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  1. R

    Mechanical vs Tissue - need help deciding

    Fortunately, ACA (unlike Medicaid) does not consider net worth. Generally Adjusted Gross Income + any Social Security that was excluded from AGA is the bulk of the income considered. It takes advance planning to structure personal financials to retire early and be able to live off savings...
  2. R

    Mechanical vs Tissue - need help deciding

    That's the unsubsidized average. Per HealthInsurance.org... "As of September 2021, there were 12.2 million people enrolled in plans through the exchanges nationwide, and the vast majority were receiving premium subsidies. For those enrollees, premium subsidies covered the bulk of their premiums...
  3. R

    Coumadin clinic

    It's been a long time since I used a coumadin clinic. They started me on 5mg pills (maybe that is a standard?), but there were frequent dose changes & splitting pills. I don't recall if they ever gave me different size pills, but based on the notes I logged back then, looks like I only had 5mg...
  4. R

    Discrepancies in INR between Coaguchek XS and Lab

    No, but my wife is and I am well acquainted with Medicare and the various supplemental and Advantage plans. Yes I know and stated it in my post which you quoted. Your comment which I took literally to mean you think Medicare does not cover any INR home testing cost was... ... which is what...
  5. R

    Discrepancies in INR between Coaguchek XS and Lab

    Your cardio means INR. Healthcare providers sometimes use the term "protime" or "PT" when discussing my INR with me even though we are both clearly talking about INR. PT and INR are used interchangeably. PT is the number of seconds to clot and is used to calculate INR. The INR includes...
  6. R

    Tissue Valve

    It may appear to you there is a mechanical valve bias on this forum, but keep in mind that many of us had their valve implanted long ago and at a young age. In other words before TAVR, before Inspiris Resilia. We had to decide based on the options available to us. Neither INR management or...
  7. R

    CoaugCheck vs Coaugusence

    I drop it directly on the "well" - that half circle area in the middle of the strip. Always works. Never used the technique they show in the video where the blood is drawn in from the edge of the strip. On the rare occasions I have been tested at a clinic, they would pick up the device and...
  8. R

    Companies for testing supplies and INR reporting

    That makes it difficult to compare services. Did they at least confirm that Biotel/CardioNet is in your network? If so, then they should be able to lookup the contract price and tell you what the cost is. You have to be pushy with these insurance company call centers. The agents don't always...
  9. R

    Having a procedure and bridging with heparin

    They were visible on an echo. I have an SJM Regent valve
  10. R

    Having a procedure and bridging with heparin

    I can't evaluate whether it is overly cautious or not since that depends on any known risks you have experienced (if any) under a low/no anti-coagulation situation vs bleeding risk and impact of the specific procedure. In my case I have a history of fibrin strands forming on my valve during low...
  11. R

    Mechanical vs Tissue - need help deciding

    Unusual perspective. Depends on your situation I guess. The big thing to me was at age 46 if I chose a tissue valve, I was looking at multiple future surgeries to replace it. This was before transcatheter valve replacement so that was not an available consideration for future risk...
  12. R

    Companies for testing supplies and INR reporting

    I listed some options in this post: https://www.valvereplacement.org/threads/home-testing-since-covid.888293/post-912020 I also received a letter from Philips regarding the name/branding change. It said only the name will be changed. All else would be the same. Ignore the $880. That is the...
  13. R

    Unexplained pain and numbness

    Agree. The link to the Berenson article on Brian Peckford's (a Canadian Politician) blog is an example of what happens when untrained individuals try to interpret statistical clinical data. Sorting out the primary study objective (safety and efficacy of Coivd-19 vaccine) from effects of other...
  14. R

    Home Testing since COVID?

    Here are the options I have on my list which I compiled about 18 months ago. I went with the Remote INR service. Remote INR Service (Bio-Tel): Provides device and all supplies (Coaguchek). Requires Rx. Bills each 4th reported test. Insured cost depends on your particular insurance plan. Since...
  15. R

    Home Testing since COVID?

    It's Bio-Tel's requirement that INR results be reported. The frequency (1 or 2 week schedule) is based on what your health care provider prescribes when signing up for the service. I arranged this with my cardiologist and requested he prescribe the 2 week testing schedule. So that is how often I...
  16. R

    Home Testing since COVID?

    They bill every 4th test you report. The cost depends on your insurance plan. The device and supplies are not an "a la carte" charge. It is all bundled. They send more supplies out than I need for my every 2 weeks testing. So I test more frequently than I report. Reporting results is via a...
  17. R

    Missed a dose. What do you do?

    1 glass per day. It takes about a week to finish a bottle of juice, but the particular juice variety is whatever happens to be next in the cupboard. So one week could be cranberry every day and the next week or even several weeks, none.
  18. R

    Missed a dose. What do you do?

    Agree. Very debatable. I've been drinking cranberry juice all of the 15+ years while I've been on warfarin. I make no attempt to be consistent in how much I drink per week though. No impact to INR one way or the other. Shortly after I started home testing in 2007, but before I started managing...
  19. R

    Dosing after colonoscopy

    I think that's a higher daily dose than most patients. Might imply you will have a rapid drop below therapeutic range. I assume from your post you have no personal history of low or no anti-coagulation therapy since you have had your SJM valve, so it's difficult to assess that side of the risk...
  20. R

    Potential replacement of mitral mechanical to tissue valve, age 40

    You've received great responses with potential areas to research. I'll add just a couple more. I had brief stroke like symptoms once within about six months of my AVR in 2006. An echo showed fibrin strands were visible on my valve. I was told the episode was likely from embolized fibrin...
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