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Woodbutcher

Woodbutcher

Well-known member
Joined
Nov 21, 2008
Messages
532
Location
Coast of Cornwall SW England.
I'm a few weeks into the world of Warfarin now and wondering about home monitoring ?
I mentioned this to my visiting nurse the other day who seemed to think it was prohibitively expensive, atleast £1000 ($1500?) !
What have people on here paid for such kits please ?

Sometimes these health care people dont always seem know what they're talking about. When I was in hospital and worrying about Warfarin issues and having to make regular trips to the local surgery for life I asked a nurse how often I'd have to go, she replied "every day to start with but not to worry because after a few months I'd only have to go a couple of times a week" !! That was just what I didn't want to hear ! Oh, and of course she was completely wrong !

Ps... Happy 2009 to one and all X
 
Welcome to the World of Warfarin!!!!!!!!

I'm not from the U.K., so I don't know what INR monitors generally cost there. We have quite a few members from the U.K. here, so I know they'll help you out.

I would strongly encourage anyone with a mechanical valve to consider buying a monitor, if they can afford to do so and if their insurance/health plan doesn't provide INR tests at a reasonable charge.
Having your own monitor will simplify your life, particularly when you're ill and/or need to add other RXes, OTC drugs, etc.
For example, today I bit the bullet and saw my family doctor. I had been struggling with bronchitis for about 10 days -- couldn't go last week since my only co-worker was on vacation through Christmas Eve, etc.
My PCP ordered a shot of dexamethasone & another steroid + gave me 3 Rxes and told me to take the amoxi I stockpile to knock out the sinusitis.
The DMS shot will increase my INR. (Been there, done that a couple of years ago.) We discussed that, and my PCP said he was certainly glad that I have my own tester. His nurse -- who used to work for a cardiologist and did INR tests there -- discussed what I should do on dosage, since she knows I adjust my own. She suggested dropping my dosage about 20% for 3-4 days, then going back to normal dosage. I thought the same thing.

So, if you have your own machine, you can monitor your INR due to RXs and OTCs that will affect your INR. It puts you in charge of the situation.

Figuring out warfarin and dosages isn't rocket science.
 
I would think that the Coaguchek XS shouldn't be too costly in England, it's made in Germany. Mine was supposed to be C$1,000.00 but I got a discount coupon and paid C$500.o0 Insurance wouldn't cover it, but I was able to put it on my yearly medical expenses for income tax purposes. Anyway, I know that I've already saved more than that much money on the gas, parking, and clinic testing.
You can Google search Coaguchek XS or Roche Diagnostics.
 
Hi Justin

I think,from memory, that my Coaguchek XS cost less than $1000 NZD.
I had to pay for it myself but that's ok - it's worth it for the freedom it gives me. I haven't looked back since I got it.

If you can afford it, I would highly recommend that you get a home testing machine too.
I don't know - would the NHS subsidise them at all - I guess not?:(

Bridgette
 
do not leave hospital without one

do not leave hospital without one

basically, the nurses at the hospital where i had surgery said "do not leave hospital without a coaguchek come tester". the day after my op they gave me the roache 0800 number with "instructions" to order one by courier so they could train me in it before i left.

that was a clear demonstration of how important they think home testing is; and i 100% agree.

actually, i already knew all about home testing from this site, but based on the apparent dificulties members in other countries have getting "permission"! to get a machine, i thought i would have to crawl over broken glass to get one! nothing could have been further from the truth.

my coaguchek cost nz$ 825 approx inc 12.5% gst/vat (400 pounds?) couriered to my hospital bed by roache. ok, so that is not chicken feed but it is a bargain for a potential lifesaver that will put YOU in control.

satisfy your curiousity and phone roache direct for a quote; you do not need permission or a letter from a doctor etc, nothing, just the dosh.
 
westie said:
basically, the nurses at the hospital where i had surgery said "do not leave hospital without a coaguchek come tester". the day after my op they gave me the roache 0800 number with "instructions" to order one by courier so they could train me in it before i left........
Click to expand...

I think that is a typo.....and should read "home" tester.:)
 
Thank you Westie, Bina, Brigette and Catwoman,,, Sounds like something I need to look into.
Could you please tell me how often you need to home test and does it hurt ? I'm not very good with needles, well I used to be ok but after my spell in hospital and being treated like a human pin cushion I now hate them !
 
Oh man, your missing out on some of the best pain in your life! :D All kidding aside, all you do is poke your finger just like a diabetic, place the sample on the test strip and wait for the result. I always use the same finger and I've got to say (I test every week) that I don't even feel the lancet stick anymore. I was really getting to like giving myself shots of Lovenox. It's a rush. You anticipate all this pain that never comes. Beats veinous sticks by long shots.

You wouldn't have to test every week if your in range. Longest I can go myself without testing is 3 weeks. By then, surely I've done something to throw my INR up or down and need a small 5% adjustment in the total dose for the week. I'm finding I have the best results with alternating doses week to week. I'll take 52.5 one week, 55 the next and then back to 52.5. All I have to work with are 5mg tablets.
 
Thanks for that Ross. I've no idea what Lovenox is though? SO you're saying that at worse I just feel a little prick (no change there then!). I'm sure I could live with that.
I've so much to learn about the whole Warfarin and Inr thing ? I have a target of 2.8 and the last three tests over a couple of weeks have been 3.3, 3.1 and 2.6 couple with a constant 3mg/day, that'll mean a lot more to you than it does to me ?
What would the inr be of somebody who wasn't taking Warfarin or similar, as you see i'm a total layman! But I do need to get my head around this stuff to keep on top of it .
Thanks again.
 
If your target is around 2.8 then your last three readings are fine - you are near enough to your range.

I think that someone who isn't taking Warfarin would have an INR of around 1.0.

Honestly, as Ross said, the test doesn't hurt at all - it's way better than going to the lab all the time for vein draws.


Bridgette:)
 
First off, who in there right mind said 2.8 for a target? 2.5 to 3.5, be happy! Heck most all of us are happy so long as were between 2.0 and 4.0. The "Pros" aren't going to tell you that, but we will. It's better to be too high then too low. You can replace blood cells if you bleed, you cannot replace brain cells if you stroke out.

Sounds to me like your currently rock solid stable. My question to you is, Are you holding back on your normal diet? Are you eating green veggies like you always have? Don't fall for the crap about not eating Vit K laden vegetables! Eat your normal diet as you always have and let the Coumadin be adjusted for that diet. Do not diet the dose your on, dose the diet you eat.

Lovenox is low molecular weight heparin and is used to bridge you at times when you must be taken off of Coumadin for surgery. The needle on the prefilled syringes are as tiny as the ones diabetics use to inject insulin and you have to give it to yourself in the same manor. Really, it's no worse then the finger sticks. It just freaks you out that your plunging this 1/2" needle into your belly and pushing the medication in.

If you haven't already, visit these two sites and they should help your understanding significantly. You'll probably know more then those managing you!

http://www.aafp.org/afp/990201ap/635.html

http://www.warfarinfo.com/warfarinfo.com2.htm
 
I didn't know I should be avoiding greens, I love greens ! The only thing I was told not to eat was Cranberries or Cranberry juice ? The 2.8 Target is printed on my "Warfarin dosing service" letter. I take your point about high being better than low. So am I to take it that a high Warfarin dose = high INR and low warfarin dose = low INR or is it the other way around ? Sorry to sound so ignorant but I am in this area anyway !
I have a pretty healthy diet on the whole, three meals a day, lots of fruit and veg, some wine and several cups of tea. I dont think I've been eating as much as normal since my op but I just haven't felt so hungry really, must be all the sitting around !
 
News flash. Cranberries have been cleared for a long time now. It was all based on some silly report to start with, with absolutely no bases. Me gets you the links for it too!

If 3mg a day is keeping you where you are, that is your dose. The correct dose is that which keeps you in your prescribed range. Some people can get by on 2mg a day and some have to have as much as 20 or more a day, but whatever keeps you in range is the correct dose.

If your not back to your presurgery excercise level, you may need an increase as you start more excercise or activity, as more blood is filtered through your liver.

Cranberry links:
http://www.ptinr.com/data/templates/article.aspx?a=654&z=1
http://www.ptinr.com/data/templates/article.aspx?a=354&z=1
http://www.ptinr.com/data/templates/article.aspx?a=191&z=1

http://www.warfarinfo.com/cranberry.htm
 
Thank you for that Ross. Gutted about the cranberries ! Why is there so much rubbish banded about by the people who really should know best ?? I had to have Christmas dinner with no cranberry sause for no reason then !? I'd be interested to see that report ?
 
Woodbutcher said:
Thanks for that Ross. I've no idea what Lovenox is though? SO you're saying that at worse I just feel a little prick (no change there then!). I'm sure I could live with that.
I've so much to learn about the whole Warfarin and Inr thing ? I have a target of 2.8 and the last three tests over a couple of weeks have been 3.3, 3.1 and 2.6 couple with a constant 3mg/day, that'll mean a lot more to you than it does to me ?
What would the inr be of somebody who wasn't taking Warfarin or similar, as you see i'm a total layman! But I do need to get my head around this stuff to keep on top of it .
Thanks again.
Click to expand...

Your INR readings are perfect! Carry on.:)
 
Woodbutcher said:
Thank you for that Ross. Gutted about the cranberries ! Why is there so much rubbish banded about by the people who really should know best ?? I had to have Christmas dinner with no cranberry sause for no reason then !? I'd be interested to see that report ?
Click to expand...

Dude if you can answer that question, heck we'd all find a way to pay you a prize. I hope to see some educated professionals before I'm planted into the ground. I'm seeing a tiny bit of light at the end of the tunnel, but there is a long distance to go yet.

Check out the links I posted above.
 
Woodbutcher said:
I didn't know I should be avoiding greens, I love greens ! The only thing I was told not to eat was Cranberries or Cranberry juice ? The 2.8 Target is printed on my "Warfarin dosing service" letter. I take your point about high being better than low. So am I to take it that a high Warfarin dose = high INR and low warfarin dose = low INR or is it the other way around ? Sorry to sound so ignorant but I am in this area anyway !
I have a pretty healthy diet on the whole, three meals a day, lots of fruit and veg, some wine and several cups of tea. I dont think I've been eating as much as normal since my op but I just haven't felt so hungry really, must be all the sitting around !
Click to expand...

If you would by accident, take a double dose of Coumadin, your INR would rise. If you forgot to take your pill one day, your INR would go a bit lower. These things are simple enough to fix, so don't worry about it too much.
--I just did my finger stick and test. I hate getting injections, but I LOVE doing my test. It's a teeny tiny needle tip.
The reading is 3.5-- a tiny bit higher than my usual 3.1-- but I haven't been very active at all the last couple of weeks. Me bad.
 
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