twinsunnysideup
Member
I would like to get feedback on this home monitoring system. I will be using it on my 12 year old daughter. Is it fairly accurate? Easy to use? How does it compare to others on the market? Thank you so much
Coag-Sense Reviews
- Thread starter twinsunnysideup
- Start date
Help Support Valve Replacement Forums:
Coagsense monitors are fairly new to the marketplace. There is a member, Protimenow, who has done comparisons between the Coagsense and the other name brands, CoaguchekXS and the INRatio, and you might look up some of his posts on this subject in the Search menu. He might also respond to your question in this thread.
twinsunnysideup
Member
Ok. Thank you.
pellicle
Professional Dingbat, Guru and Merkintologist
Hi
I can't speak much about the CoagSense because I've never used one, however you need to consider the most important point is actually the test strips: what they cost and their availablity.
There are a few players on the market and to me they are all the same (although some of the earlier models are just headscratchingly complex (even for me).
The next point to keep in mind is that they are all reliable within parameters. This is not like measuring a piece of steel with a ruler or a caliper, its chemistry. You may be surprised to learn that there are literally dozens of chemical methods to determine INR (yes, especially in labs). We tend to black box it and compare "vein draw" from a lab to a machine as if that was some sort of reference. It is not.
This is a clipping from a Roche product information pdf showing the INR's read from the same reference samples using different chemistry (mostly different lab reagents)
you will note that they are all different.
INR is a rubbery figure and the truth is that the most important issue is the term "of clinical significance"
Meaning that if your reading does not cause a change in dose it is not clinically significant.
This is another reason why I stress to people that maintaining a narrow INR range is fraught.
Myself I use the Coaguchek XS (more or less by accident). I have found it to be among the best there is (in subsequent readings) and that it has great world wide availability of strips.
I buy my strips on line for AU$140 for 24 strips. Which makes it a low priced test.
If you have not yet bought, I suggest you look for a used coagucheck XS (repeat XS not S) on eBay and save a bundle. It seems many are bought for grandparents by well meaning sons and daughters and the older person just doesn't want to use it.
People say "ohh, I wouldn't trust a used one" ... well mine is three years old and has seen a ton of use, changed country a few times and backpacked around. I sure trust that one ... so what's the difference between mine and one thats been bought, turned on twice and put in a cupboard? ANS: that one is newer
twinsunnysideup;n859821 said:
I can't speak much about the CoagSense because I've never used one, however you need to consider the most important point is actually the test strips: what they cost and their availablity.
There are a few players on the market and to me they are all the same (although some of the earlier models are just headscratchingly complex (even for me).
The next point to keep in mind is that they are all reliable within parameters. This is not like measuring a piece of steel with a ruler or a caliper, its chemistry. You may be surprised to learn that there are literally dozens of chemical methods to determine INR (yes, especially in labs). We tend to black box it and compare "vein draw" from a lab to a machine as if that was some sort of reference. It is not.
This is a clipping from a Roche product information pdf showing the INR's read from the same reference samples using different chemistry (mostly different lab reagents)
you will note that they are all different.
INR is a rubbery figure and the truth is that the most important issue is the term "of clinical significance"
Meaning that if your reading does not cause a change in dose it is not clinically significant.
This is another reason why I stress to people that maintaining a narrow INR range is fraught.
Myself I use the Coaguchek XS (more or less by accident). I have found it to be among the best there is (in subsequent readings) and that it has great world wide availability of strips.
I buy my strips on line for AU$140 for 24 strips. Which makes it a low priced test.
If you have not yet bought, I suggest you look for a used coagucheck XS (repeat XS not S) on eBay and save a bundle. It seems many are bought for grandparents by well meaning sons and daughters and the older person just doesn't want to use it.
People say "ohh, I wouldn't trust a used one" ... well mine is three years old and has seen a ton of use, changed country a few times and backpacked around. I sure trust that one ... so what's the difference between mine and one thats been bought, turned on twice and put in a cupboard? ANS: that one is newer
twinsunnysideup
Member
Great information, thank you very much!
This has been the most frustrating thing I have ever come across. We are trying to purchase the device through our insurance because they will pay for it. However, the companies/entities that will sell it are either out of network (ebay and amazon included) or sell to physicians only. The INR Mafia (Roche, Alere etc) have put a system in place where they are forcing you to purchase a service and refusing to sell the device. It's INSANE
This has been the most frustrating thing I have ever come across. We are trying to purchase the device through our insurance because they will pay for it. However, the companies/entities that will sell it are either out of network (ebay and amazon included) or sell to physicians only. The INR Mafia (Roche, Alere etc) have put a system in place where they are forcing you to purchase a service and refusing to sell the device. It's INSANE
pellicle
Professional Dingbat, Guru and Merkintologist
twinsunnysideup;n859840 said:
your welcome
you live in the USA right?
https://mises.org/library/charles-hugh-smith-us-healthcare-debacle
I still say eBay ... the strips are available for cash too
best way ... I kid you not
RobThatsMe
Well-known member
Hi Twinsunnysideup,
Don't know what your age is, but, if you are on Medicare, you would qualify, and although that would also include the services with the unit,
it would all be covered, except for a few bucks each month, That would include the machine and supplies. But t of course that wont help if your daughter is the patient, e-bay may be the way to go, or; Do you happen to have any good friend that works in a medical supply store? It may be worth asking them to see if they could help.
Rob
Don't know what your age is, but, if you are on Medicare, you would qualify, and although that would also include the services with the unit,
it would all be covered, except for a few bucks each month, That would include the machine and supplies. But t of course that wont help if your daughter is the patient, e-bay may be the way to go, or; Do you happen to have any good friend that works in a medical supply store? It may be worth asking them to see if they could help.
Rob
DachsieMom
Well-known member
I know exactly what you mean. I am 6 months out of surgery. I spent weeks researching how to buy a Coagucheck, only to run into the same roadblocks you referenced (only sell to doctors, large insurance co never heard of it, etc.). In the end, as I met my out of pocket maximum due to surgery, I used Roche's service for two reasons- I had a terrible experience with Alere's customer service, and Roche gives you a new machine, without needing it back. I am too young for Medicare, so it costs $100 per month (which I will pay myself once January rolls around and I need to restart my deductible). Don't get discouraged - while it was basically impossible to confirm beforehand, it turns out the provider was is my network and is in many networks (and even less expensive withb some insurers). Additionally, it was very difficult to use at first - I wasted tons of test strips trying to figure it out (although you don't pay for supplies) - but now it's a breeze. I still can't convince my cardio that I should buy strips from Amazon, though!
twinsunnysideup
Member
Hi RobThatsMe and DachsieMom, thank you so very much for your input.
It's for my daughter and she is 12 years old. My nightmare continues. There are absolutely no cardiologists, anticoagulant clinics or anywhere to take a pediatric patient for a finger-prick INR test. NONE. And I live in a large metro area in the USA. She is now 5 weeks post-op and the continuous blood draws (twice a week most times) are difficult, painful and debilitating to her to the point where last week I had to pull her out of school the day she had a blood draw because she could not use her arm and hand (they had to stick her in several areas).
I will never use Coagucheck/Roche for 2 reasons: one is they stalled us with the paperwork and in the end said that, even though my insurance would pay for it, it's their company policy to follow medicare (remember that my daughter is 12) and to not provide her with a service until 3 months on warfarin, so they refused to do what's commonly called an Exception. Secondly, I don't see the need for a middle man and when our deductible starts again next year we have to pay out of pocket. Our cardiologist will not order one because this practice is simply too big, bureaucratic and out of touch, so i am trying to see if the pediatrician can do it.
It's for my daughter and she is 12 years old. My nightmare continues. There are absolutely no cardiologists, anticoagulant clinics or anywhere to take a pediatric patient for a finger-prick INR test. NONE. And I live in a large metro area in the USA. She is now 5 weeks post-op and the continuous blood draws (twice a week most times) are difficult, painful and debilitating to her to the point where last week I had to pull her out of school the day she had a blood draw because she could not use her arm and hand (they had to stick her in several areas).
I will never use Coagucheck/Roche for 2 reasons: one is they stalled us with the paperwork and in the end said that, even though my insurance would pay for it, it's their company policy to follow medicare (remember that my daughter is 12) and to not provide her with a service until 3 months on warfarin, so they refused to do what's commonly called an Exception. Secondly, I don't see the need for a middle man and when our deductible starts again next year we have to pay out of pocket. Our cardiologist will not order one because this practice is simply too big, bureaucratic and out of touch, so i am trying to see if the pediatrician can do it.
pellicle
Professional Dingbat, Guru and Merkintologist
Hi
well if you sidestep the wankers in the admin and just use the machine (private ownership) its a good reliable tool in my experience and considered a benchmark in various independent testing. Just because they employ dodos and their billing wing are bureaucratic fools doesn't mean you should dismiss the machine.
I still vote for "get a used one on eBay" ... I see that over the last 2 years they are now nearly double in price used as people are bidding on them (were falling under the hammer for US$250 at one stage back in 2013).
Best Wishes
twinsunnysideup;n860083 said:
well if you sidestep the wankers in the admin and just use the machine (private ownership) its a good reliable tool in my experience and considered a benchmark in various independent testing. Just because they employ dodos and their billing wing are bureaucratic fools doesn't mean you should dismiss the machine.
I still vote for "get a used one on eBay" ... I see that over the last 2 years they are now nearly double in price used as people are bidding on them (were falling under the hammer for US$250 at one stage back in 2013).
Best Wishes
DachsieMom
Well-known member
Regarding the 3 month issue, my insurance (not Roche) also required that I be on warfarin for 3 months before home testing. I was going to the lab weekly prior to home testing and constantly bruised. The finger prick is so much better. There is only one lab in my state which will do a finger prick, so home testing was the way to go for me. You could consider trying it for a bit - they may let you keep the machine, and you could buy your own supplies.
DachsieMom
Well-known member
Also, ask if her dr will prescribe Emla cream (not sure of spelling). It will numb before blood tests. Used it for my daughter once and she did not feel a thing.
I'm sorry that I've been away from this forum for so long.
Yes, I use the Coag-Sense meter. I've compared it to CoaguChek XS, ProTIme, and blood draws. In my experience, blood draws vary, depending on where you get the blood drawn. I used to get my blood draws at UCLA Olive View Medical Center, and the results were a few decimal points above those of my new lab, UCLA Medical Center. My blood is drawn at a satellite clinic and tested at the UCLA Hospital lab.
The blood draws are primarily just a check against my meters. My Coag-Sense results have consistently been .2 or .3 below those of the lab. The calculated prothrombin times,when compared to the UCLA lab, have been extremely close. I asked the CEO at Coag-Sense about the difference in calculation of the INRs -- I was told that both are within the accepted error rates -- and they are.
For me, as long as my Coag-Sense shows an INR above 2.0, I'm comfortable. I know that the labs will probably show something marginally higher.
The Coag-Sense meter uses a mechanical testing method that is similar to the 'tilt table' method that labs use. The Coag-Sense strip has a wheel that rotates inside the strip. The clotting of the blood stops the wheel from spinning, and a value that is specific to the batch of strips is used to calculate the INR. At times, comparisons with the CoaguChek XS show differences that are often higher, and sometimes, possibly, slightly out of the range of a blood draw.
As far as Coag-Sense vs. CoaguChek XS, while the XS is somewhat easier to use (because you can just touch a drop of blood onto the side of the strip), I prefer to trust my life to the Coag-Sense.
A few more things:
I do NOT work for Coag-Sense, although I was introduced to the CEO of the company through emails that we've sent back and forth. I have no financial interest in the company.
I somehow wound up with Three Coag-Sense meters, but really, only need one. All three were recently upgraded with new firmware, by the company. The cost of a box of 50 strips is comparable to the price of CoaguChek XS strips. (There was a recent auction on eBay of strips that were still valid for more than a year - 46 strips were offered, and the asking price was 29.95 plus 9.99 shipping. If I didn't already have a year's supply of strips, I would have bought these.) If you are interested in buying one of my meters, IM me at this forum.
Coag-Sense is less well known, and probably far overshadowed by the Roche goliath marketing machine, but it's a really good, reliable meter. As I said, I trust my life to it. I trust the CoaguChek XS, also, but prefer the slightly lower results on the Coag-Sense over the slightly higher results from the CoaguChek XS. (In other words, I'd be comfortable with a 2.0 on the Coag-Sense, but if the CoaguChek XS gave me a 2.0, I'd probably want a blood draw to confirm that right away).
I plan to visit this forum more often than in the recent past.
.
Yes, I use the Coag-Sense meter. I've compared it to CoaguChek XS, ProTIme, and blood draws. In my experience, blood draws vary, depending on where you get the blood drawn. I used to get my blood draws at UCLA Olive View Medical Center, and the results were a few decimal points above those of my new lab, UCLA Medical Center. My blood is drawn at a satellite clinic and tested at the UCLA Hospital lab.
The blood draws are primarily just a check against my meters. My Coag-Sense results have consistently been .2 or .3 below those of the lab. The calculated prothrombin times,when compared to the UCLA lab, have been extremely close. I asked the CEO at Coag-Sense about the difference in calculation of the INRs -- I was told that both are within the accepted error rates -- and they are.
For me, as long as my Coag-Sense shows an INR above 2.0, I'm comfortable. I know that the labs will probably show something marginally higher.
The Coag-Sense meter uses a mechanical testing method that is similar to the 'tilt table' method that labs use. The Coag-Sense strip has a wheel that rotates inside the strip. The clotting of the blood stops the wheel from spinning, and a value that is specific to the batch of strips is used to calculate the INR. At times, comparisons with the CoaguChek XS show differences that are often higher, and sometimes, possibly, slightly out of the range of a blood draw.
As far as Coag-Sense vs. CoaguChek XS, while the XS is somewhat easier to use (because you can just touch a drop of blood onto the side of the strip), I prefer to trust my life to the Coag-Sense.
A few more things:
I do NOT work for Coag-Sense, although I was introduced to the CEO of the company through emails that we've sent back and forth. I have no financial interest in the company.
I somehow wound up with Three Coag-Sense meters, but really, only need one. All three were recently upgraded with new firmware, by the company. The cost of a box of 50 strips is comparable to the price of CoaguChek XS strips. (There was a recent auction on eBay of strips that were still valid for more than a year - 46 strips were offered, and the asking price was 29.95 plus 9.99 shipping. If I didn't already have a year's supply of strips, I would have bought these.) If you are interested in buying one of my meters, IM me at this forum.
Coag-Sense is less well known, and probably far overshadowed by the Roche goliath marketing machine, but it's a really good, reliable meter. As I said, I trust my life to it. I trust the CoaguChek XS, also, but prefer the slightly lower results on the Coag-Sense over the slightly higher results from the CoaguChek XS. (In other words, I'd be comfortable with a 2.0 on the Coag-Sense, but if the CoaguChek XS gave me a 2.0, I'd probably want a blood draw to confirm that right away).
I plan to visit this forum more often than in the recent past.
.
twinsunnysideup
Member
Thank you all so much for your feedback.
DachsieMom, even with the numbing cream which we used every time it was pretty bad. Somehow it's difficult to draw blood on my daughter. I guess some people are just like that.
However, it's MUCH BETTER now that we got the device.
Protimenow, thank you for the offer, I really appreciate it but we went ahead and purchased the Coag-Sense back in November. It's truly been life saver and we love it!
In terms of the heart surgery, I figure I will just go ahead and mention in case someone has some feedback, my daughter received the On-X valve 23mm in the aortic position. She is doing remarkably well but the valve is loud, although at school none of the kids have apparently heard it at all. The other thing is she developed PVCs right after surgery while still in the hospital and it hasn't gone away. The PVCs account for 4% of the rhythm so her doctor says he isn't worried at this point, only if its at 20% or so. I'm not very comfortable with this though because this is her 3rd surgery and never happened before.
As far as her INR, because she has the On-X valve at 3 months post-surgery the doctor OK a lower INR regimen so her range is 1.5-2.5 which is great.
DachsieMom, even with the numbing cream which we used every time it was pretty bad. Somehow it's difficult to draw blood on my daughter. I guess some people are just like that.
However, it's MUCH BETTER now that we got the device.
Protimenow, thank you for the offer, I really appreciate it but we went ahead and purchased the Coag-Sense back in November. It's truly been life saver and we love it!
In terms of the heart surgery, I figure I will just go ahead and mention in case someone has some feedback, my daughter received the On-X valve 23mm in the aortic position. She is doing remarkably well but the valve is loud, although at school none of the kids have apparently heard it at all. The other thing is she developed PVCs right after surgery while still in the hospital and it hasn't gone away. The PVCs account for 4% of the rhythm so her doctor says he isn't worried at this point, only if its at 20% or so. I'm not very comfortable with this though because this is her 3rd surgery and never happened before.
As far as her INR, because she has the On-X valve at 3 months post-surgery the doctor OK a lower INR regimen so her range is 1.5-2.5 which is great.
pellicle
Professional Dingbat, Guru and Merkintologist
Hi
try this method ... and remember, lance the side not the tips of the finger. Using this method you can lance shallower and still get a good droplet
sure, I'm using a coaguchek, but everything else is the same (finger, need a minimum amount of blood...)
twinsunnysideup;n862142 said:
try this method ... and remember, lance the side not the tips of the finger. Using this method you can lance shallower and still get a good droplet
sure, I'm using a coaguchek, but everything else is the same (finger, need a minimum amount of blood...)
pellicle
Professional Dingbat, Guru and Merkintologist
Protimenow;n862141 said:
good to see you back mate ... hope you've been well
twinsunnysideup
Member
pellicle, this is great! Thank you. I haven't had as much trouble with the finger prick but will definitely try your method. For some reason we haven't been doing the side of the finger although now that you mentioned it, I think that is what the instructions said.
One more suggestion -- since your daughter is 12 years old, she may have fun waving her arms around - over her head, to her sides, like a boat motor, or something like this, so that it will cause the blood to go to her hands. For myself, I find that, after shaving my face, the warm water and movement of my hands also makes it easier to get the blood for testing.
You might even have HER do the lancing - it may not feel as bad when a person does it to herself as it does when someone else (yeah, even a parent) does it.
I suspect that she (I didn't look back at the original post, but think that you said this was for your daughter) watches that wheel inside the strip - if not, it may be amusing for a few times. This is a visible sign that the blood is clotting, and watching and waiting for the wheel to stop spinning may be a good distraction.
You might even have HER do the lancing - it may not feel as bad when a person does it to herself as it does when someone else (yeah, even a parent) does it.
I suspect that she (I didn't look back at the original post, but think that you said this was for your daughter) watches that wheel inside the strip - if not, it may be amusing for a few times. This is a visible sign that the blood is clotting, and watching and waiting for the wheel to stop spinning may be a good distraction.
Interesting times, Pellicle, Interesting times.
pellicle
Professional Dingbat, Guru and Merkintologist
Hi
glad I can help. Perhaps its also worth experimenting with reducing the lance depth needed. The purpose is to get a blood sample of adequate size not to plumb the depths of the skin
I found that in the early days I wasn't getting good enough blood droplet sizes and was wasting strips. I'd lance progressively deeper. That would result in my finger being sore for days. I've found that this method allows me to minimise that hurt and not waste test strips (even in winter).
the lancing over time destroys nerves at the lancing site. Ask a diabetic. The idea of the side is to prevent loss of sensitivity on parts of the finger which are important for many other things (like picking things up).
glad to help
twinsunnysideup;n862153 said:
glad I can help. Perhaps its also worth experimenting with reducing the lance depth needed. The purpose is to get a blood sample of adequate size not to plumb the depths of the skin
I found that in the early days I wasn't getting good enough blood droplet sizes and was wasting strips. I'd lance progressively deeper. That would result in my finger being sore for days. I've found that this method allows me to minimise that hurt and not waste test strips (even in winter).
the lancing over time destroys nerves at the lancing site. Ask a diabetic. The idea of the side is to prevent loss of sensitivity on parts of the finger which are important for many other things (like picking things up).
glad to help
