Hometest results vs. Hospitals

[Diesel]

Well i am so excited i finaly got my INRatio home testing machine. It is very easy to use! My doctors are anxious to learn more about this machine since i am thier first patient requesting to home test.

I had the nurse from the company call me and walked me through my first test. My INR on that day was 3.3 wich is within range for me. My range is suppose to be 3.0-3.5

Now here is where i have my questions... My cardio wants me to first hometest in the morning and then go to the hospital on the same morning to see what the difference is in the results. Knowing that there could be a slight difference. But he wants to see what the differece is. So im suppose to do this the first three times i home test (go to the hospital to get thier results to compair)

SO my first home test that I did (that would count for my cardio) My home test result said. 2.8 (which would be low for me) BUT the hospital results came back and it said 3.4 (which would be in range)

SO how do i know what numbers are right, or how to make my numbers closer? They never said anything about "calabrating" the machine or anything. But My cardio isnt going to like it, if the numbers are that much difference. Concidering hometest says im low, when the hospital test says im in range.

My cardio said to re-test on tuesday at home then go to the hospital on the same morning to get our results again...

Does anyone have any thoughts to why the results are off.. Any suggestions on what to do?

DIesel

 

[Diesel]

[Okay so i know im replying on my own thread. But thats because i just scrolled down and realized that others are having close to the same problem.

But im still interested in how to tell if i truely am "low" or truely am "in range" or "high"

WHat do i do? cause the doctor gave me my dose of meds according to the Lab Draw (that said i was in range) Where i thought i should be doseing my meds according to my home test kit (which said i was low)

THOUGHTS PLEASE...............
Diesel

 

[geebee]

My lab tests and my INRatio tests always vary by about .6 or so. I go by my home test results for dosing because I truly believe they are more accurate. Lab tests can sit around which can affect results. I also believe (rightly or wrongly) that there is a difference in vein draws versus finger tip sticks. I put my trust in the INRatio. Also, a 2.8 versus 3.4 is not all that off when you consider tests can vary by up to .4 plus or minus.

You just have to talk to your cardio and get him to understand that even if you up your dose a little for a 2.8 result, it is better to have an INR that is a little higher than your range than too low.

 

[jeffp]

I ran into the same situation, but in the other direction. See my thread:
http://www.valvereplacement.com/forums/showthread.php?t=12649
I am planning to get a draw done at the hospital (different lab company) on a STAT basis in about 2 weeks and check it against the INRatio. I will let everyone know how it turns out with a message in the thread. (I still am going by the home tester reading vs the labs.)

 

[Ross]

I have a .6 difference everytime I try what they are having you try. .6 is the limit as stated in the instruction book that came with the unit. If you stray from that by more then .7, I'd be asking to have the machine checked. I, like Gina, rely on my machine results for dosing, not theirs.

Just want you to know what you are seeing is normal and the doctor should now that it is normal too. Prime example. I tested last Wednesday at 3.1 but the lab got 2.5. No big deal because it's still range. My suggestion to you is to keep yours as close to 3.5 as possible. They are being ridiculous holding you in a small window of 3.0 to 3.5. It's nearly impossible to keep you there. Don't spaz if you go as high as 4. Remember if your meter says 4, their lab is going to tell you 3.4!

So many factors play into the test results that not even if you test twice back to back with the machine, are your results likely to be the same. Frankly, I wouldn't worry about it. Unfortunately, your Doctor may try to make a Federal issue of it when he shouldn't. You can probably prove the same thing with the lab results by testing back to back there too with two different samples.

 

[RCB]

Ditto to what everyone has said

Ditto to what everyone has said

I have a .6 difference everytime I try what they are having you try. .6 is the limit as stated in the instruction book that came with the unit. If you stray from that by more then .7, I'd be asking to have the machine checked. I, like Gina, rely on my machine results for dosing, not theirs.

Just want you to know what you are seeing is normal and the doctor should now that it is normal too. Prime example. I tested last Wednesday at 3.1 but the lab got 2.5. No big deal because it's still range. My suggestion to you is to keep yours as close to 3.5 as possible. They are being ridiculous holding you in a small window of 3.0 to 3.5. It's nearly impossible to keep you there. Don't spaz if you go as high as 4. Remember if your meter says 4, their lab is going to tell you 3.4!

So many factors play into the test results that not even if you test twice back to back with the machine, are your results likely to be the same. Frankly, I wouldn't worry about it. Unfortunately, your Doctor may try to make a Federal issue of it when he shouldn't. You can probably prove the same thing with the lab results by testing back to back there too with two different samples.

I had the same problem with my machine when I first got it. I took my machine with me to the lab and tested just before the arm stick. The results were never the same. I was worried about this at first and talked to several people at QAS- they seemed unconcerned. When I finally talked to my card., he was equally unconcerned. I remember Mr. Lodwick saying that if you took one big draw and tested it right way by three different lab machine, you would get three different results. I ran a test of my own machine that way and got test results that varied by a much as .4 in 15 minutes.

Since I have a-fib and two mech. valves, I tend to do what Ross does.
Better higher, than lower is my motto. Since I began hometesting, I can control my INR results to a range of .4 every week just by adjusting the size
of a large bowl of salad I eat most every night.

Don't worry- it took about 3 months for me to feel comfortable with my
testing. Now I feel so stupid because I had not gotten a machine earlier!

 

[Dennis S]

Home testing

Home testing

From working with my home testing machine (INRatio), I have discovered that it is possible to have a minimal sample still test, but come back with a very low reading. I tried 1 test where I used the small plastic tube to collect and deposit the sample. It looked like a very small sample to me. My result came back at 1.7 (out of range).

Because I doubted the validity of the sample, I immediately re-tested with a "large hanging drop of blood", as recommended by the machine instructions and got a reading of 2.1 (in range). For many reasons, I am quite positive the second reading was correct. From this and one other experience, I am convinced that it is possible to get a sample large enough to test, but too small to be accurate. In my case, the small sample tests too low.

 

[Ross]

From working with my home testing machine (INRatio), I have discovered that it is possible to have a minimal sample still test, but come back with a very low reading. I tried 1 test where I used the small plastic tube to collect and deposit the sample. It looked like a very small sample to me. My result came back at 1.7 (out of range).

Because I doubted the validity of the sample, I immediately re-tested with a "large hanging drop of blood", as recommended by the machine instructions and got a reading of 2.1 (in range). For many reasons, I am quite positive the second reading was correct. From this and one other experience, I am convinced that it is possible to get a sample large enough to test, but too small to be accurate. In my case, the small sample tests too low.

As long as all 3 channels have blood in them, the size of the sample shouldn't make one bit of difference. It can only measure so much. If not enough, it says so, if too much, not all is drawn in into the strip, so it's fail safe.

Bottom line: The test result you get at that particular moment is only good for that particular moment in time.

 

[Marty]

As long as all 3 channels have blood in them, the size of the sample shouldn't make one bit of difference. It can only measure so much. If not enough, it says so, if too much, not all is drawn in into the strip, so it's fail safe.

Bottom line: The test result you get at that particular moment is only good for that particular moment in time.

I like Al Lodwick's aphorism..."Trying to keep your INR always at 3.0 is like driving accross the country and always keeping your gas tank half full" !

 

[Dennis S]

Maybe

Maybe

As long as all 3 channels have blood in them, the size of the sample shouldn't make one bit of difference. It can only measure so much. If not enough, it says so, if too much, not all is drawn in into the strip, so it's fail safe.

Bottom line: The test result you get at that particular moment is only good for that particular moment in time.

Maybe so, but I thought someone at Raytel gave me a pretty good "inkel" that a minimal sample would test low. This happened twice to me, and each time the large sample tested significantly higher. Each test was within a minute of the previous one, with all other conditions being identical.

 

[Ross]

Maybe so, but I thought someone at Raytel gave me a pretty good "inkel" that a minimal sample would test low. This happened twice to me, and each time the large sample tested significantly higher. Each test was within a minute of the previous one, with all other conditions being identical.

If you think about those test strips though, only x amount of a sample can get into it. If it's not enough, it won't fill all the channels and you'll get an error message. If it's too much, the excess sits on the well dot. Just the right amount enters and gives the result, so whether your testing what you think to be a small sample vs a larger one, should not matter at all. The blood is going to have the same properties no matter what.

I can see what your thinking and I once thought that too, but honestly, it doesn't matter. You can test with two huge drops and your still going to get two different results and I'll guarantee one is lower then the other. It's just the nature of testing.

 

[Diesel]

Cardio getting frustraited

Cardio getting frustraited

UGGG my cardio is getting frustraited because my levels are low, and wont stay at a good range.. and now hometesting keeps staying LOW for INR range........

Okay so i home test myself yesterday which was thursday and got an INR of 1.9 (very low) and at the Hospital they got a result of INR of 2.4 (still very low) Okay so the difference is... 0.5

So i test again today (friday) and i recieved a result of 2.4 i didnt go get a hosptial blood draw cause my doc said i can try it without.

My question is...i read the manual for INRatio and yes somewhere it did say a possiblility of the max difference should be 0.6 SOO when you look at your acutal reading.. do you add the 0.6 to your number that you got for an INR reading to determin your dose?? OR do you just go by what the machine says and thats final??

Im trying to get my levels back up to 3.0-3.5 and i need to know if i should add the 0.6 to what i see on the machine or not, cause that would make a difference if i am low or high!!

Does this sound confusing? im sorry.. i just need to know when my cardio calls and asks what my level or INR is.. do i tell him the 2.4 or do i add the 0.6 to it and say 3.0??? cause to him he wants what is the right number?

Sorry for the DARN concerns and Questions...........

DIesel

 

[jeffp]

i just need to know when my cardio calls and asks what my level or INR is.. do i tell him the 2.4 or do I add the 0.6 to it and say 3.0??? cause to him he wants what is the right number?

Just give him the reading from the machine. If he wants to correct it, he will. I find that my INRatio is consistently higher than the lab (by more than 0.6) but within 0.2 of the PCP's CoaguCheck. Go figure

 

[Ross]

As Jeff says, just go with the machine reading. Your Doc needs to increase your dose by about 10 to 15% and have you retested in one week.

 

[Diesel]

Thought?

Thought?

[Okay so question........

from what i gather most people are finding that thier levels are HIGHER with the INRatio machine vs.. the hospital draw... What about my situation where my levels are LOWER with the INRatio machine.. vs. the hospital draw??

Should i be concerned?
Diesel

 

[geebee]

[Okay so question........

from what i gather most people are finding that thier levels are HIGHER with the INRatio machine vs.. the hospital draw... What about my situation where my levels are LOWER with the INRatio machine.. vs. the hospital draw??

Should i be concerned?
Diesel

You should use the INRatio results to adjust your dose. Even if we assume the hospital is more accurate (and you know our feelings on that one), the worst that will happen is your INR will be on the high end of your range. That is much, much better than on the low end.

 

[afraidofsurgery]

Thanks for posting the question

Thanks for posting the question

Diesel,
Thanks for posting the question - I just had surgery Sept 7, had 3 home nurse INR tests using the ProTime machine, and this week went for my first outpatient draw. It was slightly lower than the home nurse results. All the comments have been so helpful - I had been wondering about the difference in the measurements w/ the blood sitting in the tube, getting transported to the hospital, then run on some machine there...

My cardio told me he wants me to home test after my INR gets stabilized. Looking forward to not having that stupid needle stuck in me for an INR that I know can be done w/ a finger stick!

Thanks for the info!
Patty

 

[Karlynn]

My cardio told me he wants me to home test after my INR gets stabilized.

Wow, isn't this a breath of fresh, encouraging air!!!!

 

[jeffp]

An update since the last post I made on this... I've had more lab work done since the last post (fun, fun, fun) and found that my home testing results are higher than lab testing on a consistent basis. Whenever my PCP or cardio get a blood draw they always run an INR also. I check with the INRatio when I get home from the lab. Home testing results are about 30% higher at the low range (INR 2.5 or so) and about 60% higher in the high range (INR 6.0 or so) and inbetween for the normal range. I'm sure I can graph it out and come up with the exponential equation, but I just try to keep it in the 3.0-4.0 range on my home test unit and that seems to keep the lab numbers at the low end of the 2.5-3.5 range. My PCP has a Coagucheck and has been getting the same numbers as the INRatio within +/- 0.2 INR. I think it may be that the lab (I'm stuck with using the same lab whether its drawn at the office or the lab) testing machine ISI calculation is out of calibration from the reagents they're using. Its hard to keep everyone happy on this INR stuff!

 

[Ross]

An update since the last post I made on this... I've had more lab work done since the last post (fun, fun, fun) and found that my home testing results are higher than lab testing on a consistent basis. Whenever my PCP or cardio get a blood draw they always run an INR also. I check with the INRatio when I get home from the lab. Home testing results are about 30% higher at the low range (INR 2.5 or so) and about 60% higher in the high range (INR 6.0 or so) and inbetween for the normal range. I'm sure I can graph it out and come up with the exponential equation, but I just try to keep it in the 3.0-4.0 range on my home test unit and that seems to keep the lab numbers at the low end of the 2.5-3.5 range. My PCP has a Coagucheck and has been getting the same numbers as the INRatio within +/- 0.2 INR. I think it may be that the lab (I'm stuck with using the same lab whether its drawn at the office or the lab) testing machine ISI calculation is out of calibration from the reagents they're using. Its hard to keep everyone happy on this INR stuff!

Same deal here Jeff, so I try to keep my INR at least at 3.3, so that when I do get a lab stick, it's over 2.5. When I tested against a Coagucheck, the results were closer together, so something is going on in these labs. Wish I could take my own sample down and see just how long it sits there and what else happens to it before it's tested.