chinita
Active member
hello all !!!!!!!!!!!
can u guys tell me the pros and cons on home monitoring
can u guys tell me the pros and cons on home monitoring
few ????????
- Thread starter chinita
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netmiff
Well-known member
Pros : do it anytime you want
takes 2 minutes
do it in your living room if you want!
no waiting at lab
no waiting for results
cons cost
who will monitor? how? these could be both pros and cons, dependng on who is doing what and when !
I just love the freedom, I e-mail my results to my doctor, he e-mails me adjustments / advice if necessary.
takes 2 minutes
do it in your living room if you want!
no waiting at lab
no waiting for results
cons cost
who will monitor? how? these could be both pros and cons, dependng on who is doing what and when !
I just love the freedom, I e-mail my results to my doctor, he e-mails me adjustments / advice if necessary.
Although I don't have a home monitor, but have looked into it thoroughly (long story), the cost of supplies could be a very big 'con'.
IMO the biggest 'pro' would be; the feeling of being in control/independent of your health....FREEDOM.
For me, going for blood work is free of charge. But it does become a hassle when you have to leave work early to get to the lab before they close. Getting there first thing in the morning just doesn't work - there is at least 10 people standing outside the door BEFORE they open
IMO the biggest 'pro' would be; the feeling of being in control/independent of your health....FREEDOM.
For me, going for blood work is free of charge. But it does become a hassle when you have to leave work early to get to the lab before they close. Getting there first thing in the morning just doesn't work - there is at least 10 people standing outside the door BEFORE they open
Pros:
Savings: I test every 2 weeks, spend (at this time) about $240 on testing supplies. If I were to go to my PCP's office for tests, I'd be paying at least $20 each. This would be about $480/year -- if I continued going every 2 weeks.
Time saved: I test at home, at my desk at work, at a hotel room when I travel on weekends. If I were to go to my PCP's office for tests, I'd be out several hours every other Wednesday afternoon, including travel and appointment time. That would eat into my annual sick leave (40 hours annually), and we can only carry over 40 hours each year, for a total of 80 hours available, if you're never sick or just ignore your illness and come to work, infecting everyone else.
Being in charge: I understand anticogulation therapy and how to adjust my dosages. Not all doctors do, nor do their employees. Initials after a person's name don't mean they know everything about their field.
Cons:
Start-up cost and testing supplies (but see first item under Pros):
Some insurance companies pony up and pay for a monitor. My first monitor was covered 100% by my then-insurer. Aetna's EOB said it would cover 80%, but that translated to 80% of what they would allow, which was actually 60% of the total price ($981 of $1,635).
Testing supplies aren't always covered by all companies. Some providers will discount their charges if you pay cash up front instead of going through your insurance company. And that exactly what I have done.
Cash up front, particularly in our economic state, is better for the seller. You get your supplies quicker, and if your insurance carrier does cover the supplies, you can submit a request for reimbursement.
For me, the pros far outweigh the con(s).
Savings: I test every 2 weeks, spend (at this time) about $240 on testing supplies. If I were to go to my PCP's office for tests, I'd be paying at least $20 each. This would be about $480/year -- if I continued going every 2 weeks.
Time saved: I test at home, at my desk at work, at a hotel room when I travel on weekends. If I were to go to my PCP's office for tests, I'd be out several hours every other Wednesday afternoon, including travel and appointment time. That would eat into my annual sick leave (40 hours annually), and we can only carry over 40 hours each year, for a total of 80 hours available, if you're never sick or just ignore your illness and come to work, infecting everyone else.
Being in charge: I understand anticogulation therapy and how to adjust my dosages. Not all doctors do, nor do their employees. Initials after a person's name don't mean they know everything about their field.
Cons:
Start-up cost and testing supplies (but see first item under Pros):
Some insurance companies pony up and pay for a monitor. My first monitor was covered 100% by my then-insurer. Aetna's EOB said it would cover 80%, but that translated to 80% of what they would allow, which was actually 60% of the total price ($981 of $1,635).
Testing supplies aren't always covered by all companies. Some providers will discount their charges if you pay cash up front instead of going through your insurance company. And that exactly what I have done.
Cash up front, particularly in our economic state, is better for the seller. You get your supplies quicker, and if your insurance carrier does cover the supplies, you can submit a request for reimbursement.
For me, the pros far outweigh the con(s).
chinita
Active member
Thanks guys!!!!!!
It is not cost effective for me to home test ? My INR has been in range and stable since my AVR in 2006 ? I test once a month (feel very comfortable with that) and my cost at my cardio is $9.00 so that is $108 a year out of pocket ? the insurance pays $11.00 which is $132 a year for them ? My schedule is extremely flexible so stopping in for a test is not a problem. ? My insurance will not pay the tester and supplies (they might if I pushed it and raised sand) because it is cheaper for them to pay monthly.
Everyone is different and considering you will be testing the rest of your life I suggest you find what works for you ? There are many here that will say that home testing is the only way to go and a few like me that have had no issues testing at the cardiologist?s office. I would start at the doctor?s office and if it is a hassle get the home tester.
Everyone is different and considering you will be testing the rest of your life I suggest you find what works for you ? There are many here that will say that home testing is the only way to go and a few like me that have had no issues testing at the cardiologist?s office. I would start at the doctor?s office and if it is a hassle get the home tester.
Cooker:
With an AVR, it's probably OK to go to monthly testing. However, for a mitral valver, that could be pushing it, since we have a higher INR range and are at higher risk of clots.
You are lucky on your co-pays.
My co-pay is either 20% or 30% -- I think 20% at my PCP and 30% at specialists -- so I expect that I would pay at least $20, what with visit + test.
Who knows what 2009 will bring in insurance changes? (I shudder to think!!!!!!)
With an AVR, it's probably OK to go to monthly testing. However, for a mitral valver, that could be pushing it, since we have a higher INR range and are at higher risk of clots.
You are lucky on your co-pays.
My co-pay is either 20% or 30% -- I think 20% at my PCP and 30% at specialists -- so I expect that I would pay at least $20, what with visit + test.
Who knows what 2009 will bring in insurance changes? (I shudder to think!!!!!!)
Good point and ....................
Good point and ....................
Catwoman.
With a mitral mechanical valve I would never feel confident testing once per month.
Thanks for mentioning the difference between mitral and atrial. I hadn't thought about it.
Chinita
If I had to I'd spend my last cent on home testing supplies--I'm that much in favour of them. And home testers have more incentive to learn the intricacies of warfarin therapy (ACT).
Good point and ....................
Catwoman.
With a mitral mechanical valve I would never feel confident testing once per month.
Thanks for mentioning the difference between mitral and atrial. I hadn't thought about it.
Chinita
If I had to I'd spend my last cent on home testing supplies--I'm that much in favour of them. And home testers have more incentive to learn the intricacies of warfarin therapy (ACT).
sue943
Well-known member
I have both mitral and aortic and am normally tested four weekly, I am quite happy with that as I am stable.
For me, it had nothing to do with which valve was replaced, they both require a safe range of INR, and many doctors prefer 2.5--3.5 for both. I have a stable INR, but I was concerned about having lab draws since they were in my arm vein and some techs were bruising my vein. I was worried about doing that for the rest of my life.
The home monitor is safe and reliable, it's a simple finger stick.
I don't have to drive anywhere.
No money spent on gas and parking.
Able to test any time I want.
My tests cost me $7.50 each
Peace of mind, priceless
The home monitor is safe and reliable, it's a simple finger stick.
I don't have to drive anywhere.
No money spent on gas and parking.
Able to test any time I want.
My tests cost me $7.50 each
Peace of mind, priceless
chinita
Active member
thank you all for your answers!!
I am a mitral valver since twenty years ago , but I still don't /would'nt understand many
things on my situation(this all started when I was very young so I never really put attention to it)
I am a mitral valver since twenty years ago , but I still don't /would'nt understand many
things on my situation(this all started when I was very young so I never really put attention to it)
D
DannyB0723
Has a choice now....
Has a choice now....
I just got the call the other day. The Dr's office is now going to be working with QAS for home testing.
So far I know nothing except what I've read on here.
The costs as of right now are my biggest concern. I don't go to the the Dr's office, I go to a lab and there isn't any copay...(yet). I work the mid shift where I am so stopping by isn't a problem. Its only a few miles out of the way, I'd say less than 5.
I guess my only concern is.....Lately it seems I haven't been stable. I've gone from 4.7 to most recent result is 2.6 and and every where in between. Testing has gone between two weeks to every 10 days. My current doses are 10mg 3 times a week, 7.5mg the rest of the week.
Since I have a mechanical valve, I know this is going to be a life long issue.
I guess my question would be....Is there better control with at home testing?
I mean other than not seeing the lab techs any more (been going to the same lab ever since the surgery 5 years ago kinda got attached to them)
cost vs control is my only issue's.
Dan
Has a choice now....
I just got the call the other day. The Dr's office is now going to be working with QAS for home testing.
So far I know nothing except what I've read on here.
The costs as of right now are my biggest concern. I don't go to the the Dr's office, I go to a lab and there isn't any copay...(yet). I work the mid shift where I am so stopping by isn't a problem. Its only a few miles out of the way, I'd say less than 5.
I guess my only concern is.....Lately it seems I haven't been stable. I've gone from 4.7 to most recent result is 2.6 and and every where in between. Testing has gone between two weeks to every 10 days. My current doses are 10mg 3 times a week, 7.5mg the rest of the week.
Since I have a mechanical valve, I know this is going to be a life long issue.
I guess my question would be....Is there better control with at home testing?
I mean other than not seeing the lab techs any more (been going to the same lab ever since the surgery 5 years ago kinda got attached to them
)cost vs control is my only issue's.
Dan
netmiff
Well-known member
Danny, (if I may call you that), first of all, welcome to the forum !
I don't think it is so much a question of who does the testing, but who does the dosing !
If you start another thread in the regular anti-coagulation bit, and list your weekly doses, dates of tests and results for the last few, someone should be along with some suggestions.
BTW, who does do your dosing? And if you get home monitor, who will do it, and how?
I don't think it is so much a question of who does the testing, but who does the dosing !
If you start another thread in the regular anti-coagulation bit, and list your weekly doses, dates of tests and results for the last few, someone should be along with some suggestions.
BTW, who does do your dosing? And if you get home monitor, who will do it, and how?
I do not have a machine at home yet, I still go to the doctor's office and it costs me nothing as we have already paid a lot out of our pocket money. YET, i want to buy one for the convenience, as when I go to the doctor's office, i always wait like one hour, plus one hour back and forth and wait for the result for the second day. and Some weeks I go twice, some weeks I go once. During the December Holidays, I shall be in the East Coast and it will be convenient to have one and test myself instead of looking for a place to test my blood. So, in brief, the benefits for me, the ease of doing the testing at home while I am in my pajamas in my own kitchen is worth any diference in money I will have to pay.
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D
DannyB0723
Jeanette,
Yes, chuckles, Danny will work.
All my dosing is done through the coumadin clinic at the cardiology Dr's office. I (being careful now) assume it will be the same after/if I get the home tester. The introduction meetings are next week so I'll probably/hopefully will find out more then. Heck I'm not even sure the insurance will cover it yet. What I've read here I really don't think that there will be any trouble. I'm just trying to figure out if the costs are going to be worth the benefits. My insurance is fairly good here so the up front costs should be small but not too sure about the continuing costs.
Dan
Yes, chuckles, Danny will work.
All my dosing is done through the coumadin clinic at the cardiology Dr's office. I (being careful now) assume it will be the same after/if I get the home tester. The introduction meetings are next week so I'll probably/hopefully will find out more then. Heck I'm not even sure the insurance will cover it yet. What I've read here I really don't think that there will be any trouble. I'm just trying to figure out if the costs are going to be worth the benefits. My insurance is fairly good here so the up front costs should be small but not too sure about the continuing costs.
Dan
Ross
Well-known member
I just got the call the other day. The Dr's office is now going to be working with QAS for home testing.
So far I know nothing except what I've read on here.
The costs as of right now are my biggest concern. I don't go to the the Dr's office, I go to a lab and there isn't any copay...(yet). I work the mid shift where I am so stopping by isn't a problem. Its only a few miles out of the way, I'd say less than 5.
I guess my only concern is.....Lately it seems I haven't been stable. I've gone from 4.7 to most recent result is 2.6 and and every where in between. Testing has gone between two weeks to every 10 days. My current doses are 10mg 3 times a week, 7.5mg the rest of the week.
Since I have a mechanical valve, I know this is going to be a life long issue.
I guess my question would be....Is there better control with at home testing?
I mean other than not seeing the lab techs any more (been going to the same lab ever since the surgery 5 years ago kinda got attached to them
cost vs control is my only issue's.
Dan
Hi Dan!
Yes there is much better control with home monitoring and also self dosing. Come on down the the anticoag forum and give us the lowdown on everything from your current weekly dose, how often your tested, how often and how much of a dose change are they giving you, what you eat and your diet, additional meds your on, then we can see just what the problem is. 95% of the time, it's the manager that's doing the dosing causing the problems.
When I was going to the clinic, my in range % was down to 45% of the time. With home testing and now self dosing myself, I'm in range 83% of the time.
My very limited look at this came up with a Canadian article that said that home testers have 60% less issues post surgery. This has to be weighed against the cost/time/confidence factors on a personal basis. My surgeon said if he was having a valve replaced he would invest in a home tester. Based on the study, my surgeon's reccommendation, and the positive things said by home testers on this site, I am looking at getting one. I imagine I will do lab testing for a while to get stable (I hope) and then will move to home testing. Still have to discuss this with my docs to see how it all works. Maybe this will be covered in my pre-surgery clinic on Monday!?
Ross
Well-known member
The largest single cause of a person not being stable is the person managing them. We see it in here daily. It's sad, but true. Many so called professional Coumadin managers haven't got a clue what they are doing.
What study
What study
Good morning Cameron, and welcome.
Do you have the source/name of the Canadian article? If so would you post it. I'm very interested to see it because I think rate of 60% success is so low.
Last week I attended a meeting about home testing and learned 1 Toronto hospital offers training to patients prior to discharge following valve surgery.
Cheers
What study
My very limited look at this came up with a Canadian article that said that home testers have 60% less issues post surgery. This has to be weighed against the cost/time/confidence factors on a personal basis. My surgeon said if he was having a valve replaced he would invest in a home tester. Based on the study, my surgeon's reccommendation, and the positive things said by home testers on this site, I am looking at getting one. I imagine I will do lab testing for a while to get stable (I hope) and then will move to home testing. Still have to discuss this with my docs to see how it all works. Maybe this will be covered in my pre-surgery clinic on Monday!?
Good morning Cameron, and welcome.
Do you have the source/name of the Canadian article? If so would you post it. I'm very interested to see it because I think rate of 60% success is so low.
Last week I attended a meeting about home testing and learned 1 Toronto hospital offers training to patients prior to discharge following valve surgery.
Cheers
Lance,
This is the initial link I found to a CTV article. It mentions where the full article can be found.
http://www.ctv.ca/servlet/ArticleNe...ulation_monitoring_071115/20071120?hub=Health
This is the link to the abstract of the Open Medicine article.
http://www.openmedicine.ca/article/view/77
Hope it helps.
Cameron
This is the initial link I found to a CTV article. It mentions where the full article can be found.
http://www.ctv.ca/servlet/ArticleNe...ulation_monitoring_071115/20071120?hub=Health
This is the link to the abstract of the Open Medicine article.
http://www.openmedicine.ca/article/view/77
Hope it helps
.Cameron
