Temp:
For many years doctors' standard practice for checking INR was once a month. However, I believe this is changing, moreso in Europe, but also in the US. Medicare, for example will provide anticoagulation services for valvers but the valvers are required to test weekly. Home testing is the way to go. It is so easy and totally safe. Albert and I both take Coumadin and we test together, once per week. The entire testing for both of us is less than 15 minutes from getting the monitor from the drawer to returning it to the drawer. Nice time saver...
There are hundreds of people who will tell you they test once a month and that is sufficient. For them, it probably is sufficient.
Al tested every four weeks from October 1990 until December 15, 2000. He had no problems whatever during those 10 years. Most of the time his INR was steady and he had very few dose changes. Then, in December 2000, he had 2 strokes.
His first stroke, a TIA, knocked him out for several hours. He was hospitalized for 6 days. Two days after he returned home, right before my very eyes, he had a severe stroke, a CVA. He spent a month more in two different hospitals. After he was released from the hospital, he had to go for speech, physical, and occupational therapies for some 5-6 months
According to some of the many doctors who treated Al, his strokes were caused by a "Coumadin failure." His INR with the first stroke was 1.8 and with the second it was 1.6.
If he had been testing weekly, it is likely that the low INR numbers would have been caught before the damage was done.
Somebody recently told me that getting a stroke while on coumadin was very unlikely "these days." Jokingly said, probably one tenth of one percent. Well, that may be true, but Al's chance of getting a stroke was 100%.
Blanche