Don't believe my meter

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olefin

olefin

Old Fart
Supporting Member
Joined
Jan 22, 2009
Messages
884
Location
ARBut really a Texan at heart!
Below are the test results since I started home testing. Feb 23 09. Testing weekly except one day when tested at lab.

2.9 7mg
2.6 7mg
4.0 7mg lab 3.4 reduced to 6mg
4.9 6mg
4.2 6mg
3.9 6mg
3.7 6mg
..... 6mg lab 3.4
3.5 6mg
2.4 6mg increased to 7 mg
5.9 7mg tested other hand, 7.1 !!


Today I didn't believe the 5.9 so I immediately tested again in my other hand and got a 7.1!
The INRatio2 meter shows no errors.
Anybody had this problem?
 
Did you drop your machine? If not I would return it as defective, and get a new one.
 
Sorry, lighting storm, off line.
No, I haven't dropped the meter.

Update... right after my post I called QAS.
They suggested testing my wife. Wife tested 1.1
Wifes test was from a new box of strips.
QAS suggested testing myself again, since I had gone to a new box of test strips.
My retest showed 6.8.
After testing wife, I believe the meter!

It's after hours will contact my cardiologist in the morning. I'm sure he will want a lab test.
 
Dayton

Dayton

I am so sorry you are having these problems so soon after getting your monitor.

In the 8 years that we have had monitors, (well, 8 years for Al and 3 years for me), we have both had INRs that seemed to make no sense whatever.

The first thing we used to do was to test me...when I was not on anticoagulation. Imagine our surprise when Al's reading of INR=7.5 was followed by my reading of INR=1.1. The doctor reqired a STAT lab test, which showed 6.9. We have no thoughts about what did this. As far as we knew, nothing had changed.

Another time, not so long ago, Al got an INR=9.5...which is the highest possible on the INRatio. Again don't know what caused the trouble. There are so many anomalies that we have had with both the ProTime monitor and the INRatio that all I can say is. Welcome to the vagaries of anticoagulation.

May I suggest that you contact the doctor who oversees your home testing...that would probably be the doc who writes the scripts for the anticoagulant. Al Capshaw's advice about getting another test is excellent, but I don't especially see a blood draw as being the Gold Standard here. A blood draw is fine, but comaprison with another finger stick should be able to give needed information. IMO, you should see professional medical assistance on this.

I wish you the very best. This will be solved in a good manner soon. It will be hard for you, so I wish youpatience and strength.

Kind regards,
Blanche
 
Well, I guess your meter's probably right. I haven't been that high in quite a while, but remember that the nurse at my cardio's office said the machines aren't real accurate at the higher ranges. You just know you're high.
 
Well, then, there, now....

Well, then, there, now....

Dayton:
As soon as I finished my post to you, I see that you have solved your concerns about the reliability of your monitor.

When my INR was very high, our doc suggested that I skip for 2 days and....I asked him to let me decrease my coumadin intake by 50% for two days, with his blessing to eat all the salads and spinach I could devour.

Our doctor agreed to the 50% reduction in anticoagulant, and then told me that he was not going to make salads for me. Things went back to normal very quickly.

Blanche
 
Dayton:

Are you possibly becoming more sensitive to warfarin?
You're an aortic valver, aren't you? If so, why did you increase your dosage when you got the 2.4? You were on 6mg then.

What about dropping your dosage back to 6.0... take a half dose tonight (3mg), then go to 6.0 for 3-4 nights, see what that does. If it's still fairly high, drop it by 0.5 down to 5.5 and see what that does.

Is your activity level fluctuating? Started/stopped any meds, either OTC or RX?
 
catwoman said:
Dayton:

Are you possibly becoming more sensitive to warfarin?
You're an aortic valver, aren't you? If so, why did you increase your dosage when you got the 2.4? You were on 6mg then.

What about dropping your dosage back to 6.0... take a half dose tonight (3mg), then go to 6.0 for 3-4 nights, see what that does. If it's still fairly high, drop it by 0.5 down to 5.5 and see what that does.

Is your activity level fluctuating? Started/stopped any meds, either OTC or RX?
Click to expand...

Interesting catch Catwoman!

Maybe the 2.4 was a False Low???

Dayton - Do you have a copy of AL Lodwick's Dosing Guide?
(or any other Dosing Guide?)
 
Dayton, your INR of 2.4 should not have needed such a drastic increase in dosing.
You might have tweaked it up a bit, but not more than a tweak.
The daily 6mg (42mg weekly) was increased to 7mg (49 weakly) that is a BIG bump up.
 
Thanks Blanche.


Are you possibly becoming more sensitive to warfarin?
Click to expand...
I don't think so, my INR has always been pretty wild.

You're an aortic valver, aren't you? If so, why did you increase your dosage when you got the 2.4? You were on 6mg then.
Click to expand...
Because my control is 2.5 to 3.5. And it had dropped 1.1 from the week before. Also few weeks before I was at 7mg.

Last week after getting the 2.4 I almost retested. I now wish I had but that's past.

Is your activity level fluctuating? Started/stopped any meds, either OTC or RX?
Click to expand...
No to all. I fast walk 3 miles every day... everything has been routine all week.

One thing has changed but I wouldn't think it had anything to do with the big change... for the past week I've started switching to warfarin. The past week I took 2 mg warfarin and 5 mg coumadin.

Dayton - Do you have a copy of AL Lodwick's Dosing Guide?
(or any other Dosing Guide?)
Click to expand...
Yes, I have Lodwick's Dosing Guide.

Since it's after hours I've made the decision to not take any warfarin/coumadin. tonight. Will contact my cardiologist the first thing in the morning.

Thanks Catwoman a and Al for your input.
 
I'm always able to adjust with 5%....either up or down.
If you had been on a nose dive, then your increase of 7mg per week may have been successful, but sometimes we just don't know exactly what our bodies are doing, and maybe a 10% increase (4 or 5 mg) would have been enough.
Not to worry, you will be fine. :)
 
Outrageous...Mark get a grip

Outrageous...Mark get a grip

Since you tell us that you are a highly educated person, who has much experience with statistics, may I suggest that you think before you leap. Having said that, what you are doing here is outrageous. You are not using your education or your good mannars and courtesy.

You have hijacked almost every post you have made here. Stop this insanity. I worry about you and I care about you...But, you are out of control. We are here to help each other, not to try to controvert things are said in support of others.

And, Mark, if you read this thread beyond the first posts you would see that indeed the problem was not a problem of one's meter. I would think you should be dreadfully ashamed of yourself. Get a grip on yourself man.

You told me that you...(paraphrasing) tell it like it is. Well, this is my tell it like it is. I think you have much to contribute here and would like to be able to call you friend. But, so far, all I have seen from you is disrespect, discord, and indifference to others.

This is not your thread....This is your friend's thread. Help your friend...

Blanche
 
Dayton, you increased your dose by 17%, which is too much, especially for 0.1 off, which is statistically insignficant. What I would have done is tested again in a week to see if it was a fluke or a trend. It sounds like you are bouncing between 6 and 7 mg per day, and sometimes even after lowering your dose, your INR went up. I noticed that you are testing in the lab occasionally. which is good, but the one time you did both, they weren't close. I am assuming there was a gap between the two tests? Have you taken your machine with you so you can do the home test within minutes of the lab draw to make sure it is calibrated correctly? I'm thinking 6.5 mg is where you should be, but with the numbers bouncing around, it's difficult to tell.
 
Just got off the phone with my Cardiologist.
He said I did the right thing by skipping last night dosage. Said to start back Friday with 6 mg and retest Monday. My lab test is due next Wednesday.

I agree, the increase was 1 or 2 mg high but I doubt that was what caused the large INR increase. The week before I started testing, the lab showed 2.1. Dosage was increased from 6 mg to 7 mg, next week, I tested 2.9, the next week 2.6. If I'm out of control, I prefer to be at the high end. I've been there several times.

May be some good come of this... now the doctor sees how fast my INR changes. Also he's going with the meter reading and not requesting me to come in for lab test. ;)
I think testing my wife while I was showing high probably increased his faith in my meter.

I noticed that you are testing in the lab occasionally. which is good, but the one time you did both, they weren't close. I am assuming there was a gap between the two tests? Have you taken your machine with you so you can do the home test within minutes of the lab draw to make sure it is calibrated correctly?
Click to expand...
The test were done within 10 minutes. But he sends his blood work to another city and doesn't get results until the next day.
 
Olefin please don't take this as idiotic, but you do have the correct strip code entered into the machine for your strip right? If it's the wrong code, that could be why.
 
I've seen ISI of 2.0 mentioned before but I don't remember what instrument that was for.

Another note, while the RATIO does cancel out one factor, I wonder about the Accuracy and Variation there is in the ISI number. I don't even know what factors determine ISI. Maybe I need to review my Protime Book :)

'AL Capshaw'
 
Dayton:

With the 2.4 -- even though your range is 2.5-3.5 -- I wouldn't have adjusted it for that slight of an "out of range" INR. Even though your range is 2.5-3.5, for an aortic valver, the 2.4 is still acceptable.
For a mitral valver, that's another story.

Because your INRs have bounced around for a while, I doubt that the switch to warfarin is a factor since it appears that you were on Coumadin with these early INRs you posted.

Those are just hunches off the top of my head.
 
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