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westie

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background
- i was the first patient, and still the only one, at the general medical practice i attend to have an inr tester. even my doctor had never seen one before. having said that, the doctors there say they have hundreds of patients taking warfarin and that it is no problem at all. also, the doctors are totally supportive of self monitoring and self dosing. also, they have no problems with my never going to the blood lab, they accept the technology behind these testers

- so on my recent visit to check blood pressure and pulse, i asked my doctor if he had talked to other patients about self monitoring. he said he had talked to quite a few patients about it but all of them had retorted "why should i pay for the home testing machine etc when i can get tested 100% free at the blood lab"! ( in new zealand, all blood testing is 100% free and blood testing collection centres are found in every suburb )

i just can not understand the attitude of these people, self testing/dosing is such a no brainer! maybe they just do not understand the benefits

seems ironic our north american members have to almost crawl over broken glass to self test/dose when we kiwi's can instantly buy them without prescriptions and use them without any medical insurance implications; all inr doseage disasters here are 100% taken care of in free public hospitals. private hospitals do not touch these problems!
 
For some it is economics .... My insurance pays for my testing but not a home tester or strips ... I test at my cardiologist office that is five minutes from the house .... I'm always in range ... it takes all of 15 minutes and the gal who pricks me is hot and loves chimps:D;) .... I think I will stay with my current arrangement ? for many it just boils down to personal choice ? to each his/her own
 
i doubt it's really the cost, that sounds more like an excuse. (but don't you get
machines and strips for free, too?)

some people are scared of technology.
others are scared of learning new things.
they want to do it the old, traditional way.
they think it's too complicated.
they may be unable to prick themselves.
they trust the doctor, he/she's a professional.
they don't trust their own judgment.
they get to visit the big city away from the land-lice.
 
ChouDoufu said:
i doubt it's really the cost, that sounds more like an excuse. (but don't you get
machines and strips for free, too?)

some people are scared of technology.
others are scared of learning new things.
they want to do it the old, traditional way.
they think it's too complicated.
they may be unable to prick themselves.
they trust the doctor, he/she's a professional.
they don't trust their own judgment.
they get to visit the big city away from the land-lice.
Click to expand...


No, we have to pay for the machine and strips ourselves Chou. But I don't regret investing in a Coaguchek - for the freedom it gives me.
It's great!
A doctor at our little hospital where I live suggested that I get one - he got the Roche rep to send me all the info and I just rang and ordered it. Haven't looked back since. I have been a home tester for 2 years now.
But each to their own - some people have valid reasons for lab testing, like Cooker and his hot chick, LOL....
 
Is there any way of determining

Is there any way of determining

the percentage of patients with mechanical heart valves preferring lab testing? It's more understandable if these patients take warfarin for other reasons--stents, etc. My PCP said stent management is not as critical as mechanical valve management is.

There must be something we're not aware of. Are POC monitors and strips tax deductible?

Maybe the unwilling patients have never encountered problems (poor management) with their labs. And I wonder about the state their veins are in following years of lab tests. Following my surgery I was referred to cardiac rehab where I was the only valver in a group of about 200 members. They were more concered about low-fat diets and fitness than properly controlled ACT.
 
I think many people on ACT have no idea there is any such option as home testing. I doubt they have been educated/informed there is an alternative to going to the lab regularly.
 
I have a different view

I have a different view

I believe that people shun home monitoring because of lack of knowledge about Coumadin/Warfarin. People don't want to pay because they know very little about the possible problems with anticoagulation. One man told me that he only goes to the lab every several months because the lab and the monitor are just ways to "line the doctor's pockets." He said that the doctors tell you about strokes and bleeds just to scare so you will come more often.

Al has his mitral valve replaced in 1990. He tested every four weeks without fail. (Engineers are precise). Neither one of us knew diddly about anticoagulation or how Coumadin worked, or...We didn't need to know anymore than the doctor told us after his surgery. No big deal....none whatever.

CoaguChek monitors were available for home testing in the mid-late 1990's. We didn't bother even looking into them. Lab tests were free and the lab was very close to our home. No big deal. Besides, insurance didn't cover the monitor. I filed the info on the home monitor with the other medical stuff.

Jump forward to December 2000. While having lunch, with friends, in the local pub, Al had the first of three strokes. He was due to have his monthly INR-test the next day. He was hospitalized, in two hospitals from mid-December to late January. Life has not been the same since.

So, these are the reasons that I advocate education on anticoagulation, not home testing in an of itself. I believe that people need good reliable information to make the best decisions. With a good understanding of anticoagulation, a person can make an informed decision about what is a fit for their situation. Knowledge is power.

Regards,
Blanche
 
costs

costs

.
while all children in new zealand get free inr testers and test strips, everyone else has to pay 100%, though i think there has been a free hospital board initiative to people living in the remote east cape where is is hard for them to get to blood test clinics regularly. as i recall the hospital board, which has to carry the cost of hospitalising victims of inr screw ups worked out it would be cheaper to pay for inr testers.

i doubt any of our medical insurance companies cover inr testers or test strips either; they have got no incentive to do so because 100% of the screw up are paid for by the state. and also the medical insurance co's would rely on the fact that all kiwi's have got instant access to top inr testing and hospitalisation at free public hospitals so they have no liability.

our free system is tops for some things like inr care, strokes and accidents, but is the total pits for access to heart operations where the private medical schemes really do front up

and just in case my kiwi slang does not translate, "tight kiwi" means someone who is mean with money
 
My wife wanted me to buy a monitor right after AVR, 17.5 years ago but I was too tight. For I had no insurance or Medicare. We sure could have used one for we traveled for months at a time over the county in our motorhome. I carried a prescription from my cardiologist to be used in any state. I would go to the local hospital outpatient lab. It had instructions to give the INR results to me. I would call him if I was out of control range, other wise I never called.

Last year I found out from Ross on another forum that Medicare had started covering the cost in 2001.
And I have Blue Cross that covers all other cost. So it will cost me nothing. Now days we take road trips and cruises so the INR monitor will be nice.


Over the years I've always tweaked my dosage or told my cardiologist that I wanted to be retested sooner than he wanted. I feel that I knew as much or more about taking warfarin and adjusting the dosage than most doctors. I have more at stake than they do. :D

I've never minded going to his office for INT testing... for the last 10 years we been living within 5 miles and I have no fear of simple needles. What I didn't like was when I got out of control I had to request test sooner than he wanted. I don't mind getting a little high but when I get down below 2.5, I get very concerned. Also was a problem when we are traveling.

I thought it was strange when I asked my cardiologist about home monitoring that he had never heard of it. But he sure didn't mess around with the forum I took him... he faxed it to QAS the same day... maybe he's glad to get rid of my testing. :D
 
tax deduction - ha ha ha!

tax deduction - ha ha ha!

in new zealand we have tax, in every direction!

we pay tax, we do not get deductions. there are no deductions for medical anything.

the inland revenue department would laugh their heads off if someone made deductions for an inr tester or test strips.

public health systems mean huge taxes and anomalies and the best and worst care and waiting lists and little choice and health care rationing....

but sadly, i am not sure if there is a better alternative!
 
A couple years ago, I self-tested for about six months with no problems with the testing but the hassle between insurance and Raytel over who paid for what drove me back to my GP's office for finger sticks. Like Cooker, my GP is 2 miles away and I go in at my convenience and at lunchtime so there is very little waiting time....and the price is right, -0-, Medicare pays 100% with no copayment. I normally test on two week intervals and seldom have to adjust. When I do adjust, my doc and I agree on the adjustment. I get a "warm fuzzy" feeling having my doc look over my shoulder. Even though I've been on this stuff a long time, I am still a lay patient and I rely on him to remaine the expert. I need to add that my current GP is the best I've ever had in understanding INR and as long as he is around I'll let him make the calls.

If I lose my GP or the rules and/or cost sharing changes, I might change back to home testing since it is easy to do.
 
Dick, I've never had to pay anything with Medical Care but the reason is Blue Cross.

Also notice you got a finger stick. When we traveled and went to a different lab every month or week, I never had but one that tested with a meter. It was a small town hospital lab, the guy pricked my finger and showed me my INR on the meter... I liked the instant results. Usually takes a lab about 20 minutes to run PT/INR

I go to the local VA clinic once a year so I can qualify for discounted drugs. They do blood work but usually never check INR for they know I have my own cardiologist. For some reason this one time they did... must have used a meter for they got instant results! That's another story. :eek:

My cardiologist said he had a meter but never relied on it. He sends the blood sample to a local lab and then his office calls me the results.

Sounds like you have a great GP. I used a GP once for about a month. He wanted to lower my INR control, I fired him.

My first cardiologist was in TX. He was outstanding, he was the one that diagnosed my aortic stenosis. If I was out of control, he would always retest in a week and told me to do the same when on the road. I like the cardiologist I have today but not as well as the first. My last INR was a 2.1 and he only raised it 1 MG a day. I've added several extra MG's this month and Friday's INR was only 2.2.

I'm looking forward to doing my own testing as soon as QAS can locate their lost trainer!... that's another story. :eek:
 
Quote:seems ironic our north american members have to almost crawl over broken glass to self test/dose when we kiwi's can instantly buy them without prescriptions and use them without any medical insurance implications. End quote

It's because we have insurance companies who want our $$$$ - all we can give them or all they can take!
 
Bina said:
I have just included my $500 monitor in my medical expenses for the 2008 tax year. Stay tuned for the results of that.....
Click to expand...

Hi Bina,

Both of my POC monitors were tax deductible and so are my strips. Tax returns are prepared by a firm of accountants. Hopefully nothing will have changed from 2008.
 
Better alternatives? Become a billionaire .............

Better alternatives? Become a billionaire .............

westie said:
in new zealand we have tax, in every direction!

we pay tax, we do not get deductions. there are no deductions for medical anything.

the inland revenue department would laugh their heads off if someone made deductions for an inr tester or test strips.

public health systems mean huge taxes and anomalies and the best and worst care and waiting lists and little choice and health care rationing....

but sadly, i am not sure if there is a better alternative!
Click to expand...

Absolutely dead on. Taxes pay most medical expenses here. Doctors and hospitals are excellent. Wait times to see specialists are horrendous. This is the first time I've encountered "rationing" when referring to "wait times". Gives pause to wonder about. I need to see two specialists--oculist and dermatologist--appointments made for next September:eek: so I'll manage with optometrist and luck. The skin specialist should be flayed for refusing to renew a prescription without seeing me for 6 months. Being entranced with the Da Vinci Code I think a cilice is in order for him.;)
 
WOW COOL:) I never even thought about submitting my monitor and expenses of it on my taxes. Should be interesting what my accountant says to that, but you betcha' I'm going to try!
heartfelt
 
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