Anybody using Coag Sense for INR testing?

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dick0236

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That was my plan to periodically compare to a lab draw.........
Another way for a quick and cheap accuracy test of your meter is to "stick" your spouse or a good friend (you'll find out who your real friends are:unsure:).......assuming he/she is not on AC you should get a reading close to 1.0 (normal INR). I do this once, or twice, per year with my wife. If her reading varied much from 1.0 I would suspect some kind of problem and follow up with my doc.......have had no meaningful variance yet.....8 or 9 years on two meters.
 

tom in MO

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Good idea dick, but your accuracy check is at a concentration level not relevant to your therapeutic range. You could probably skip that practice. If you need reassurance, see if they will do your INR at a blood draw for something else and test the same day on your home meter.

From what I've read, there's no need to check your meter, but I agree it's kind of disconcerting there is no "calibration and maintenance program" for something you bet your life on. However, that's kind of a good thing if you can trust the little machine to be "foolproof."
 

Keithl

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Good idea dick, but your accuracy check is at a concentration level not relevant to your therapeutic range. You could probably skip that practice. If you need reassurance, see if they will do your INR at a blood draw for something else and test the same day on your home meter.

From what I've read, there's no need to check your meter, but I agree it's kind of disconcerting there is no "calibration and maintenance program" for something you bet your life on. However, that's kind of a good thing if you can trust the little machine to be "foolproof."
I plan on bringing meter with me for my regular blood work which is twice a year and ask them to do an INR test and then check my meter at same time.
 

Protimenow

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First I want to thank everyone here and this forum in general. I have been INR testing twice a week to dial in my INR. I am switching cardiologists because mine is just not collaborating and seems not happy I chose a mechanical valve. I spoke to the new cardiologist's nurse who ironically is the nurse I see at the Coumadin occasionally at clinic for my testing. We chatted and she says I will like my new cardiologist and both of them will work with me on my INR.

My INR today (Friday) was 3.1 and Monday was 3.7 so it looks like 7.5 is a tad high for me and we are tuning it in. My goal is to land between 2.0 and 2.5 and stay there permanently even though at 90 day they say with the On-X I can go to 1.5-2.0. Just not worth the possible risk for me.

As for machine I think I will buy one in next few days out of pocket as over the long haul the money is minor, but will be cheaper than the service. I know I can buy used, but I don’t buy used anything, just my nature. I like the thought of the Coag-sense, but the extra step of the tube looks to be a pain in the ass. So I will likely do the CoaguCheck XS.
I don't find that extra step to be a pain in the ass. Instead of touching the blood droplet to a strip, I touch a tube to the blood drop, then transfer the blood onto the strip. For me, the extra accuracy is worth the extra step.
 

Protimenow

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Was doing some more reading and found this article that basically says Coag Sense and CoaguCheck XS are very accurate at INRs below 3 and above 3 the delta grows rapidly.

https://www.ncbi.nlm.nih.gov/pubmed/28379875
Not exactly. The Coag-Sense uses a different method for determining INR. It's supposed to be accurate up to an INR of 8. I was told that some clinics will use the Coag-Sense to confirm INRs of 4 and above.
Of course, you want your INR to be below 4, so either meter should be okay when you're in range. For INRs above 3.5 or so, I, personally, would be more comfortable with my Coag-Sense to give me an accurate value.
 

Protimenow

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No matter your reasons for new, used, etc, get your meter and batch of strips tested against a known standard. I have a meter purchased new through my insurance and I buy 48 test strips in a batch from ebay. When a new package of test strips arrives, I have a lab draw done and before I leave the office I test with my meter. The lab results and meter have never exceeded a .1 differential. However the coumadin clinic meter and mine were often very different with .7 being the greatest. Love the Coagucheck XS.
I STRONGLY disagree with the idea that you have to have each new batch of strips compared to a lab draw. You report that your lab draw and meter results were within .1. Do you know why? It's because the strip manufactures carefully check their strips and determine the correct reagent value for each batch.
These manufacturers don't want the loss of life that can be pointed to a bad batch of strips, they don't want the legal liability of sending out a bad batch of strips. They don't want the embarrassment of a recall related to a bad batch of strips.
It's the reason Roche sends a code chip with each new batch of strips. It's the reason Coag-Sense strips have a calibration code on EACH strip.

I've tested my INR when the manufacturer of my warfarin changed. I've tested after starting a new medication or drastic changes to my diet. I haven't tested specifically to verify the accuracy of a new batch of strips.

I don't think this is necessary.
 

Protimenow

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That was my plan to periodically compare to a lab draw. I like that the CoagSense has individually wrapped strips.
In the past, I've compared my meter results to a lab draw. Until recently, although I had full confidence in my meter, I'd get a blood draw monthly (insurance wanted monthly draws).
When my insurance changed, I haven't bothered with blood draws very often.

The Coag-Sense strips come individually wrapped. The strips are more robust than CoaguChek which, if I recall, should be used within five minutes of removing them from the container that they come in. Coag-Sense strips can actually be used hours (or maybe even days) after removing them from the wrapper as long as they're kept away from moisture. The only arguable drawback to individually wrapped strips is that they take up more space than a bunch of loose strips in a tube. When you get a new box of Coag-Sense strips, they come in a box - when you get CoaguChek strips, you get a tube or two and a code chip. If you plan to travel for months at a time, the Coaguchek strips will take up less space.
 

Protimenow

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Good idea dick, but your accuracy check is at a concentration level not relevant to your therapeutic range. You could probably skip that practice. If you need reassurance, see if they will do your INR at a blood draw for something else and test the same day on your home meter.

From what I've read, there's no need to check your meter, but I agree it's kind of disconcerting there is no "calibration and maintenance program" for something you bet your life on. However, that's kind of a good thing if you can trust the little machine to be "foolproof."
Years ago, when I had to go to an anticoagulation clinic, the nurses talked about 'calibrating' the meter. They used Hemochron or Protime meters which, I assume, COULD be calibrated.

Today's meters probably can't be calibrated - they were designed to give accurate results for all tests. Consider a busy cardiologist's office where perhaps 50 or more tests are done per week. They wouldn't want to be concerned with calibration or the accuracy of the meter -- it had to always be within range. I doubt that the medical industry would have jumped on board as fully as many have in recent years if they had to worry about meters that dropped in accuracy.

I fully endorse the idea of having your blood draw compared to the test on your meter. I've done that - but didn't bring my meter to the blood draw - your INR wouldn't shift radically between the time the lab draws your blood and the time you test with your meter (within an hour or two). Also - depending on where your blood is drawn, it's possible that the people who draw your blood may mishandle it. I've had at least one experience where my blood was mishandled, and a false result was determined.

(And yes, we self-testers are trusting our meters with our lives. I made the mistake, years ago, of blindly trusting the wrong meter. I'm comfortable with the choice I've made. After years of comparison to lab results, I'm confident in the accuracy of my meter).
 

Protimenow

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I'm sorry to monopolize this thread, but I occasionally look at eBay to see if I can get a few CoaguChek XS strips for testing, just to continue my comparison with Coag-Sense. I only need one or two, because I don't test with the CoaguChek XS for any reason other than comparison.

I saw that there are ads for capillary tubes used for collecting and depositing blood onto the CoaguChek XS strips. This is the 'extra step' that some on this forum 'hate.' Wondering why, if you can just touch your finger to the side of a CoaguChek XS strip or squeeze a drop on top, you would need a capillary tube (or tube with bulb), I looked further.

I got a few answers:

In some cases, you're wasting a strip if the blood droplet isn't large enough to make it into the strip.

In other cases, the person being tested is unable to reliably put the drop onto the strip. For example, the ill or infirm may not be able to touch the strip. Or, perhaps, people with bad fingers or hands, or arthritic fingers, can't move the finger to the strip.

In these cases, using a collection device (capillary tube) is the way to get the right amount of blood collected and deposited onto the CoaguChek XS strip.

Again, it's an 'extra step' similar to what the Coag-Sense user takes.

Over the years, Coag-Sense has come up with various collection devices, ranging from mini-pipettes, to a few different kinds of capillary tubes, to their new device that uses a capillary tube and a plunger that deposits the correct amount of blood into the strip.

With a little practice, this tube is very easy to use - since I learned to use this device after a few tries, I've had 100% success with it. It's easy to use. It cuts down on wasted strips. The 'extra step' is, for me, not a problem.
 

Keithl

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Seems CoagSense has tight control on distribution here in USA. I contacted them and basically they refer you to Wilburn Medical and requires a prescription. I have talked to Rick Wilburn and he is a great guy, but I have yet to find one anywhere else. I may wind up with a CoaguCheck XS because I don’t want to wait 3-6 months for my doctors to decide I can self test when I am doing a better job managing my INR than the clinic is.
 

Protimenow

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I've found many Coag-Sense meters on eBay. They're listed as Coag-Sense PT/INR meters, and I see them for as low as $169. I'm not sure why your search didn't show these on eBay. I don't know if I can or should give you the listing number, but it was easy for me to find these listings. (FWIW, I now have TWO Coag-Sense meters. One has had very little use, the other was my go-to machine for a few years and has done, probably, a few hundred tests. I also have the new, PT2, meter. I may be interested in selling my less used 'classic' meter.

Let me know if you have trouble finding these new, old style, Coag-Sense meters on eBay.

I don't quite understand why your doctor should give you trouble about self-testing. (FWIW - if you can afford it, the new meter is really nice. Also, some medical supply companies may also bundle the meter with the strips. Also - you may want to contact Coagusense to see if they can make a referral for you)
 

Protimenow

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I haven't seen the new PT2 meters on eBay. You probably have to check medical supply houses, or go to the Coag-Sense site and see if they can refer you to a dealer or distributor.

This meter has only been out since March, so there may not be any available on places like eBay.

The original meter is a very good meter. For a self tester, it will do the job very well. The new model has more features, it's considerably smaller, and stores a lot more test results (although the 200 on the original is still plenty for a self tester).

If the PT2 hadn't come out, I would have been fine continuing with the original model.

If you have any financial issues, or can't justify the extra cost for the new model, or are having trouble getting a prescription for a meter, a Brand New original model is not a bad choice.
 

Keithl

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Well I give up trying to buy one legitimately. Seems the only place to buy a Coag-Sense PT2 is through Wilburn Medical and he needs a prescription. Seems the 2 cardiologist offices I am dealing with will not write a prescription and only order a service. Since I can’t find a Coag-Sense PT2 it looks like e-bay CoaguCheck XS will have to do.
 

Keithl

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OK finally got a Coag-Sense PT2 on order, some people are doing me a few favors which I greatly appreciate. Meter with supplies due next week. Can;t wait to report on it then in July I have physical and will bring meter to compere to a lab draw.
 

Protimenow

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That's great news. Both meters work well, the PT2 has many new features.

I've had mine for a few months, and I prefer it to the original model because of the new features and added memory.

If you have any questions about tweaks or how to use it , you can ask them here, or send me a message using the messenger on this site. A couple tweaks I appreciate -- I prefer to have the sound turned on, this can be done through the settings. Although you can run this very well without sound, the prompts to insert a strip, the prompt telling you when a test has finished, and other sounds are helpful.
 

Keithl

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Thanks, unit arrives tomorrow. Will probably wait u til weekend to do some test then bring it next week to compare to clinic and then in a few weeks to my primary doc to compare to a lab draw.
 

Keithl

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Well I finally received my Coagusense today and will become acquainted with it this week. Ironically while I paid for Coagusense out of post, I am getting a Coagcheck XS via a service and since my surgery maxed out my max out of pocket the service will not cost me anything this year so I can compare both meters.

The scam these services have here is a joke. So for weekly testing and a loaner meter my cost is $117 a month until I hit my deductible then $27 a month. I asked about extra test strips and they said 12 strips and lancets are $240! What a joke, all about the health care companies lobbies with government and medical chains that allows this to happen.
 

Protimenow

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Dick made this same point a few years ago. In his case, the services were ripping off Medicare every month, and, if I recall, he was tired of seeing this happening to the Medicare system.
For CoaguChek XS and Coag-Sense, strips are about $5 or so each. I get 100 lancing devices (preloaded, ready to use, safe after use) for about $25 or so.

So far, I've been careful to not get a 'free' meter, or a system that charges to send my results to my doctor. I've been self-managing for years, and only had a problem when I waited too long between tests or trusted a faulty (now discontinued) meter.

I think you'll like the Coag-Sense. There's not much to 'study' in order to be able to use it. The biggest challenge may be learning how to incise your finger in order to get a good drop formed on the side of the incision, touching the transfer tube to the drop of blood, then transferring it to the strip. Beyond that, it's as easy as the CoaguChek XS.

Because of the bells and whistles built into it, it takes a minute or so to start up, but beyond that, it should be a pleasure to use.
 
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