Getting frustrated...

[rjbdaddy]

I have been on Coumadin for 19months now, went through a very steady period where my INR testing was once a month but I have had some spikes in the past few months without any major changes in routine or diet. I was running 5-6 KM on treadmill and my INR went down - now back to running same distance and my INR is up near higher end of range (2.5-3.5).
Now back to every 2 week testing.
Also - can anyone advise on CoaguChek and theself testing kits in Canada (Alberta) and how your coumadin doseage is perscribed when using those systems?

 

[Karlynn]

You're in range - don't sweat it. Most of us want to be at the higher end of our range. If you saw my INR tests where I made no changes in my dose, routine or diet, you'd be amazed. We often say that anything between 2 and 5 is nothing to worry about.

When you say you've had spikes in the last few months, what do you mean. We could help you if you'd give us your INR #'s and the corresponding doses you were taking when you got those #'s.

for example - INR 3.5 on a 40mg/week dose, INR 3.0 on a 35mg/week dose.

By knowing these things we can tell whether or not the issue is truly having an unstable INR or due to too many dosage changes.

 

[Ross]

Why frustrated? If it's in range, even at the higher end, which most of us prefer anyhow, no reason to be frustrated. Be happy if it's between 2 and 4!

You would probably have to purchase directly through Roche for the Coaguchek up there, but I'm not positive. I'll let the Canadians speak on that, but your prescriptions would be obtained the same way they are now. As long as your in range, no dose change. If your high out of range, reduce by 10% for the week and test in a week to see where you are. Vice versa for low out of range. I don't believe in monthly testing. The most I can go is 2 weeks without mine creeping out of control on me.

 

[Freddie]

Welcome rjbdaddy, always nice to see a fellow Canadian

In order to get a home monitor, you'll have to get a prescription from your doctor and make sure the prescriptions reads "monitor plus strips". The machine is $500.00 and you'll have to have a training session - London Drugs carries the machine and should also have someone there qualified to train you.

After you receive the monitor you'll still have to go to the lab for a couple months (pending how often you get your INR checked) to do a comparison with the monitor then forward (or phone/e-mail) your doctor with the results.

Its my understanding that Albert is on the ball when it comes to home monitors, here in Saskatchewan we are still living in the dark ages therefore I don't have a monitor YET.

If I'm incorrect on any of the above information Bina or Lance (who are down East) will correct me - they know everything one needs to know about home monitors in Canada.

Don't fret about your readings now - your doing fine.

Once again welcome to the forum

 

[Freddie]

rjbdaddy,
I've sent you a private message. Click on the top right corner - where it says "Welcome rjbdaddy" to retrieve it.

 

[Tbone]

You are in a nice range. I wouldn't worry about it, just keep up the good work & if you have any questions this is the place.

 

[Ross]

After you receive the monitor you'll still have to go to the lab for a couple months (pending how often you get your INR checked) to do a comparison with the monitor then forward (or phone/e-mail) your doctor with the results.

Why do they persist in comparing apples and oranges? Someone has got to get it through to them that different reagents will yield different results. They act as though INR is specific number that can be obtained automatically and that is just not how it works.

 

[catwoman]

Why do they persist in comparing apples and oranges? Someone has got to get it through to them that different reagents will yield different results. They act as though INR is specific number that can be obtained automatically and that is just not how it works.

Yes, and you may or may not get an identical INR. I've tested on my own machine back-to-back and gotten 2 numbers -- not far apart, though. But some idjits may think getting 2 different INRs is not good enough.

 

[Freddie]

Why do they persist in comparing apples and oranges? Someone has got to get it through to them that different reagents will yield different results. They act as though INR is specific number that can be obtained automatically and that is just not how it works.

Sorry Ross,
I guess should have mentioned until your doctor feels comfortable with the results from the monitor

Keep in mind that this is from my experience of trying to obtain XS monitor. As you know our other members in Canada have no problems with their doctors and the monitor.........its just me.

 

[Ross]

Yes, and you may or may not get an identical INR. I've tested on my own machine back-to-back and gotten 2 numbers -- not far apart, though. But some idjits may think getting 2 different INRs is not good enough.

They can do the samething with their lab results too, but dare them to do two back to back tests of their own! They won't do it. Why? Because it would prove that INR is not an exact science and also perhaps that you might actually know what your talking about.

 

[Bina]

Hello rjb,
Here is the phone number for the Roche company who provides the Coaguchek XS.
1-877-426-2482
Feel free to call and speak to a rep, they will glady send out an info pamphlet to show your doctor if needed.
www.coaguchek.com
www.roche.com
I had my kit and training within 2 weeks.

 

[lance]

Roche Diagnostics advises ......................

Roche Diagnostics advises ......................

performing a comparison test once every six months. The most my comparison tests have differed over the past two years is .2. Usually the comparison is the same for both of us using the XS.

When I bought my first monitor (Coaguchek S) I had an uphill battle convincing my PCP they were accurate and safe to use. I found a hospital in Toronto that recommended them and was trained there. Also, I'm part of a test group, study? focused on the accuracy and efficacy of home monitoring so the hospital monitors my ACT.

A prescription was required for my "S" and when it wore out it was replaced by Roche. A second prescription wasn't required nor was one required for the strips. Alberta might be different though.

Learning about warfarin and self testing is the best present patients can give themselves. I would never be without one and you're veins will thank you.

 

[catwoman]

They can do the samething with their lab results too, but dare them to do two back to back tests of their own! They won't do it. Why? Because it would prove that INR is not an exact science and also perhaps that you might actually know what your talking about.

Does anyone know why the reason for any difference in INRs from two back-to-back tests?

No one has ever told me this, but my guess is it's because particles are not always 100% evenly distributed in any sample of your blood, i.e., no one has ever been shaken up as in a cement truck prior to being bled for a lab test or pricked for a finger-stick test.

Any thoughts?

 

[Ross]

Does anyone know why the reason for any difference in INRs from two back-to-back tests?

No one has ever told me this, but my guess is it's because particles are not always 100% evenly distributed in any sample of your blood, i.e., no one has ever been shaken up as in a cement truck prior to being bled for a lab test or pricked for a finger-stick test.

Any thoughts?

I think that's probably a correct assumption. At any given moment, our blood may or may not have the exact same amounts of testing elements present.

 

[catwoman]

I think that's probably a correct assumption. At any given moment, our blood may or may not have the exact same amounts of testing elements present.

That right there is an excellent argument to refute a medical professional opposed to POC testing (finger-stick) because it's "not as reliable" as a good ol' lab draw.

 

[zipper2]

I have been on Coumadin for 19months now, went through a very steady period where my INR testing was once a month but I have had some spikes in the past few months without any major changes in routine or diet. I was running 5-6 KM on treadmill and my INR went down - now back to running same distance and my INR is up near higher end of range (2.5-3.5).
Now back to every 2 week testing.
Also - can anyone advise on CoaguChek and theself testing kits in Canada (Alberta) and how your coumadin doseage is perscribed when using those systems?

Hello and welcome from Calgary rjgdaddy,
I say screw the lab they take the vials of blood and they sit all day as the person coffee's at Tim Hortins,then remember they gotta deliver the vials to hospital lab for readingsNot sure how that can give us a true inr here.
blood sits all day in vehicle.
Also i haven't found anyone or anywhere better than vr members to help
regulate your warfarin better than here if you need help at anytime.
You've proved safe here,and glad you joined us.
Had my machine over a year but on on warfarin 16 years and i didn't know
how to regulate dosages as theres noone out there to understand to teach you,like here. Still learning myself.

zipper2 (DEB)

 

[Ross]

That right there is an excellent argument to refute a medical professional opposed to POC testing (finger-stick) because it's "not as reliable" as a good ol' lab draw.

My PCP is the lab director and he and I go round and round. He's finally given up on the fact that I can do this myself. I was shocked actually.