Anticoagulation Adviser

[Marty]

The Anti- Coagulation Advisor is a handheld slide chart and nomogram that promotes consistent and high quality warfarin dose management.It is based on the 10% solution and guidelines adapted from the American College of Chest Physicians.It was developed for the profession by our good friend and guru Dr. Jack Ansell, Professor of Medicine, Boston U. ( he will promptly answer questions if you contact him at [email protected]). The First Edition 2001 is published by Hudson Physician Communications,Inc. Also contact www.anticoagulation-advisor.com for more info.
I advise all warfarin patients to get one of these guides not just self testers and self dosers. Compare what the guide says with the advice you get from your doctors office. When I started out the office would call me, always a lab tech or aid and sometimes would really give me off the wall schedules. I never could figure out the algorithims. They often were not right for me. We are all different. Where were the doctors? In the ICU saving lives ,I think.
Many folks have conscientious people like Al looking after them...but not all.

 

[Blanche]

Marty:
Thanks for the info. You bring up many good points. Appears to me that while the doctors are in the ICU saving lives, those who take coumadin are being treated by aides and techs, some of whom have no medical training and certainly little or no understanding of anticoagulation. During my husband's visit to his cardio recently, I asked if I could "take a peek" at their new Coumadin Clinic. Imagine my surprise when I saw who was working in the clinic. It was a woman who used to answer the phone. In past dealings, I found her to be a sweet dim wit! When I asked her about her education and training, she told me she was in the medical field for 9 years....always at a front desk. She couldn't answer any of my questions. But, she assured me that all she had to do was "look it up" on the chart.....which was handwritten. I later found that she was no longer working at the desk because she "couldn't get the hang" of the new computer system. My cardio has 13 other partners working out of his office. Nothing like health care by committee. Now you know why hubby's anticoagulation is monitored by his internist, not his cardiologist.

I have thought for a long time that people who visit coumadin clinics or lab test should ask for the credentials of those who monitor. If that person is anything less than a registered nurse, I would complain like H---, and find a new place for testing.

 

[LUVMyBirman]

Thanks Marty!

Blance, my word! Very scary! Does your husband have a handle on what works for him?

 

[Blanche]

Gina:
It is scary, but that is what is happening at coumadin clinics all over. Monitoring anticoagulation has become another revenue stream for doctors. How hard can it be? I know you've read many posts here where people have been given bad and even life threatening directions from those who staff coumadin clinics.

Before his stroke in 2000, everything worked just fine. But then, I remember someone here said that one could run across the freeway many times before being hit. Would you believe that in the 10 years between Al's valve replacement and his stroke, neither of us had ever heard the term INR? When he had his valve replaced, there really weren't alot of people getting that type of surgery and there was no internet.

What works now is being an informed consumer. It's people like you and the others here who have provided information and asked questions that enable Albert the make reasoned and informed decisions about this own health care. He also shifted his anticoagulation management to his internist. The internist sees him on a regular basis for a variety of other ills. He is always available and often calls us with lab results himself. And, Albert does test on the ProTime monitor each week. He still sees his cardio twice a year and the neurologist every three months.

The important thing, as I see it, is to find a competent doctor who is accessible and willing to work with one who is informed and knowledgeable. Given the state of medicine today, one just can't afford to be a passive patient.