INR testing

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AgilityDog

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Nov 5, 2007
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Once a week, unless I'm way way out of range from illness or a change in other meds, then I might, maybe, test mid-week.
 

ALCapshaw2

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North Alabama
Most Clinics recommend testing INR every 4 (or maybe 3) weeks IF Stable.
IF your INR has changed and/or you had a Dose Change, then test in 1 or 2 weeks.

Medicare (USA) will pay for Weekly Testing if you have been approved for Home Testing.
Some Home Testers test every 2 weeks when their INR is stable.

'AL Capshaw'
 

dick0236

Eat the elephant one bite at a time
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louisville, KY USA
I test every two weeks using home testing. Since I started home testing about one year ago, I have had only one small (one day) "hold" of 1/2 dose. After being "jerked around" by docs and/or PT labs for many years, home testing is the ONLY way to go.

I just completed my bi-weekly test and got a 3.6(range 2.5-3.5). I have a new PCP and will be curious about his dosage recomendation after he gets this result. Obviously, I will be making no adjustment, regardless of what this new guy says, but it will give me an understanding as too how he and I will get along:wink2:........Docs office just called back with instructions "patient to self-dose and check in one week". He and I will get along:thumbup:.
 
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Bina

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East Ontario, Canada
Hi Lise !
The past 3 years I've been testing at home every 2 weeks, recently I forgot and tested after 3 weeks.
Am always in range, but I prefer to test every 2 weeks. (insurance pays 80% of my test strips).
 

prdraper1

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Lincolnshire, England
Does the USA have INR clinics ? In the U.K. at least with my clinic, we have a dedicated INR clinic with almost 300 patients on warfarin. At first I went to the doctor once a week and after stabilising I was transfered to the clinic and am tested every 2 weeks at present as my INR seems to be dropping with my increase in fitness, when stabilised I shall then be tested monthly. The clinic uses the pin prick tester but the doctor uses a blood sample, I don't know what the difference is. I don't know if there are any home testers in the U.K. and if there are how is the dose of warfarin altered without a prescription? I have seen the medication tables for warfarin and it does seem to be an inexact science.
 

ALCapshaw2

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YES, thre are MANY Coumadin / AntiCoagulation Clinics in the USA.
There is a website with a directory giving the locations of those clinics
(see wwwacforum.org - Locations - 3rd in the list on the left side of the page).

Here is a copy of a post I made some time ago about the demographics of my local clinic:

Patient Demographics at My Coumadin Clinic

The recent thread / poll asking how many Tissue Valvers were on Coumadin made me curious about the Patient Demographics at my Coumadin Clinic so I asked the Charge Nurse for their numbers.

MY Coumadin Clinic Patient Demographics are as follows:

328 Patients with Heart Valves - presumably mechanical? = 11.4%

2000 Patients with Atrial Fibrilation = 69.4%

552 Patients with other factors (DVT, Clotting Disorder, etc.) = 19.2%

2880 Total Patients served by 4 Certified Registered Nurse Practicioneers (CRNP) and several Technicians and other staff members in Huntsville, Alabama, "The Rocket City" (Home of NASA's 'Rocket Team', The Redstone Arsenal, and a lot of Low, Medium, and High Tech Industries with a population of approximately 300,00 for the county).

'AL Capshaw'

(Yes, I realize this does NOT answer the question about what percentage of Tissue Valvers are on Coumadin, but it does point out that the vast majority of patients on Coumadin are on it because of Atrial Fibrilation and to a lesser degree, Deep Vein Thrombosis - DVT, and Clotting Disorders).
 

MarkU

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Sarasota, FL
I get tested every six weeks normally, but my INR has been pretty stable over the past nine years. On the rare occasions when I do get out of theraputic range they've had me come back in every week until it settles down again.

Mark
 

Bina

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Bina did your insurance cover your machine also, I sent everything with a request to my insurance and it was denied.
Lise, the machines are not covered by basic private insurance. But, the test strips should be. I would keep calling and talk to a supervisor and make her understand that it is basically the same as the diabetic test strips which they should cover too. If they dont cover diabetic equipment, then u may be up the creek.
The year I got my machine we also had enough other medical expenses to make it worthwhile to put it under Medical Expenses on the year end Income Tax form. Keep in mind that you may include most medical expenses for any 12 month period starting or ending in the tax year that you are filing for. Include the test strips if your insurance refuses to cover them.
 

catwoman

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Sep 23, 2003
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near Fort Worth TX
Does the USA have INR clinics ? In the U.K. at least with my clinic, we have a dedicated INR clinic with almost 300 patients on warfarin. At first I went to the doctor once a week and after stabilising I was transfered to the clinic and am tested every 2 weeks at present as my INR seems to be dropping with my increase in fitness, when stabilised I shall then be tested monthly. The clinic uses the pin prick tester but the doctor uses a blood sample, I don't know what the difference is. I don't know if there are any home testers in the U.K. and if there are how is the dose of warfarin altered without a prescription? I have seen the medication tables for warfarin and it does seem to be an inexact science.
My cardio's practice has one, and it's listed with many others at www.acforumorg --

Consultants in Cardiology
Phone: 817-252-5000
1300 W. Terrell, Fort Worth , TX 76104

However, I already had my own machine when I switched to my current cardio, and he's OK with home-testing.

There are algorithm dosing charts online. I bought mine (two copies) from Al Lodwick and also scanned it as a jpg or pdf, stored both sides on flash drives and in e-folders on my laptop and at work -- just in case I ever lose the originals. However, after you've used them enough, you've pretty much got them memorized. :))
 

njean

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New Mexico
Lise, the machines are not covered by basic private insurance. But, the test strips should be. I would keep calling and talk to a supervisor and make her understand that it is basically the same as the diabetic test strips which they should cover too. If they dont cover diabetic equipment, then u may be up the creek.
The year I got my machine we also had enough other medical expenses to make it worthwhile to put it under Medical Expenses on the year end Income Tax form. Keep in mind that you may include most medical expenses for any 12 month period starting or ending in the tax year that you are filing for. Include the test strips if your insurance refuses to cover them.
You're absolutely right Bina! We do that! :)
 

Marty

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Jun 10, 2001
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Location
McLean, VA
Just curious to know how often do you test?
Every two weeks while in range-2.5-3.5. If out of range and I have to change dose, every week tll I get back in. I am a valver but my wife Alice takes warfarin for a-fib and her range is 2.0-2.5. If she is "therapeutic", she tests every three weeks but like me tests weekly if she has to make a dose change. We manage our own doses with the " 10% rule". It works. Alice is required to call in results to her cardiology group. My PCP doesn't require call in. He does check my records and does an arm stick once a year.
 

Protimenow

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California
My INR has been pretty stable for a long time. I was concerned that going 2-3 weeks may not have been particularly wise, but, from the reported experience of those here, I guess I shouldn't have worried. If I make major changes to diet or activity, I try to test a bit more frequently.
I just got a new CoaguChek S meter and 48 test strips expiring in June 2011 -- it looks like I'll be testing weekly between now and the time the strips expire -- even if it's not really necessary. I have about 20 strips for my ProTime, expiring in March 2011. I'll probably do some simultaneous tests with both meters, but will have to decide how often to test (and which meter to use).
It looks like, come March or June, I'll have to decide which meter to use regularly and again evaluate how often to test. (Some of this may relate to how many strips come in a package and when they expire -- if 48 CoaguChek strips expire in 48 weeks, it's probably a no-brainer)
 

RI Mom

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Jan 14, 2009
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Woodbridge, Virginia
I have a child who takes Warfarin and we typically check every 2 weeks if he has been stable for at least a month. By the way, we did get the INR home monitor covered through insurance. If you haven't yet, have your cardiologist write a letter. I'm not sure how the insurance companies look at this but my child was only 4 when we got ours so they may have been looking at the cost of lab work for the next 20 years vs. the cost of a machine and test strips. It's definately worth pursuing an appeal.
 

olefin

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Jan 22, 2009
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ARBut really a Texan at heart!
Just curious to know how often do you test?
Once a week since I been home testing. Before it was monthly. I like weekly much better. My cardiologist when we lived in TX required monthly test if I was in control, if out of control, test weekly or sooner until in control. After moving here the cardio wanted to test once ever 2 months... I said no! My third cardio likes home testing and dosing. :thumbup:
 
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