Is it possible to travel internationally for six months of the year while on Warfarin?

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stewartu

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May 21, 2022
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I'm a 57 year old male and will have my BAV replaced this week. I am still trying to decide whether or mechanical or biological valve will be best.

My wife and I are retired and travel at least half of the year, mostly internationally. I am concerned that a mechanical valve, daily warfarin, and being tethered to periodic INR testing will prevent me from this traveling lifestyle.

Has anyone here selected a mechanical valve and then been able to roam the planet without being stuck with frequent lab INR tests?

Your help is greatly appreciated.
 

pellicle

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I lived in Finland three times for between a year and 4 months with warfarin and my coaguchek.

I don't see that it matters where you are as long as you have your tester and drugs.

Another mem here goes up into Alaska fur trapping with his coaguchek and drugs for about 4 months at a time...

I trust my coaguchek and my own self management far more than a lab
 

Keithl

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I would buy your own testing machine and supplies and bring enough warfarin with you. If you INR varies a lot, bring enough pill sizes to adjust accordingly. I manage my own INR and have a good relationship with my DR who calls in whatever scrips I need to adjust.
 

pellicle

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I manage my own INR and have a good relationship with my DR who calls in whatever scrips I need to adjust
its good to have that isn't it. I know a new member has just built that relationship with his GP on the first visit post surgery. He just took the spreadsheet with graphs of his situation and the doctor approved him for self management.
If you show them you're diligent and regular in testing then they want to support you.
To be honest why shouldn't most people manage themselves? Granted a few probably can't.
I always draw the comparison to diabetics, imagine them needing to go through a clinic or wait for a blood draw.
 

Keithl

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its good to have that isn't it. I know a new member has just built that relationship with his GP on the first visit post surgery. He just took the spreadsheet with graphs of his situation and the doctor approved him for self management.
If you show them you're diligent and regular in testing then they want to support you.
To be honest why shouldn't most people manage themselves? Granted a few probably can't.
I always draw the comparison to diabetics, imagine them needing to go through a clinic or wait for a blood draw.

My cardio would not let me do it even though I brought my spreadsheet with ranges and does, my GP/PCP was fine with it. I save the $120 a month for the service. It was harder to buy the Coag-sense as they want a prescription,, but I got it without one. My DP/PCP would likely write a scrip now if I wanted her to. I have a spreadsheet with every dose and reading since I started tracking myself almost 3 years ago.
 

Chuck C

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I have a mechanical valve and self test. If a person does self testing, which is easy, I see no reason not to travel. I have a week long trip coming up and am not worried about it at all.

If you go mechanical, I would strongly recommend self testing. Even if you dont, it would seem that one could get tested at a lab you are traveling to in most areas and call in the results.
 

pellicle

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@stewartu

I would second this ...
If you go mechanical, I would strongly recommend self testing.

... and add that that one of the other differences between Mech and Tissue is this
  • as mech valves are durable with the primary medical side effect being requirement of ACTherapy (warfarin) you are able to make a very significant difference in your health outcome. If you're a hands on person then a mech is the only choice that you can have a hand in managing
  • tissue valves are only managed surgically. In the main do not need ACT so require the patient to do nothing (although that ratio changes as the valve is in longer, and closer to end of its life you'll see statistically increased likelihood of needing ACT) but the consequence is they do wear out over time and (depending on your age at surgery) will require another surgery.
so if the patient decides they can't handle managing themselves they should pick a tissue prosthetic and submit to iterative redo surgeries.

In terms of decision matrix everything else are lower frequency issues that feed into that decision process.
 

pellicle

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PS:

My cardio would not let me do it even though I brought my spreadsheet with ranges and does, my GP/PCP was fine with it.

I'd probably change cardiologist over that and top points awarded to your GP (some cardiologists think they know stuff outside their speciality I hope he's good at everything else).
 

Al3x

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I've yet to travel abroad on Warfarin and have three practical questions. I appreciate the answers will vary depending on where you are traveling from and to but would welcome any generic comments.
  1. How do you acquire enough Warfarin for your trip? My GP limits me to one month's supply at a time.
  2. If you run out whilst overseas / lose your pills, it is a challenge to acquire more?
  3. Have you ever needed to declare that you are bringing the medication into the country at customs?
 

MdaPA

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I've yet to travel abroad on Warfarin and have three practical questions. I appreciate the answers will vary depending on where you are traveling from and to but would welcome any generic comments.
  1. How do you acquire enough Warfarin for your trip? My GP limits me to one month's supply at a time.
  2. If you run out whilst overseas / lose your pills, it is a challenge to acquire more?
  3. Have you ever needed to declare that you are bringing the medication into the country at customs?
Below is one good resource that I think addresses your questions:
Traveling with Medication: Everything You Need to Know | SmarterTravel

Couple of suggestions:
- Tell your Dr. you are traveling and expect to be out of county for X number of days/months and they should give it to you (you should have more than 1 month supply if you are home anyway, 90-day supply/script is common in the U.S.). Warfarin is not addictive or a narcotic so this should not be an issue. Take extra just in case.
- Store some in your carry-on and the rest in other/checked-in bags in case one gets lost.
- Leave pills in their original Rx bottle and bring a copy of the Rx
- Learn the customs/entry requirements for each county you are traveling in order to avoid questions/issues.
 

Chuck C

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How do you acquire enough Warfarin for your trip? My GP limits me to one month's supply at a time.

I just have to comment on how silly it seems to me that any physician would do this. Warfarin has a shelf life of at least a year and is not a controlled substance. My cardiologist writes me 3 months at a time, with a year's worth of refills. If I want to add another size in the mix, for example I have 6mg and would like some 4mg pills, I just message him as to why I want the other dose and he sends it in for me. Heck, I've probably got over 18 months of prescriptions on file, as there was some overlap from the ones the Coumadin Clinic gave me early on. We long ago established trust, with me initially bringing all my data and showing him that I test weekly and am in range over 90% of the time.

I sure hope that your GP is a reasonable person and if you were going away for an extended period of time that he would cooperate and give you a larger prescription. I think if my GP or cardiologist did not work with me in a reasonable manner that it would be cause for firing.
 

tom in MO

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I've yet to travel abroad on Warfarin and have three practical questions. I appreciate the answers will vary depending on where you are traveling from and to but would welcome any generic comments.
  1. How do you acquire enough Warfarin for your trip? My GP limits me to one month's supply at a time.
  2. If you run out whilst overseas / lose your pills, it is a challenge to acquire more?
  3. Have you ever needed to declare that you are bringing the medication into the country at customs?

  • How do you acquire enough Warfarin for your trip? My GP limits me to one month's supply at a time. Ask for more. My insurance company allows for 3-month supply. You can also get your prescription early, usually by 10 days, thus you can build up a stockpile as a buffer.
 

KLS39

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Years ago before I was on warfarin I was traveling to Europe and my thyroid medication was going to run out on the trip and it was too early to fill it before the trip. I was able to call my insurance company and get a vacation override.
I fill my pill case before traveling and always bring the prescription bottles with remaining pills in case I get stuck somewhere longer than planned. I put them in my carryon with my Coagsense machine and supplies. My bag did get pulled at security when leaving Serbia because of the Coagsense but once I explained what it was everything was fine.
 

pellicle

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Hi

...appreciate the answers will vary depending on where you are traveling from and to but would welcome any generic comments.
  1. How do you acquire enough Warfarin for your trip? My GP limits me to one month's supply at a time.
  2. If you run out whilst overseas / lose your pills, it is a challenge to acquire more?
  3. Have you ever needed to declare that you are bringing the medication into the country at customs?

  1. I took a 3 month supply with me because my Dr heard my actual argument (not a general non specific question) and gave me a prescription which allowed it to all be filled in one transaction (Australia has both rules and exception clauses for rules). As well I took a prescription with me to Finland and because I was going to be there for a year. Later I got a prescription from a local hospital in Finland but because I was (am not) Finnish I had to pay full price of EUR10.99 for a bottle of 50 tablets ... I got 3 repeats.
  2. in India I just went to a pharmacy and they didn't ask for anything more than my passport ... I wasn't after heroin.
  3. not that I recall, every place I've been to pharmaceuticals were allowed when accompanied by prescription. I even carried literally a years supply of amoxicillin because I knew of the difficulties of getting that in the EU. I always carried my meds in my carryon and nobody has even blinked once at anything (except in Singapore where they confiscated my nail clippers ... on my way home! ...)
so far I have travelled to Finland, UK, Ireland, the Czech Republic, and India (I think that's it :unsure:) .. PS: obviously in and out of Australia too.

HTH

PPS: oh, and things would be different if you were carrying something borderline or sus like "medical marijuana" ... large amounts of Oxycotin ... polonium ... although Russian Diplomats seem to get that into the UK.
 
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Estrazz

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Sep 24, 2021
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personally I wouldn't recommend the CoagSense, I'd say go with a Roche

Pellicle,

What is the reasoning behind this suggestion? Where I bought my monitor from the CoagSense was the only option and so far I am happy with it.
 

pellicle

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What is the reasoning behind this suggestion? Where I bought my monitor from the CoagSense was the only option and so far I am happy with it.

if its working for you then good, as I don't have one (nor inclined to buy one) I can only say its related to second hand reports of significant variations of INR from Lab and the poor response (you must be faulty not our gear) from them.

A recent reference

to my eye they are only popular in the USA and perhaps only because in the USA its harder to own one (unlike outside the USA where they can be bought readily or even given to you) .
 

rajeevgoswami

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I travel a lot overseas on my business. Doing it for 19 years since my AVR. I have a st Jude mechanical valve. My trips were international mostly from india to USA ( 18-20 hrs of flight). I never had problems. I keep my additional stock of anticoagulant in my travel bags. Since food varies a lot ( I am a vegetarian). I get my INR tested when I return some times.
 

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