INR Testing

[hayden]

do you get finger stick or blood drawn??

 

[Gnusgal]

I voted "finger stick" because that's what I do with my home test unit. But if I have to get my INR tested at the lab it's a needle draw. That only happens in the hospital and about twice a year to double check my home numbers.

 

[fyrfytr]

I also voted Finger Stick as I home test and every six months get a blood draw.
Take Care

 

[Karlynn]

I home test, so it's the finger stick. Unfortunately for me, I tested today and have 3 bubble errors before I got a sufficient test. My poor little fingers. I only test on my right hand because my finger tips on my left hand are caloused from guitar playing.

 

[hensylee]

i TAKE my brother to hospital lab once a month, or more often if directed by cardio's office. He is in asssited living, so can't do the finger stick. Wonder why they can't do a finger stick at the hospital? It certainly would be easier on him.

 

[Gemma]

Jim has a blood draw every 12 weeks (or more frequently if his dosage is changed) which is what the clinic uses to adjust his dose. He also tests at home in between, about every 2-4 weeks, to keep an eye on his INR.

If hsi INR is out of range according to his Coaguchek (finger stick) monitor, the idea is he has to go for another blood test to convince the clinic it really is out of range and THEN they'll tell him what dose to change to.

The second part is hypothetical, as he hasn't been out of range yet, but his GP thinks Jim would probably be perfectly capable of adjusting his own dosage if need be. Aah, the joys of NHS funding! They all know his Coaguchek works just fine, but nobody wants to take responsibility for him just phoning up and telling them his results!!!

(I didn't vote in your poll as it's both answers).

 

[terryj]

My husband uses his PCP and gets blood drawn about every 4 weeks to check his INR.

 

[hayden]

The reason I asked this question, was because I PASS OUT everytime they draw blood, Doctor said we were not gonna do through that anymore. I have to be sedated or numbed for an IV>> I quess that I am a wimp!!

Thanks for all the response!!

 

[Guest]

You would be much better off to get a finger stick tester than to be sedated. I wonder why your doctor can't understand that.

 

[ccrawford]

I'm amazed at the number of docs and institutions that still rely on blood draws to test INR's. My family doc's practice uses finger sticks, but the county hospital to the south of us still uses blood draws exclusively. Even though my family doc uses finger sticks, I'm a staunch beleiver in home testing. In my case it saves a bunch of time and gives me more flexibility. I also set my own doses, but report what I'm doing via email to a coumadin clinic. They have never had a problem with my dosing. Chris

 

[Marty]

I'm amazed at the number of docs and institutions that still rely on blood draws to test INR's. My family doc's practice uses finger sticks, but the county hospital to the south of us still uses blood draws exclusively. Even though my family doc uses finger sticks, I'm a staunch beleiver in home testing. In my case it saves a bunch of time and gives me more flexibility. I also set my own doses, but report what I'm doing via email to a coumadin clinic. They have never had a problem with my dosing. Chris

Chris, At a meeting 5 or 6 years ago a DuPont rep told me that a study done at Duke showed only about 15% of people on Coumadin had the smarts to self dose like you and I do. I think this figure is a little low. What do you think?

 

[ccrawford]

Marty - I think that's hogwash. I think a lot more people are capable of self dosing/self testing, maybe after a little encouragement. The dosing chart covers the waterfront about 90% of the time and knowing how the half life of Coumadin works is pretty useful. Round out this with information about drug/herb interaction that anyone can access via the web, and that about covers it. I think a lot of people don't do this because their doc doesn't encourage it for various reasons. The other ingredient I almost forgot is a Coumadin clinic that is willing to accept your test results and self dosing data via email and intervene only when needed. With an investment of time to learn the right stuff, I think most people could get comfortable with self testing. If I sound like an advocate, you betcha I am, especially for those folks who are still fooling around with blood draws. I save a bunch of time by not driving to town, waiting in a waiting room with sick people, getting weighed, getting my temp taken, etc - all of which has nothing much to do with getting my INR. Self testing is the berries !!!

 

[William]

Yes, self testing is the way of the future, or at least that's what my Cardio doc says. Right now I go to his office and have my finger pricked. Will

 

[Gnusgal]

I think the issue isn't so much that people aren't SMART enough to self dose, it's that they aren't EDUCATED enough to self dose. Those of us here at VR.com are very educated on how coumadin works and therefore are completely capable of determining what we should do with our dosage if we're off (once we get the hang of it, of course).

What I don't get is why they won't educate coumadin users like they do diabetics. After all, diabetics have to self-test, then determine (on their own!) how much insulin they need. If they can do it after training, so can we! (And we don't have to be nearly as picky! ) I think the doctors and hospitals are at fault for not putting together education/training for patients who go on coumadin. From what I understand (someone correct me if I'm wrong) diabetics go through classes before they start self testing and self dosing.

 

[ccrawford]

Niki - You're right on target. Its important to separate self testing from self dosing. The manufacturers already do a pretty good job with their self testing education that they package with the machines. Self dosing is probably a little more complex, and causes some discomfort with the docs because they would probably be named in a lawsuit regardless if they were directly involved in the process of a patient's regulation. I think there needs to be an accreditation entity that is composed of members of the health insurance industry, physicians, coumadin clinics, manufacturers, and home testers/doser. I believe this would be needed to overcome some of the barriers. Some examples of the barriers I'm talking about: If a clinic is going to provide oversight for a home tester/doser, then they need to have a fee structure in place that compensates them for that role. They also need to have email and a scheduler that reminds them to call a patient if they have not reported in within so many days of a target. Physicians need to be comfortable that a process is in place that has proven itself to be dependable and safe. The educational material for a self doser needs to have a thorough review and blessing of the accrediting agency, and the medical profession needs to share that comfort. Self dosers should be required to take an exam that is graded by another party - maybe their physician. I can already envision some of the material required in a lesson plan for home dosers. Some of this material would be useful for Coumadin users even if they didn't self dose because it would provide some additional protection to them in event one of their care-givers drops the ball. There is enough expertise right on this web site to create the educational material. Getting the barriers reduced on a national basis is another project of much larger scope. I'd be interested in hearing what Al has to say regarding the success of such a venture - especially from a clinic managers perspective. Chris

 

[Guest]

There are also some companies that are taking the home tester a step further and doing that reminding and reporting the results to the physicians. They are using the Medicaid rules that require testing every week.

I have always thought that if someone could use the internet, then they could self-dose. It isn't that hard with dosing algorithms.