Coumadin Rookie

[brocansky]

I'm having my BAV replaced and my aortic root replaced on Monday, Jan 9th. I'll be receiving a St. Jude valve and I'm feeling very overwhelmed reading all your posts about blood testing. I am sure hoping I get a good training about all of these acronyms (I don't even know what INR is ) when I'm in the hospital. I'll be relying on you guys to help me out for sure.

My question is about the home test unit. Is this something insurance pays for? I understand the price is around $2,000, yes? I have Blue Shield HMO. Do you have any advice about what I should be learning in my last few days before surgery?

thanks
Michelle

 

[hensylee]

mICHELLe, my brother has to have his blood checked every month, but he's in assisted living facility and the nursing staff doesn't do it for him. I take him to local hosp lab and they take the blood, test it, send results to his cardio, who then decides if it's in range (between 2.5 and 3, I think) and makes any necessary adjustments in his coumadin.

Al Lodwick is our official coumadin man - it's his profession. At the end of all his posts, he shows his web page. He will answer questions here, but if you go to his web page, you'll get answers there, too. Of course, members will be along shortly to help you along, too.

Insurance does pay for the machine, but you have to go through your doctor.

When you come into VR, just ask a question and many will answer it.

 

[Karlynn]

Yes, definitely check out Al's web site at www.warfarinfo.com

INR is just a fancy acronym for the number assigned to how fast the blood forms clots. A normal clotting factor is 1. Those of us on ACT (AntiCoagulation Therapy) usually have a target range anywhere from 2 - 4. For an AVR it's 2 - 3, but many people have other factors involved that push the target area up higher. I'm a mitral valver and mine is 2.5 - 3.5.

Most of us like to keep our INR's on the higher side of the range, just for a safety cushion and it's much easier to lower an INR that's too high, than to raise an INR that's too low.

Home testing is great, and will do a good job of helping you stay in range. Check to see if the hospital you are having your surgery at has any sort of home-testing program, or study group. I know Mayo Clinic has a program going where they send a lot of their ACT patients home with testing units.

Many insurance companies do cover the cost of a home unit and supplies. The best way to go about finding out if your company will, is to contact QAS. You can find their number by clicking on their banner link at the top of each Valve Replacement page. They will do all the leg work for you and are very nice to work with.

QAS will require a prescription from your doctor as one of the first steps. Hopefully your doctor will be on-board with home testing. The majority are, but some are still in the dark ages and take some convincing. If your doctor balks at the idea ask him if he would have you go to a lab 2 - 3 times a day to get your blood test for your blood sugar reading if you were diabetic. If he says "No", or "Don't be silly." ask him why he thinks it would be so much harder for you, to stick your finger, put a drop of blood in a machine and call him with the INR number, than it would be to stick your finger, put a drop of blood in a machine and call him with the blood sugar number. (And most diabetics don't even call, they just figure out their own insulin dose). The only difference is with INR, you would be doing this 1 time a week at the most, not 2 - 3 times a day like diabetics must.

I know your surgery will be successful. While this is a scary process, it's an oft done surgery.

Keep asking questions - the more you know, the better you will feel.