHHHH--banging my head on the table

Print this out and show it to her--well you can guess what I mean.

Yesterday was the six-month comparison vein and monitor check-up date.

So yesterday a.m. I drove to town (20 minutes), put the paper work through (5 min.) sat and waited for technician (10 min.), explained to technician I would be performing my own test on my own XS (10 min.). Everything went well. Technician watched me while I ran the test with the results displayed in oh a minute or two and I drove home (another 20 min.).

Arrived home and e-mailed XS results to Toronto. Within two hours my manager contacted me. Continue with the current dose.

At 5:30 to-day the doctor's office called with the results of the vein draw that they had just received (a day and a half later).

So tell your doctor my XS read 3.6. The vein draw was 3.5.
My previous comparison test 6 months ago was vein--4.0, XS 4.2.

These tests will never be exactly the same, neither would a back to back vein draw using both arms be the same.

I'm really sorry. There are noned so blind as those who will not see or you can lead a horse to water, but you can't make it drink.

Roche will tell you the location of their customers in Sask. Hopefully there is a hospital you could contact and someone there could teach you to use it and manage your warfarin.

 

[lance]

Her dosing is wrong

Her dosing is wrong

First of let me express my appreciation to all of you who took the time to point me in the right direction to web sites and other means of information of obtaining a home monitor. But once again I tried.

According to my doctors findings:
- the Coagucheck XS is only 76% accurate. Meaning in her words:
"the machine can be .5 high or low when your range for INR is 2.5 to 3.5. The accuracy improves when your on the lower end of the scale"
- ".5 high or low would mean a change in dosage. If you were 3.3 with the monitor, you could actually be 3.8 and have to change or skip a dose or you could be 2.8 and be fine.

As I tried to explain all of my findings and that the FDA approved the monitor, she would except - no such luck. In fact she didn't have nothing nice to say about FDA.

I explained how it would give me the freedom and the independence of being in control.....the response "but the monitor is not accurate enough to give you any freedom".

The doctor made a suggestion about me signing a waiver that "she would not be responsible blah, blah and that I would be responsible.......it would be like me prescribing the use of home marijuana." Guess she doesn't believe in that either.

She could tell that my French temper was beginning to show.

She return all my papers I had printed out and on a closing note she said, "the coagucheck XS is better than the coagucheck S, maybe the next generation will be better. We'll just have to wait and see."

So, there you have it. Stuck on going to the lab. There was nothing more I could do or say......in fact I think I said to much..........she now wants me to go to lab once month not comfortable about that.

Your doctor is a jerk.

A reading .5 high or low could result in a doseage change? 3.8 and skip a dose? That is wrong, wrong, wrong. She doesn't know what she is doing. Maybe that's the reason she behaves as she does. Test INR once a month--what an idiot.
Try and find a cardiac hospital that uses home monitoring. Even reading about the situation makes me angry--probably you can tell. I'm going to invite my cavalier onto my lap, pat him and play with his ears. Then I'll cool down.

 

[Ross]

You're doctor is a jerk.

A reading .5 high or low could result in a doseage change? 3.8 and skip a dose? That is wrong, wrong, wrong. She doesn't know what she is doing. Maybe that's the reason she behaves as she does. Test INR once a month--what an idiot.
Try and find a cardiac hospital that uses home monitoring. Even reading about the situation makes me angry--probably you can tell. I'm going to invite my cavalier onto my lap, pat him and play with his ears. Then I'll cool down.

Exactly right! This Doc may well kill you.

 

[Karlynn]

Freddie - seriously, it's my humble opinion that this doctor's attitude about home testing and how she explains it makes big warning bells go off in my head. If she does not believe the experts on this - then what other knowledge important to your health is she dismissing because she doesn't bother to believe the experts.

She really is the worst kind of arrogant.

I think I would have told her - "Fine - I'll sign a paper releasing you from responsibility. Just sign the papers for me to get a machine."

 

[Freddie]

- ".5 high or low would mean a change in dosage. EXAMPLE: If you were 3.3 with the monitor, you could actually be 3.8 with a lab test and have to change or skip a dose or you could be
actually be 2.8 and be fine."

Let me say I'm just as frustrated and peeed off

I've edited the above statement to try to clarify the example she gave me.

She doesn't like me going over 3.5, and believes the reason insurance won't pay for the machine is because "our" government hasn't approved it.

Ross: I'll do okay....I've got you guys

Lance: what color is your Cavalier? (I'm jealous)

 

[lance]

Roche monitors have been approved ..................

Roche monitors have been approved ..................

Hi Freddy,

Health Canada had already approved home monitors prior to 2004 when I bought my "S". The "S" was preferred by Toronto General, my INR manager did her Masters on home monitoring. I'm not sure if she has published or is amassing more data. Unfortunately the attitude expressed by your PCP about home monitoring is not unique. I contacted Hamilton General (where I had my surgery) about their experience with home monitoring to be informed they were expensive and few patients used them. That was their response last week. Their position had not advanced in four years when I last contacted them on this subject. I was extremely motivated to obtain my own and was prepared to do/contact whatever was required. Luckily my PCP came on board because I found a hospital to train me. Hard to argue under those circumstances. I was very lucky my PCP listened and continues to listen when we discuss home monitoring. If there is a pharmacy in Saskatoon that sells them maybe you could learn what doctor wrote the prescription and proceed from there. I'd also contact every hospital performing open heart surgery for assistance. Roche might be able to help in this regard. I certainly hope so.

My cavalier is a ruby male and will be 2 at the end of June. I got him last June following the death of my 15-year old Tibetan Terrier. He has settled in well, is somewhat aggressive and other than that quite the little love bug. How old is your Blenheim. No reason to be jealous whatsoever.

 

[Philip B]

Dump Her

Dump Her

So your doctor is more comfortable with a once a month lab check that she is with a weekly check with a home monitor? What's wrong with that picture?

Dump your doctor and replace her with one who is supportive of your efforts to engage in proactive coumadin management. If you don't want to dump her, exchange a signed waiver for a Rx and get a monitoring machine.

-Philip

 

[zipper2]

Freddie

We all wanna remain healthy and we expect our doctor to help us
to do so,however while doctors are good at healing you when you fall sick,they aren't always good at keeping you healthy, like seems he or she
is an illness specialist not a wellness specialist...like id be leary not going for
an inr ,checking it once a month for me anyway is too long a time frame.
This doctors camping in two tents one afraid to do anything and two maybe
already been under a lawsuit,seems his or her patients are a big obstruction
in the practice of medicine,obviously for you to sighn a waver for use of the coagucheck xs.
im so sorry they dont get it at all with all information etc. all your hard efforts.Of course im beaking off as ive had such a bad experience with any and all these doctors in Saskatoon youll find in past posts of mine due to coumadin and surgery that im gonna now pick up my chihuahua and unstress
now too. Dont forget Ron has a coagucheck testing in his pharmacy also that he has open to all to use.I know its hard to replace doctors as others arent seeing new patients,the same here but try looking Freddie obviously you gotta do other alternatives now ,and there has to be more in Saskatoon then N.Battleford,dont know what else to suggest im upset for you too.

zipper2

 

[lance]

Try Alberta

Try Alberta

Four years ago I posted asking for personal experiences with home monitors from members of this board.

One I remember was from a patient in Alberta. If I remember correctly he worked in the oil fields and because of travelling to and from a clinic used a home monitor. His cardiologist recommended the monitor to him and he was instructed on its use by the hospital/cardiologist. He posted a very informative thread outlinig his positive experiece.

Yes, aren't our companion animals wonderful stress relievers. Sometimes they cause it, but all in all great little gaffers to have around.

 

[Bina]

GRRRRRRRRR
Bina getting mad!
How about keeping this doc as your GP, since you like her for that; even though she is incredibly narrow minded....and locating another doc for your INR.

 

[Freddie]

I've thought of that Bina, but its not the end of the world. We don't always get what we want and I believe everything happens for a reason. Maybe the money that was to go for the monitor is meant for something else???? Who knows....time will tell.

I'm going to be giving this issue a break and in time check out other avenues.

In the mean time..............

Life goes on.

 

[ALCapshaw2]

IMO, anyone who tells you to HOLD a dose for a day because of an INR of 3.8 does NOT understand anti-coagulation. Personally, I would never HOLD for anything under 5.0 (and even at that number, I'd be more inclined to just cut my dose in half for a day..)

Have you bought Al Lodwick's Dosing Guide? ($5 U.S. www.warfarinfo.com)
EVEN IF you continue to let this Doc manage your anticoagulation, it would be useful to have Al's guide as a reference for your own wellbeing / understanding.

'AL Capshaw'

 

[Freddie]

Yes Al, I have the guide.

 

[geebee]

Freddie,

Sorry things are not going the way you wanted but, hopefully, things will change in the future for you. Keep plugging away and you will end up home testing eventually.

 

[Magic8Ball]

Perhaps i could setup an internet business.

Here in Australia you don't need to ask, you just go and buy it yourself.

You could send me the money, i could buy it and post it to you....no-one would be any the wiser....i wonder if coagucheck australia accept paypal.

Or you could just come over here for a holiday and pick one up.

I'd be mad as hell in your situation, the only problem i had is that the insurance company would not pay for it, i had to pay for it all myself.

 

[BAMAMATT]

First of let me express my appreciation to all of you who took the time to point me in the right direction to web sites and other means of information of obtaining a home monitor. But once again I got denied.

According to my doctors findings:
- the Coagucheck XS is only 76% accurate. Meaning in her words:
"the machine can be .5 high or low when your range for INR is 2.5 to 3.5. The accuracy improves when your on the lower end of the scale"
- ".5 high or low would mean a change in dosage. If you were 3.3 with the monitor, you could actually be 3.8 and have to change or skip a dose or you could be 2.8 and be fine.

As I tried to explain all of my findings and that the FDA approved the monitor, she wouldn't except - no such luck. In fact she didn't have nothing nice to say about FDA.

I explained how it would give me the freedom and the independence of being in control.....the response "but the monitor is not accurate enough to give you any freedom".

The doctor made a suggestion about me signing a waiver that "she would not be responsible blah, blah and that I would be responsible.......it would be like me prescribing the use of home marijuana." Guess she doesn't believe in that either.

She could tell that my French temper was beginning to show.

She return all my papers I had printed out and on a closing note she said, "the coagucheck XS is better than the coagucheck S, maybe the next generation will be better. We'll just have to wait and see."

So, there you have it. Stuck on going to the lab. There was nothing more I could do or say......in fact I think I said to much..........she now wants me to go to lab once month not comfortable about that.

Freddie,

I by no means am attempting to pour salt in your wound, but I had my INR checked yesterday AT THE COUMADIN CLINIC with a coagucheck XS that the nurse raved about. Again, sorry you are having difficulty getting your own machine, I just find your Dr's comments astounding when you consider the clinic that I was in yesterday has over 1,000 patients (who knows how many they see a day) and they are all tested with the same machine she has such an objection to!

Matt