Inr Monitoring

[Ram Patel]

I am thinking of buying an Inr monitoring device. I want to measure Inr only once a month or when I have change in medicine or some other factors that may affect Inr.

I do not want to call in the results to device provider. My doctor is one block away and he can tell me right away if I need to change dosage of coumadin.

I have aortic valve since 1977 and is still doing well.

I need suggestion about the device and the supplier who does not insist about weekly testing and calling in results.

 

[Ross]

Hi Ram and welcome aboard.

Have a look at the link below, decide on which meter you'd like to use, the click on more information. There are downloadable forms that are necessary for your Doctor to complete and you will need a prescription for it.

QAS handles the insurance paperwork if your using insurance for purchase. They do not insist on you calling in, only if your on medicare and even then, I don't think it's mandatory. Testing, test when you want whether it be monthly or weekly, that's up to you.

http://www.ptinr.com/data/templates/article_alt.aspx?z=5&articleid=234

 

[Karlynn]

Welcome Ram!
Wow, a mechanical Aortic Valve since 1977. If you feel like it, we'd love to hear your story.

 

[Marty]

Hi Ram and welcome aboard.

Have a look at the link below, decide on which meter you'd like to use, the click on more information. There are downloadable forms that are necessary for your Doctor to complete and you will need a prescription for it.

QAS handles the insurance paperwork if your using insurance for purchase. They do not insist on you calling in, only if your on medicare and even then, I don't think it's mandatory. Testing, test when you want whether it be monthly or weekly, that's up to you.

http://www.ptinr.com/data/templates/article_alt.aspx?z=5&articleid=234

To get more specific, Ram. I have used a Coaguchek Classic for seven years, which is no longer available for sale to the public. Mine served me well and still is in good working condition. I understand the company still has a few left that they will sell only to doctors. I am now using Hemosense INRatio which I believe is state of the art. It has onboard controls and an isi of 1 which is an upgrade over my old Coaguchek. QAS is a good outfit to buy it from and get your supplies.

 

[Blanche]

Ram Patel:
Welcome! Hope you find answers to your concerns. It is my opinion that you have not provided quite enough information about your circumstances for us to give you the information that you are seeking. But, that not withstanding, I will pose a few possibilities to you. If you are looking to obtain an INR monitoring device through Medicare, then you must comply with Medicare's requirements. They require that you test weekly and that you phone in your results to an accredited agency, or as you have stated a "device provider." Other insurance plans have their own guidelines or requirements, however, Medicare is the only agency that I know of that required weekly testing. If you are not covered by medicare, you must still follow your particular insurance company's regulations.

If, however, you wish to purchase your own INR monitoring device with your own money, you can do what ever you wish so long as you have a doctor to authorize the purchase and monitor your anticoagulation. The doctor who "is one block away" might do this for you. It would be that doctor's decision as to when your INR is measured and how frequently.

I would wonder why you have decided to test only once a month. My husband tested once a month for ten years with no problems. However, a month after that he had several small and one large stroke, all of which could have been avoided had he tested more frequently. Now, he tests weekly. You mentioned that you might test more frequently when you had a change in some other factors that may affect INR. Seems to me that people on anticoagulation have a change in these factors quite frequently and that those changes can not be specifically determined. Noone has yet to determine why my dear one had strokes. They just called it a Coumadin failure. If he had tested weekly, it is likely that what ever "change in factors" that caused his INR to plummet would have been caught and his problems could have been averted.

Regards,
Blanche

,

 

[Dotty]

INR Machines

INR Machines

What is the best machine to purchase for weekly home testing. I filled out all the forms for QAS but was denied by my insurance company because QAS was not a preferred provider. I got a call from another home care agency the day before I received the denial to say they had my machine. Apparently, the insurance company negotiated with their preferred provider. Anyway, they gave me a PROTIME Microcoagulation system (has five channel cuvettes). I am just wondering what is the best product. Any insight anyone can give me would be greatly appreciated. So far, I have learned that it runs on batteries and not on AC. Also, the cuvettes must be kept refrigerated which means I can't take it with me on any lengthy trip..so what is one to do???

 

[Blanche]

Hello, Dotty:
My husband, Al, has been using the ProTime Microcoagulation System, with the 5 channel cuvettes since March 2001. We brought the machine from QAS with our own funds and we continue to purchase cuvettes with our own funds. Albert usually tests weekly, but sometimes more frequently when there are problems or concerns. Albert's monitor runs on batteries, which have never been replaced. They maintain their charge for about 10 tests. He recharges the monitor, overnight, by plugging it into any ordinary wall plug.

If you are not comfortable taking the monitor on vacation for long periods, you can certainly continue whatever practice you were using before you got the ProTime system. We have not had any difficulties traveling, but we have always traveled in the United States and have been able to find or make arrangements for refrigeration of the cuvettes. You might have difficulties in other countries, however.

Hope this helps some.

Blanche

 

[catwoman]

Dotty:

I have a ProTime machine and I have traveled with it by car & by air. The cuvettes can be kept at room temperature (check manual to see range for room temperature) for up to 30 days total, or opened for I believe either 8 or 24 hours. (I don't open take a cuvette out of its packaging until I turn my machine on, so I haven't needed to know the shelf life of an opened cuvette.)

When I travel with the cuvettes, I put them in a zip-lock bag with "blue ice" in an ice chest or a collapsible one. There's usually a refrigerator at my destination where I can transfer the cuvettes to.

When flying, I travel the ProTime machine & cuvettes, Tenderlettes, etc., in a carry-on bag that goes under the seat in front of me -- not in an overhead bin. Haven't had problems going through security yet.
I always run tests on the battery, so I haven't taken the charger with me. Some have said they always run their tests with machine plugged in.

 

[geebee]

If you are traveling and staying in hotels, just let the hotel know you have a medical need for a refrigerator and they will usually make sure you have fridge in your room at no additional charge.

 

[ClickerTicker]

...Also, the cuvettes must be kept refrigerated which means I can't take it with me on any lengthy trip..so what is one to do???

Hi Dotty,
I've travelled a fair bit with my CoaguChek, see this thread for tips: http://www.valvereplacement.com/forums/showthread.php?t=11322
This may or may not be applicable to other brands of INR tester - I don't think they're even available over here. Home testing gives you so much freedom - if you've ever had to arrange an INR test in a strange city (or country) then you'll know how much hassle it is!

 

[Valve-Viking]

Hi Dotty,

I just came back home(to Sweden)yesterday after a trip to Vietnam,
Indonesia and Singapore. I use the Coaguchek device, the cuvettes are
stabile for 60 days in room-temperature, meaning that the one´s I did
not use during my 10 day trip, still has 50 days of storage left in room
temperature once I put them back in the fridge again. If I stay more then
a night in a hotel, I put them in the minibar just.

I do travel a lot with my Coaguchek and I never had any trouble. I would
feel very vulnerable and "naked" without it. It really gives you both freedom
and peace of mind. Tested myself in Singapore two days back and you
never now what different diets, climat and timezones does to you, so I
was very reliefed seeing that INR 2.7 reading popping up on the screen,
went for a nice walk, had a beer and just relaxed. Without it I´d be
wonderring if I had 1.5 due to too a lot of green vegetables the last few
days or 4.5 due to the generous amounts of "Dom Perignon" on the flight!

/
Martin

 

[catwoman]

If you are traveling and staying in hotels, just let the hotel know you have a medical need for a refrigerator and they will usually make sure you have fridge in your room at no additional charge.

Gina:

That's right -- I'd forgotten about that. A diabetic friend & I frequently room together and she takes along a little cooler for her insulin. But she has told me that she can get a room w/ refrigerator at no extra charge, if needed. Seems we could do it, too, for our testing supplies.