As one who home tests, do you ever go the lab for testing?

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bdryer

Well-known member
Joined
Oct 22, 2010
Messages
429
Location
Canada
Hi

Norm got me thinking after one of his posts on the On-X study thread. He posed the question of, why I prefer to not see a PCP regarding my INR results. I would like to limit responses to this thread to people like me, those required to be on warfarin for life. Although I must thank Norm for guiding me with the question of, "As one who home tests, do you ever go to the lab for testing?

I am comfy with my CoaguCheck XS. I use the on-line calculator from this site. So far any adjustments made by the local anti-coagulation clinic were mirrored by the on-line calculator. I was released several weeks ago from the clinic as I am now stable. They passed me off to a PCP. I have no experience sampling his ability to set my INR. I have been considering simply home testing and adjusting as required on my own. Being a techy, I am more then aware that testing equipment requires calibration. Hence, I will go to the lab say semi-annually and do a side by side comparison. Eventually my PCP will be involved as the lab only sends the results to qualified professionals.

My question stands,"As one who home tests, do you ever go to the lab for testing"? I want to discover if competency with home testing and reliability of a modern device, can totally eliminate the lab.

Thx
 
I have been home testing for approximately 18 months, and no, I never go back to the lab or my cardiologist's office for retesting. My cardiologist completely agrees with this. My experience is that after you have tested for a while, you know immediately upon testing whether you are in range, and whether a change in medication is merited.
 
I have been home testing for over 11 years.

I do go to the lab on occasion, (once per year), to have them run a test.
Also, I bring my home testing unit with me, and run my test there right after they perform their test.
The reason for this is to confirm the results between the two, and confirm that my unit is still accurate.

When I first obtained my home test unit, I used to test, then call in my results and have them adjust my dosage.
It got to the point that I could pretty much determine what their adjustment recommendation would be,
and I then just begain self-dosing based on my home unit results.

That being said, I do work closely with them during those times that I have had to have surgery, and also during my "bridging" with Lovenox prior and post surgeries. I will call in my home test results, and tell them what I would do, and we would discuss it. I think I did this mostly to confirm my actions. They have never once disagreed with my recommendation. But, I did feel better with them also monitoring during these times.

Rob
 
bdryer said:
Hi

Norm got me thinking after one of his posts on the On-X study thread. He posed the question of, why I prefer to not see a PCP regarding my INR results. I would like to limit responses to this thread to people like me, those required to be on warfarin for life. Although I must thank Norm for guiding me with the question of, "As one who home tests, do you ever go to the lab for testing?

I am comfy with my CoaguCheck XS. I use the on-line calculator from this site. So far any adjustments made by the local anti-coagulation clinic were mirrored by the on-line calculator. I was released several weeks ago from the clinic as I am now stable. They passed me off to a PCP. I have no experience sampling his ability to set my INR. I have been considering simply home testing and adjusting as required on my own. Being a techy, I am more then aware that testing equipment requires calibration. Hence, I will go to the lab say semi-annually and do a side by side comparison. Eventually my PCP will be involved as the lab only sends the results to qualified professionals.

My question stands,"As one who home tests, do you ever go to the lab for testing"? I want to discover if competency with home testing and reliability of a modern device, can totally eliminate the lab.

Thx
Click to expand...

Through my experience and being in Canada, your PCP will have to be "on broad" with you using your own monitor and adjusting your dosage. So you best check that out, otherwise you might see yourself going to the lab every 2 weeks.

In order to keep my doc 'happy', I go to the lab every 2 to 3 weeks and the results from the lab compared to my CoaguCheck XS is usually within .3

My doc has a problem with me using the monitor, but has no problem with me adjusting my dosage :confused2: Maybe it has something to do with our health care system and being paid for receiving the test results, I dunno.
 
My cardio office "manages" my warfarin ;-), but every 4 to 6 months I get a lab done and test myself at the same time. The labs are usually lower by .3 consistantly.
 
No. Never. Unless I'm hospitalized, and even then, I take my INRATIO with me and do my own tests until and unless I'm too ill.

I have checked my machine against my doctor's machine, right after my AVR when it was taking forever to get me back in range. The two machines were spot on identical in back to back tests.

BDryer, since you are uncertain of your PCP's experience with coumadin, when you have an out of range test, you should input your dosage and test results into the online calculator to check for changes BEFORE you call in an out of range test to your doctor. It will give you a suggested adjustment that is pretty durned accurate. Then compare what the online says to what your PCP says.
That will very soon let you know whether your PCP is competent to manage your INR. Or NOT.
 
Thx gang for jumping into this thread. Your responses are excellent.

My only concern is about the calibration of the device. It's understood that the device carries out a self diagnostic test when booted up. With this said, I e-mailed the following questions to Roche :-

1/ I have a Coaguchek XS. Does the device carry out a self calibration when booted up?

2/ Is it necessary for me to do a side by side comparison with a lab result , [IE vein draw] to confirm calibration of the device?

I am more then comfy managing my own INR. Especially since many of you great folks have pioneered the way, proving competence and proficiency with the device and the on-line calculator.

I'll post the response from Roach when received on this thread. "Hey.....has anyone else posed the calibration question to the MFG of your device"?

Again, "a Big thanks gang".
 
No, I haven't asked the manufacturer... but the clinic we use only uses the coaguchek machines and they find that many of the machines are off, consistently, by a certain amount. Ours is off by -.1 (reads .1 low always), whereas Skyler's mom's machine reads .2 high always. The clinic makes us go in annually to be sure the calibration is consistent. So far, after 5 years, it's been consistent. If it changes drastically, they switch out the machine.
 
I purchased my own Coaguchek XS as my insurance wouldn't cover it. I test weekly with my own unit. Since my ins does cover lab testing (100%) I do a lab test every month or so. The lab test gets called into my Coumadin clinic (thru my cardiologist's office) and that keeps them happy. It's also reassuring that the lab test is pretty much in line with my Coaguchek results. If my ins covered home testing, I don't think I would do any lab testing. I'm not sure what I will do if I come up out of range when home testing as that hasn't happened yet. I would like to do my own dosing, but I don't think my Coumadin Clinic would like it, so we will see when the time comes.
 
I've been home-testing since late Nov. 2003, and have not gone to a lab for a draw. I have probably had IINRs by lab draw in conjunction with a TEE (my INR was 2.0 when I had my last TEE, about 3 years ago). I have taken my unit to the PCP's office twice to compare. My ProTime 3 was off by about 0.3 with his CoaguChek. My INRatio was either the same or only 0.1 off.
I see no reason to take my unit in, to spend time and my $$ to reassure myself and my PCP's staff that everything is hunky-dory. I have a notebook with my INR results, should anyone want to inspect them. I've gone to my PCP for 20-25 years, when he was in private practice (he's now part of the Baylor Health Care System in the North Texas area), so we have a long, satisfactory relationship.
 
bdryer said:
Thx gang for jumping into this thread. Your responses are excellent.

My only concern is about the calibration of the device. It's understood that the device carries out a self diagnostic test when booted up. With this said, I e-mailed the following questions to Roche :-

1/ I have a Coaguchek XS. Does the device carry out a self calibration when booted up?

2/ Is it necessary for me to do a side by side comparison with a lab result , [IE vein draw] to confirm calibration of the device?

I am more then comfy managing my own INR. Especially since many of you great folks have pioneered the way, proving competence and proficiency with the device and the on-line calculator.

I'll post the response from Roach when received on this thread. "Hey.....has anyone else posed the calibration question to the MFG of your device"?

Again, "a Big thanks gang".
Click to expand...

I'm thinking that you may be confused regarding the Coaguchek monitors. The OLD model required a manual quality
check and occasional calibration. The NEWER Coaguchek XS doesn't require anything more than
turning it on and swapping the code chip whenever you start a new batch of test strips.

You DON"T need to do side by side tests per say, but many doctors may ask for it occasionally and mark
down those results on your file.
The Coaguchek XS has tested consistently and allows for a variance of .2 when compared to a lab.
By the way, labs use a different reagent, so of course the results will show a slight variance.
I have been home testing since 2007 and my monitor is bang on.
They are manufactured and used in Europe (Germany, Switzerland, etc) where quality excels.
 
sarahsunshine said:
No, I haven't asked the manufacturer... but the clinic we use only uses the coaguchek machines and they find that many of the machines are off, consistently, by a certain amount. Ours is off by -.1 (reads .1 low always), whereas Skyler's mom's machine reads .2 high always. The clinic makes us go in annually to be sure the calibration is consistent. So far, after 5 years, it's been consistent. If it changes drastically, they switch out the machine.
Click to expand...

Please read my previous post to BDryer. Your monitor is probably not "off". INR is not an exact science on these monitors,
but they are pretty darn accurate for our needs.
 
Hi Bina

You bring up some great points instilling confidence in the device.

As stated, I have fired off an e-mail to Roche. It will be interesting to read what they say.
 
Bina said:
The Coaguchek XS has tested consistently and allows for a variance of .2 when compared to a lab.
By the way, labs use a different reagent, so of course the results will show a slight variance.
I have been home testing since 2007 and my monitor is bang on.
They are manufactured and used in Europe (Germany, Switzerland, etc) where quality excels.
Click to expand...

Ahhh.. Bina. Do I sense perhaps a little bit of German pride here.
Of course, we both know they always over-engineer everything. :)
 
Hi gang

I saw my cardiologist for the 1 year post op regime. I told him I am home testing and use the on-line calculator. I then got into me sending my results to my PCP and relying on him to rewrite my warfarin perspiration. Without even asking , my cardiologist whipped out his prescription pad asked me what dosage I would like and produced a 1 year prescription. He said their is no need to call in the results and that he will handle the renewals.

What a relief to have control over my testing and dosing.

My cardiologist was adamant in the past that "plavix" would be my future anticoagulant drug. He has come full circle as people on this drug have been having life threatening or catastrophic bleeding events and that you can not test and adjust the dosage. Hey we on VR.ORG already new that! Keep sharing the info! Warfarin ROCKS!
 
bdryer said:
Hi gang

I saw my cardiologist for the 1 year post op regime. I told him I am home testing and use the on-line calculator. I then got into me sending my results to my PCP and relying on him to rewrite my warfarin perspiration. Without even asking , my cardiologist whipped out his prescription pad asked me what dosage I would like and produced a 1 year prescription. He said their is no need to call in the results and that he will handle the renewals.

What a relief to have control over my testing and dosing.

My cardiologist was adamant in the past that "plavix" would be my future anticoagulant drug. He has come full circle as people on this drug have been having life threatening or catastrophic bleeding events and that you can not test and adjust the dosage. Hey we on VR.ORG already new that! Keep sharing the info! Warfarin ROCKS!
Click to expand...

Your cardio dude is right on. My GP gives me a 1 year prescrip for 2 different doses of Coumadin and I take what
I need. He likes it if I call with my INR results every few months, but other than that he leaves me to do what
I want based on my tests, diet, etc.
 
mecretired said:
I purchased my own Coaguchek XS as my insurance wouldn't cover it. I test weekly with my own unit. Since my ins does cover lab testing (100%) I do a lab test every month or so. The lab test gets called into my Coumadin clinic (thru my cardiologist's office) and that keeps them happy. It's also reassuring that the lab test is pretty much in line with my Coaguchek results. If my ins covered home testing, I don't think I would do any lab testing. I'm not sure what I will do if I come up out of range when home testing as that hasn't happened yet. I would like to do my own dosing, but I don't think my Coumadin Clinic would like it, so we will see when the time comes.
Click to expand...

Can you tell me what you paid for the unit, and what you pay for the strips? I do not have insurance, and the blood tests are getting very expensive.
 
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