Home Testing since COVID?

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tom in MO

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I'm glad your insurance covers that Tom... unfortunatly, my insurance refuses to cover it. Hopefully someday that will change, but for now, I can go monthly to the coumadin clinic, or when my work forces me to miss my appointment, I may go longer than I should between INR screenings. This is unacceptable to me. I don't want to bet my life on something that is unknown either, but I sure don't want to make my testing longer than needed too. Neither option is good.
Since insurance doesn't cover it, I'd still ask your cardiologist or their nurse. I thought about getting my supplies outside of my insurance network and my cardio's nurse was helpful. Things change too, if it's been awhile since you were denied, ask again. Home testing is the standard for care.
 

RAS

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Omaha, NE
I cannot find the test strips anywhere from a licensed durable goods supplier,
I get all that, but as I stated above, my insurance does not cover the service,
Here are the options I have on my list which I compiled about 18 months ago. I went with the Remote INR service.
  1. Remote INR Service (Bio-Tel): Provides device and all supplies (Coaguchek). Requires Rx. Bills each 4th reported test. Insured cost depends on your particular insurance plan. Since my plan covers this provider, I did not ask for cost outside of insurance.
  2. Acelis Connected Health: I think they also use Coaguchek device/strips. Requires Rx. Cost outside of insurance $120 per box of 6 strips. I think they provide the device as well, but not sure.
  3. mdINR PT/INR At Home Monitoring Service. I did not get any details on this one, but probably similar to above.
  4. BerryMedics: They sell Coaguchek strips, but not the device. $130 for 24 strips outside of insurance. Rx apparently not required. They are BBB accredited. You would need to buy the device somewhere.
 

Protimenow

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I've skipped past some of the repetitive stuff in earlier messages to get to what I think is the real point.

If you previously self-tested (using that damned InRatio meter), self testing again shouldn't be a big deal.

The meters - CoaguChek XS, Vantus, or Roche's new model, or the Coag-Sense all come with built in quality control.

They have to.

These meters are used in clinics, doctor's offices, and possibly even hospitals, and people use them for home testing.

Some meters probably do hundreds of tests a week.

They're designed to do thousands of tests - all tests must be within 20% of 'actual' INR (there's no such thing as an exact INR).

I wouldn't worry about buying a used meter - all but one of my meters has been used - and all have given 'accurate' results. I bought a used XS, missing the blue strip guide and battery cover, for $30. There's supposed to be a plastic piece that can make the meter functional - I didn't get one with my meter, but found that I can slide half of a used strip in the area where the blue guide used to be, and it worked. You may also be able to talk Roche into helping you.

These meters seem to have gone up in price - but I haven't checked eBay for a few weeks.

In regards to the strips - most sellers indicate the expiration date of the strips. In boxes of 24 or 48, strips sell for around $4 or so, each.

There are a lot of us, myself included, who manage our INRs. If you need help, Pellicle is a great resource.

If you're not comfortable with self-management, the expensive services can ask your doctor to do it for you -- or, perhaps, you can call your result in to you doctor and hope that you get good dosage advice. In my experience, the people here know a lot more about INR management than most doctors or clinics. We have to - our lives depend on it.
 

perrybucsdad

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Location
Perry Ohio
I've skipped past some of the repetitive stuff in earlier messages to get to what I think is the real point.

If you previously self-tested (using that damned InRatio meter), self testing again shouldn't be a big deal.

The meters - CoaguChek XS, Vantus, or Roche's new model, or the Coag-Sense all come with built in quality control.

They have to.

These meters are used in clinics, doctor's offices, and possibly even hospitals, and people use them for home testing.

Some meters probably do hundreds of tests a week.

They're designed to do thousands of tests - all tests must be within 20% of 'actual' INR (there's no such thing as an exact INR).

I wouldn't worry about buying a used meter - all but one of my meters has been used - and all have given 'accurate' results. I bought a used XS, missing the blue strip guide and battery cover, for $30. There's supposed to be a plastic piece that can make the meter functional - I didn't get one with my meter, but found that I can slide half of a used strip in the area where the blue guide used to be, and it worked. You may also be able to talk Roche into helping you.

These meters seem to have gone up in price - but I haven't checked eBay for a few weeks.

In regards to the strips - most sellers indicate the expiration date of the strips. In boxes of 24 or 48, strips sell for around $4 or so, each.

There are a lot of us, myself included, who manage our INRs. If you need help, Pellicle is a great resource.

If you're not comfortable with self-management, the expensive services can ask your doctor to do it for you -- or, perhaps, you can call your result in to you doctor and hope that you get good dosage advice. In my experience, the people here know a lot more about INR management than most doctors or clinics. We have to - our lives depend on it.
Yes, that darn INRatio meter.

You know, you talk about the Roche's meter's doing a self test, but I believe the INRatio also did a self test, which is why I never understood the issue with the test strips. I still have a few strips (well past their expiration) and I have used them at times when I missed my appointments. In fact, I just used one the same day I went for my last INR and it was extremely close to what was reported on at the lab with their CoaguChek. Mine was 2.4 and theirs was 2.5.

Since I live in Cleveland, I go to Cleveland Clinic for my cardiology care, and unfortunatly the doctors just don't have the time for me calling in the results. Now, I might be able to get the Coumadin Clinic to go along, but I think what I will just do is keep my monthly appointments, and use my meter to test in between appointments to keep a better track on it. I do have a nonmogram that was given to me years ago by my cardiologist when he was with a different hospital. He was my cardiologist when I was in my 30's and now again when I am in my 50's, so I'm lucky in that sense. I still would not self adjust without the Coumadin Clinic directing though, but it comes in handy when you get a nurse who wants to make some huge adjustment and you know that should not be the case.
 

perrybucsdad

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Perry Ohio
OKay, so I received my Coaguchek meter today, and I have never had an issue with testing in the past with my other testers (not CoaguChek), but I have gotten three Error 5 results in a row. Before I waste a 4th strip, what could be causing this? In the manual it just says Error applying blood to the test strip. Okay, so what am I doing wrong?

Steps I'm doing are:

Insert new strip from tube, and verify the code is correct.
While waiting for warm up, clean my finger and dry it
Use clicker
Squeeze finger to get a nice blood drop
hold my finger next to the strip (I believe I want it on the side where the clear part is?)
Wait until it beeps, then take finger away
Then I get Code 5 ... Grrrrr
 

Christyleedh

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Oct 22, 2021
Messages
21
OKay, so I received my Coaguchek meter today, and I have never had an issue with testing in the past with my other testers (not CoaguChek), but I have gotten three Error 5 results in a row. Before I waste a 4th strip, what could be causing this? In the manual it just says Error applying blood to the test strip. Okay, so what am I doing wrong?

Steps I'm doing are:

Insert new strip from tube, and verify the code is correct.
While waiting for warm up, clean my finger and dry it
Use clicker
Squeeze finger to get a nice blood drop
hold my finger next to the strip (I believe I want it on the side where the clear part is?)
Wait until it beeps, then take finger away
Then I get Code 5 ... Grrrrr
I make sure I have a large enough drop. I used to use a different lancet and it didn’t give me enough blood and I use to get error messages all the time. I drop the blood on top of the strip, and not the side. Maybe that is the problem?
 

Chuck C

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Dec 5, 2020
Messages
1,176
OKay, so I received my Coaguchek meter today, and I have never had an issue with testing in the past with my other testers (not CoaguChek), but I have gotten three Error 5 results in a row. Before I waste a 4th strip, what could be causing this? In the manual it just says Error applying blood to the test strip. Okay, so what am I doing wrong?

Steps I'm doing are:

Insert new strip from tube, and verify the code is correct.
While waiting for warm up, clean my finger and dry it
Use clicker
Squeeze finger to get a nice blood drop
hold my finger next to the strip (I believe I want it on the side where the clear part is?)
Wait until it beeps, then take finger away
Then I get Code 5 ... Grrrrr
I had an error message about the 10th time I tested. I think it was same as yours, 5. If you look at page 35 of your Manual there are instructions for cleaning the Strip Guide with alcohol. I cleaned it and all was good going forward. Even without an error message this seems like a good practice from time to time.

I know that I have received this message for blood drops that were too small since then. It is one of those situations where I can tell that the drop is borderline in size and I go through that: "Hmmm, looks a little small, do I feel lucky?" And, sure enough, sometimes it comes up error 5.

Having lost a few strips from small drops, I now do the following:
-Do as many push ups as I can for a couple of sets to get good blood flow to the arms.
-Warm my hand- I like to use a heating pad for a couple of minutes
-just before pricking, I actually swing my arm back and forth vigorously, which forces the blood towards the hand via centrifical force.

If I follow all of the above I almost always get a good drop.
 

perrybucsdad

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Location
Perry Ohio
Okay.. maybe the side is (I always give it a nice sized drop of blood). When I go to the Coumadin Clinic, they have the hospital version of the tester, and he always takes the unit, and slides the strip across the blood drop (sort of like sliding a butter knife across your finger so that the side of the knife is touching the finger) and it looks like it "scoops" the blood onto/into the strip. Maybe the other (their) tester has different strips? I thought they were all the same.
 
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Chuck C

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Okay.. maybe the side is (I always give it a nice sized drop of blood). When I go to the Coumadin Clinic, they have the hopital version of the tester, and he always takes the unit, and slides the strip across the blood drop (sort of like sliding a butter knife across your finger so taht the side of the knife is touching the finger) and it looks like it "scoops" the blood onto/into the strip. Maybe the other (their) tester has different strips? I thought they were all the same.
Their method might result in fewer errors from small drops, but I would be hesitant to go away from the instructions, per the manual, which is from the side. See attached image from the manual. But, not sure if they have a different Coaguchek device with different protocal at your clinic.
 

Attachments

perrybucsdad

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Their method might result in fewer errors from small drops, but I would be hesitant to go away from the instructions, per the manual, which is from the side. See attached image from the manual. But, not sure if they have a different Coaguchek device with different protocal at your clinic.
The method in the manual was how I did the first test, and it was an error 5. Who knows....

On a different note, does anyone know where to find a little carry case for the device, the finger pricker, and the tube of test strips for when I travel? I really don't want to just throw this loose in a travel suitcase or something.
 

pellicle

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On a different note, does anyone know where to find a little carry case for the device, the finger pricker, and the tube of test strips for when I travel?
it didn't come with one?


Mine has this, and I just put that little thing zipped up into my carry-on.

Dimensions

IMG20211125124716.jpg

I've taken it on quite a few (including long haul) flights and trips just like that

if not this looks adequate:

but I would suggest adding a bit of stiffening or perhaps just using a CD case (which this looks like it started life as ...
 
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perrybucsdad

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No, I bought mine used, and it was just the unit. Those cases are nice for the ladies I guess, but was looking for something that was more plain like the original one.
 

Redone

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Boston, Massachusetts
it didn't come with one?


Mine has this, and I just put that little thing zipped up into my carry-on.

Dimensions

View attachment 888238
I've taken it on quite a few (including long haul) flights and trips just like that

if not this looks adequate:

but I would suggest adding a bit of stiffening or perhaps just using a CD case (which this looks like it started life as ...
Where is the best place to purchase the kit?
 

pellicle

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Where is the best place to purchase the kit?
I'm Australian, but for you I'd say eBay. I recommend you reach out to @Chuck C for advice on this matter.

A good second hand one should be under $150. Second hand ones are generally sold by a family who purchased one for an elder parent, that person didn't use it, it gets sold. The only thing I've ever seen go wrong with these is that (cheap) batteries were left in for a long time and they leaked, or a button was damaged by some (perhaps ham fisted) press. As an old electronics tech I'd say buttons are generally good for a few thousand presses.
 
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pellicle

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Those cases are nice for the ladies I guess, but was looking for something that was more plain l
Similar auctions showed identical units to the one I mentioned in black, blue and other plain colours. However I understand that for the fashion conscious it would look odd at the dinner table or in a restaurant.

Same seller different auction had this:
1637871673080.png


Indeed at the bottom of the page in "sponsored similar items" we see this:
1637871505778.png


Looks pretty good actually (removable sections even) ... does that go with your decor?

and "you're welcome" (thanks for not even saying thanks to me feeding you options at no charge).
 
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pellicle

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Protime makes a good point here, worth expanding upon

They're designed to do thousands of tests
To this point my meter has done something like (on average and conservatively) 60 tests per year, over the time I've used it that makes for at least 540 tests (I'll leave it as an exercise for the reader to determine over what duration this is).

I know it only has a limited warranty but like most quality (made in Germany) electronics it will either fail soon or last for decades (who has ever had a stereo that lasted like 20 years). So that works out that the meter has cost less than a buck a test. When adding a $6 charge for the strips soon the meter is insignficant.

One can't even drive to the clinic (let alone pay for parking or account for down time from work) at this rate. If you have a mechanical valve you need to actually look into the future and anticipate the requirement for this. I mean its what I call a "no brainer".
 
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Redone

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I'm Australian, but for you I'd say eBay. I recommend you reach out to @Chuck C for advice on this matter.

A good second hand one should be under $150. Second hand ones are generally sold by a family who purchased one for an elder parent, that person didn't use it, it gets sold. The only thing I've ever seen go wrong with these is that (cheap) batteries were left in for a long time and they leaked, or a button was damaged by some (perhaps ham fisted) press. As an old electronics tech I'd say buttons are generally good for a few thousand presses.
Great! Thank you 🙂
 

perrybucsdad

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Perry Ohio
Similar auctions showed identical units to the one I mentioned in black, blue and other plain colours. However I understand that for the fashion conscious it would look odd at the dinner table or in a restaurant.

Same seller different auction had this:
View attachment 888240

Indeed at the bottom of the page in "sponsored similar items" we see this:
View attachment 888239

Looks pretty good actually (removable sections even) ... does that go with your decor?

and "you're welcome" (thanks for not even saying thanks to me feeding you options at no charge).
The one case you have the red box around looks perfect. I just ordered one. Hopefully the unit will fit in one of the pockets. Nice part is I can also store by glucose tester in it too.

I remember the old testers. I had bought one in the early 2000's. I forget who made it, but I recall I had to refrigerate the test strips (well, they were more like hard plastic slides). I forget why I stopped using that one. It was larger, possibly 12" x 4" x 3". Then I went to the INRatio. I recall that was not cheap when I bought it. I've never been fortunate to have insurance pick up the cost on any of them or the supplies.
 

pellicle

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Then I went to the INRatio. I recall that was not cheap when I bought it. I've never been fortunate to have insurance pick up the cost on any of them or the supplies.
oddly enough in Australia there is totally no support for (balanced by no resistance to) meters. Our health insruances act like they don't exsit. However as I mentioned earlier they are essentially $1 / test over time and the strips are $6.

In my vernacular I'd call that a non issue (I spend far more on wine)
 
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