lab vrs at home variance

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Christine

hello all, i just did my first at home test with my protime on the same day (20 minutes apart) as my blood draw.. the lab reported a 1.9 INR while my machine gave me a 2.3 INR.. does anyone know if this is too much variance?

10 days ago it was 2.8 from the lab - i started taking pravacol (cholesterol) which is why i retested in 10 days.. and i stopped taking 30mg of COq10 daily when i ran out the thursday prior (i take enough pills, if i don't need it, i'm trying to cut down) - i try to eat a side salad (bagged iceberg type) with my lunch, but was not as consistant last week

has anyone heard anything on cauliflower? i thought it was realatively low in vit k, then i read (after i ate some raw as a snack several nites) that it is pretty high.. i've been snacking on raw veggies (sugar snap peas and cauliflower and some baby carrots) thinking they were low in vit k.. maybe that might be why my numbers took a dive..

i have a appt via phone with the QA nurse tonite regarding my walk thru phone call (first time users, she didn't get my info until last nite, but i already figured out how to use it.. ) i'll hit her up regarding the variance in lab vrs home testing.. but any info ya'll might have would be greatly appreciated..

thanks
christine
 
My Vitamin K listing has:

Cauliflower, fresh/frozen, boiled, 1/2 cup, pieces, 20 mg

which is fairly low, but also leaves a number of questions, such as, Is there a difference between fresh and boiled?

Carrot, fresh, boiled, 2/3 cup, 15 mg
Peas, green, fresh/frozen, boiled, 1/2 cup, 24 mg
Peace, mature, dry, boiled, 2.3 cup, 5 mg

and by comparison

Kale, raw leaf, 817 mg

I hope this helps.
 
Christine

Christine

Over the last 18 months since we have had the ProTime monitor, we've had similar variations many times and worry little about them. What is important is that you are out of your range, which I am assuming in 2.5-3.5. Your surgery wasn't that long ago. People vary. Some take a long time to stabalize their INR. As long as my hubby is in range, we worry little about variations that could be caused by a multitude of things.

My husband, Albert, has his mitral valve replaced in October l990. He has never worried about vitamin K in vegatables and foods. As long as you stay consistent, the medication will do it's job and regulate the blood. No foods are forbidden in moderation. Actually, the body does need some Vitamin K to work effectively. Did you know that the body manufactures its own Vitamin K?

On one of the posts recently someone listed a link to a comprehensive list of foods and their Vitamin K content. You might want to look at it to get a feel for the topic. Iceberg lettuce isn't that high. The "Greener" lettuce, like Romaine and Leaf lettuce, and spinach should be used with some care. Actually, medication changes and some herbal products can cause more difficulties then diet. I hope this helps. I'll look around for the list or perhaps someone else here will post it again for you.

I'd love to swap some low-fat recipies with you. Perhaps we can do so another time. There is a place on this board for that.

Kind regards,
Blanche
 
There is a list of vit k content foods at the Coumadin website

www.coumadin.com

click on CONSUMER

then click on HEALTH/LIFESTYLE

Hope this helps
 
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thanks guys.. i s/w the QA nurse last nite.. she mentioned that the protime is more acurate than labs most of the time because of it's reagents' sensitivity level.. she also mentioned that if you don't clean your finger good with the alcohol and also dry it completely with gauze - it could affect the results.. i was in a hurry when i tested trying to beat the clock.. which she mentioned not to be intimidated with the 2 minute time frame, as long as we don't put the tenderlett in the couvette, all we have to do is just redo with another tenderlette, the couvette is fine and can be used up to 8 hours if opened.. the tenderletts being less expensive then the couvettes..

she also mentioned that COq10 also raises INR levels and since i stopped taking it 4 days prior to being tested, that's probably what caused my drop..

i have the list of vit k levels which was linked here.. quick question, what level is considered high?

the nurse was very informative and gave me her number if i have any questions and she'll also call me next week when i do my follow up test (with lab also) since my doc raised my coumadin levels yesterday.. he basically flipped me.. i was 5mg daily except monday and thursday when i was 7.5mg, now i'm 7.5mg daily except monday/thursday when i'm 5mg... with that in mind.. since i'm using more tablest per month.. and my insurance only pays on a month basis - how do others manage this.. is this where a second script for maybe 2mg may be better.. debating on calling my doc for it.. thanks again..

wish me luck.. going on first vacation since my operation.. boyfriend's family reunion in Louisana.. leaving tonite..

christine
 
Hi Christine,

Here is a link to the govt USDA site chart for Vit K.

http://www.nal.usda.gov/fnic/foodcomp/Data/Other/pt104.pdf

Also, here are some guidlines to use to evaluate Vitamin K content.

Low: Less than 30 ug/100g
Med: Between 30 and 150 ug/100g
High: Over 150 ug/100g

This may have more information for you to consider. I have a copy of this chart printed out and I keep it with me while traveling.

Rob
 
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Dosage?

Dosage?

Christine..I'm no Dr. Al..but..I have been on same dosage since 2 months post-op and you are 4 months post-op. Sounds to me like you should have found your dosage before now (correct one) Made my head swim when I read your dosage change Yesterday:rolleyes: I have my home Protime and can keep in range by adding or subtracting Vit. K foods. Mostly adding greens when I go out a tad. Like 4.0....Today I was 3.4 and 2 weeks ago a perfect 3.0......but I only eat Iceburg salads...quit coleslaw, cabbage, Southern foods.....Have fun on vacation but get the correct dosage when you get back home and you will be in fat city....Amazing how you will stay in range. Bonnie
 
Christine,
Can you please explain what you mean about the couvette/tenderlet thing. I too have trouble with the 2 minute time.
Sharon
 
See if I can help

See if I can help

Sharon, First you really need to have your finger warmed up and rubbed and down below your breastbone before you incise. Then incise over toward the end and top of finger.. Sling it (hand) around a bit to get blood flowing. Blot, then fill. If you cannot fill in the 2 min. time frame DO NOT put it in the Protime. Leave your cuvette alone and try again...or take the cuvette out. It will be good for 8 hours. Do you have someone to help? I let my husband watch protime and push the red button for me to incise while I hold the Lassette TIGHT against my finger. Hope this helped. Bonnie:)
 
Hi Bonnie,
Yes, I know the procedures from the nurse who trained me, from reading posts and also from Blanche. It seems that my left hand is easier to get blood from, sometimes. My right hand finally starts to flow after the 2 min are up. I understand all the correct ways of doing the stick but it is frustrating. I'm hoping that with time I'll do better. In the beginning my heart would beat so fast with me trying and my husband coaching - it made me feel so panicky. Usually it takes 2 times to do the job, once it took 3. I didn't know that you could save the cuvette if you didn't insert the one with the blood (can't remember its name). Anyway I'm almost out of my supply that I thought would last me 9 mos. I will try using the arm swing tip next time.
Sharon
 
Tips

Tips

Sharon, Got the tip about swinging the arm from Rain..another Valver from Co....Also high on finger and off to side...Probably bacaue it is more softer..than in middle. Yes...Do NOT put Tenderlett in the machine if you are running late..Just calm down and do it again..The pricking thing..in a new Tenderlett. The cuvette will be good for 8 hrs. And don't worry..we still get a reading of no good..bubbles, ect. I HATE when that happens. But this is still better than going down to the lab for a draw.:) :cool: Bonnie
 
Sharon

Sharon

I just read your user ID. Wow, Over 5 years since you had your valve replaced. How are you doing? Would love to hear about your now lifestyle..Walking, ect. if I'm not being too noisy.:D :D I am a little over 6 months. Bonnie
 
Hi Sharon,

I had a hard time when I first started using my Protime too. I could net get enough blood for the sample, and the 2 minute timer would expire. After the 2 minutes, the blood would flow like a river. I wasted several testing units due to that.

I spoke with the nurse, and she said it was nerves, and gave me some tips on getting more blood to the fingers. The same ones that Bonnie described.

I have been using my unit for 2 years now, and have to admit that once you get over the nervousness that you first have when using the machine, you will have no problems. I rarely have a problem drawing blood for the sample these days.

I warm my hands in warm water first, then while the machine is warming up, I swing my arm around in circles ( after I clean the finger with alcohol.. swinging also helps dry that too!)

Hope things settle down for you soon. Ohh, and "yes" as long as you do not place the blood sample into the cuvette, then you can use that again if you failed to draw enough sample in the tenderlette funnel the first time.

Have a great weekend!

Rob
 
Thank you Bonnie and Rob for the tips. I'm going to do a test tomorrow and hope that the arm swings will do the trick.
Sharon
 
arm swings worked

arm swings worked

Hi Bonnie and Rob,
Finally got around to taking my inr. I went to the lab first and rushed home - got it done within the recommended no more than 15 minutes after the lab draw was done. Warmed the hand then swung my arm around - the blood was right there - no problems it was so easy. Thanks for the help. Just heard from the dr my lab inr was 3.64 - my home test was 3.7 . A bit high but just had a nice salad to offset the higher inr. I'm a happy camper finally.
Sharon
 
Hi,
I just wanted to thank you all for the tips on how to get blood out in the two minute time frame. It is really encouraging to know that we weren't the only ones having problems with the unit.

Martha (mom to Chrissy 13 years, St Jude aortic valve replacement -- 4 open heart surgeries, pacemaker, truncus arteriosus)
 
I have also found the 'warming and swinging' techniques helpfult.

Another trick is to squeeze each side of your first knuckle. I believe this blocks the return veins, increasing the blood in the fingertip.

'AL'
 
You know, I've never had a problem getting enough blood in the time frame... Now I've had PLEANTY of problems with air bubbles, but I seem to bleed just fine. ;) However, recently I've been doing MUCH better at getting my test right the first try. :D My card absolutely loves that I have the home machine. I have to wonder why other doctors would be hesitant... Guess I'm just lucky, but I already knew that...
 
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