Quantcast

Life after Mechanical Valve --- 31 years old

Help Support ValveReplacement.org:

pellicle

Professional Dingbat
Joined
Nov 4, 2012
Messages
7,227
Location
Queensland, OzTrayLeeYa
...The only thing I had to change in my life was after my St. Jude was installed, my cardiologist asked me to give up my position as a volunteer firefighter.
dunno if you've read of the fires around near where I live, but we've had a few. I know a few of the local "fireies" (volunteer bush fire brigade) because they live and work in my town.

It's hard stuff that they do and my hat is always off in gratitude of what they do.

Thanks for your kind words, but I don't think there is too much more magic in my spreadsheets than you have in yours ;-)

Keep on Tikkin mate
(just FYI this is the last one burning around my joint:
Swanfels (east of Warwick) – bushfire as at 1pm Mon 14 Oct

The previous bushfire warning has changed.

Queensland Parks and Wildlife Service (QPWS) crews are currently monitoring a bushfire burning in an inaccessible area at Swanfels Valley between Emu Vale and Mount Moon. This fire is posing no threat to property at this time and QPWS crews will continue to monitor the blaze over the coming days. Residents may be affected by a smoke haze and are asked to close windows and doors and if suffering from a respiratory condition, keep medications close by. Motorists should drive with caution and to conditions. If residents are concerned their property is under threat they are advised to call Triple Zero (000) immediately.

https://www.ruralfire.qld.gov.au/map/Pages/default.aspx )
 

Protimenow

Well-known member
Joined
Aug 10, 2010
Messages
3,600
Location
California
Hello
Got my St.Jude Mech Valve at 22. I am 45.
1) I do it all, Beach Volleyball (tournament), Softball team, used to play flag football (body cant take it anymore), Ski, spearfish and dive.
2) Mini stroke like 6 years in was not taking Warfrin correctly. Got lucky, never missed a monthly blood work after that.
3) Dont really know but my goal is to beat Dick0236 :)
You should really consider testing weekly. During a month, it's possible to have a low INR and, possibly, another TIA. (I know - it happened to me). If you can, get a meter and supplies and self-test weekly.

Monthly is not enough to be safe.
 

Protimenow

Well-known member
Joined
Aug 10, 2010
Messages
3,600
Location
California
" If you wish to home test, you will need to have a good paying job or one with good healthcare benefits. You'd need that with a tissue valve as well, since they need to be replaced."

Not true. This makes it sound like it costs thousands of dollars a year to self-test weekly.

A meter, retail, is about $700 or so (and will probably last for a decade or more), and the strips cost about $5 each. You can probably get a meter for considerably less cost on eBay. The cost of weekly testing - even if you have to pay for it without insurance coverage - isn't all that bad. I rarely eat out, but the cost is less than two lattes or a fast food burger or two.

The co-pay for some clinics may be more than the cost for self-testing.

I've been self-testing since April 2009, and have recorded each test on a spreadsheet. I originally started with a Protime meter, graduated to a Protime 3, then moved to an InRatio -- reliance on that damned meter, which was reporting an INR of 2.6 (when the hospital got a 1.7) resulted in a TIA. At that point, I was resolved to test a variety of meters against each other, and against a hospital lab. My results gave me the most confidence in the Coag-Sense meter (I've seen 'new' Coag-Sense meters - the original design - for less than $200). The Coag-Sense uses a mechanical method of detecting when a clot forms. It often gives results that are .1 or .2 behind the lab (depending on the lab). My second choice is the CoaguChek XS. It's the most available, and most frequently used. For me, it often registered slightly higher than the lab results, and usually a bit higher than the Coag-Sense.

I've found that some lab results were WAY OFF. I've gotten to the point where I would rather trust the meter than the lab. If I had some CoaguChek XS strips, I'd compare results to the Coag-Sense.

Please - commit to weekly self-testing. If it makes you more comfortable, have a blood draw every month or so. If your doctor requires that you go to a clinic or lab for testing, do it. It will help validate your meter's results against the lab results (and may even reveal data about the lab or meter that should be explored further).
 
Last edited:

tom in MO

Well-known member
Joined
Jan 17, 2012
Messages
1,415
Location
MO USA
There are many people who have trouble affording rent and food, much less lattes. They have valve replacements at the same frequency as the wealthy.

Does anyone know if Medicaid covers home testing? I am pretty sure Medicare covers it. However the working poor with a significant insurance deductible has to make hard choices.
 

Protimenow

Well-known member
Joined
Aug 10, 2010
Messages
3,600
Location
California
Tom: I know exactly what you're talking about. If I didn't have my Coag-Sense meter, and some strips, I probably wouldn't be able to do self-testing. I would like to use my CoaguChek XS once in a while, just for comparison to my Coag-Sense (just curiosity -- I fully trust my Coag-Sense with my life), but I can't afford to buy CoaguChek XS strips.

Balancing the cost of a meter and supplies against food, housing, transportation, and other essentials is a terrible thing to have to do. I know. I've done it, and I'm still doing it. CoaguChek strips fall out of the equation for me because a) they're not necessary and b) I already have a meter that I trust more than the XS.

I haven't tried to see what Medicad will or won't cover, because I don't need that coverage - I have my own meter and a supply of strips. (You can sometimes find a good deal if you keep watching eBay)


I suspect that Medicaid will cover the cost of testing - if not home testing, they may cover testing at a clinic (not the best idea). They may even cover the cost of a meter and supplies. I don't know. I haven't tried. But it would make sense for Medicaid to support home testing (or, yuk, testing at an anticoagulation clinic), because it's a lot cheaper for the system to pay for you to maintain your INR than it is to have to pay for medical care, and possibly lifelong care, if you have a stroke.

A person in the terrible financial position where it's a choice between eating and testing should try Medicaid to see what they'll cover.

(FWIW - I'm now on Medicare, and they will apparently pay for testing, but it may have to be done through a clinic, the clinic will get a lot of money for, essentially, doing nothing, and I'm not about to stick the Government with these unnecessary costs).
 
Last edited:

LoveMyBraveHeart

Well-known member
Joined
Aug 6, 2019
Messages
137
Location
USA
Tom: I know exactly what you're talking about. If I didn't have my Coag-Sense meter, and some strips, I probably wouldn't be able to do self-testing. I would like to use my CoaguChek XS once in a while, just for comparison to my Coag-Sense (just curiosity -- I fully trust my Coag-Sense with my life), but I can't afford to buy CoaguChek XS strips.
Is the Coag-Sense less expensive? Is it the type that comes with a capillary transfer tube? Looking in to buying one as the cardiologist works for a large chain clinic that refuses to allow her to write the prescription for a meter. I believe the clinic we test at now uses the CoaguChek XS...seems like less steps than the Coag-Sense to complete the test, but I don't mind extra steps is the meter and strips are reliable and less expensive. I'm trying to figure out a way to allocate 500-700$ worth of funds for a meter alone, not to mention the strips we would need to buy bi-annually or annually. Thank you in advance.
 

pellicle

Professional Dingbat
Joined
Nov 4, 2012
Messages
7,227
Location
Queensland, OzTrayLeeYa
... I believe the clinic we test at now uses the CoaguChek XS...seems like less steps than the Coag-Sense to complete the test
Protime has a long history here of preferring the CoagSense over the Coaguchek. He personally has a collection of these devices (although I believe he sold one or two) and it verges on a hobby. He has done some examinations because he's reported that for him his XS led him to a different INR number than blood draws obtained. I understood he had a TIA associated with that differing INR which understandably motivates him.

This is not my finding, nor an industry wide one and not the findings of a number of users of the XS (that it differs significantly from the XS. So given the extra fiddlefarting around to use it if there is no clear (for you) benefit in the results then why?

An important issue is consumables and being able to obtain them. I can't get the consumables (strips) in Australia nor in Europe (both places I've lived) and so even if it were somehow better (which there is little evidence to support) its useless without the strips.

If (as you say) you are already getting your bloods done by an XS to the satisfaction of your medical professionals then I would submit : "if it ain't broke don't fix it".

Lastly I will say that INR is at best a rubbery number, it is not like measuring the thickness of a piece of steel with a micrometer. Accordingly (if you delve into the details) its unwise to seek precision but only to seek consistency and repeatability.

Searching on this forum will reveal his posts and his and my discussions on this topic.
 

LoveMyBraveHeart

Well-known member
Joined
Aug 6, 2019
Messages
137
Location
USA
Protime has a long history here of preferring the CoagSense over the Coaguchek. He personally has a collection of these devices (and it verges on a hobby) and has done some examinations because he's reported that for him his XS led him to a different INR number than blood draws obtained. I understood he had a TIA associated with that differing INR which understandably motivates him.

This is not my finding, nor an industry wide one and not the findings of a number of users of the XS (that it differs significantly from the XS. So given the extra fiddlefarting around to use it if there is no clear (for you) benefit in the results then why?

An important issue is consumables and being able to obtain them. I can't get the consumables (strips) in Australia nor in Europe (both places I've lived) and so even if it were somehow better (which there is little evidence to support) its useless without the strips.

If (as you say) you are already getting your bloods done by an XS to the satisfaction of your medical professionals then I would submit : "if it ain't broke don't fix it".

Searching on this forum will reveal his posts and his and my discussions on this topic.
Hi Pellicle!

We are currently going to the ACC weekly for testing, I believe they use the CoaguChek XS. I am happy to go to the clinic for now (other than the copay every time) since the testing is as frequent as it should be, but in about a month they are going to back him off to testing once a month. I am not comfortable waiting that long between tests, so am researching home testing machines. Since the cardio can't prescribe a meter and strips, I am looking at purchasing a machine out of pocket, which isn't a small purchase (at least to us 25 year olds just trying to be able afford our first house). Just attempting to gather as much information as I can about cost and accuracy of the meters folks on here use. I really don't care who makes the meter or what it's called, as long as it and sourcing its supplies are reliable. Here's hoping I can either a) find a cardio that is able to prescribe or b) the clinic chain our cardio works for now sees the light and will start supporting home testing. Anyway, sorry to ramble!
 

pellicle

Professional Dingbat
Joined
Nov 4, 2012
Messages
7,227
Location
Queensland, OzTrayLeeYa
Hi

... but in about a month they are going to back him off to testing once a month. I am not comfortable waiting that long between tests, so am researching home testing machines.... I am looking at purchasing a machine out of pocket...as long as it and sourcing its supplies are reliable..
I think that the fact that the Roche XS is the go to Point of Care machine for 90% of the industry suggests its reliable and it seems to me to be cheaper to purchase and operate.

I believe that with the market penetration of the XS that in 10 years time it'll still be supported by strips.

If trying to save money I'd look carefully (do a saved search) on eBay for a used machine (they come up now and then) just purchase new ... the USA is supposed to be the king of the free market economy right? eBay has many reliable sellers of strips and as long as they are unopened with the code chip and a reasonable remaining time on their use by date you're good to go. I've not ever heard of there being fakes.

.. Anyway, sorry to ramble!
no trouble ... its the main point of the site ... rambling to get things out of your head and said (as well as varying perspectives).

:)

PS: in case you missed it I did this quick cost analysis on the first page of this thread:

Let me give you a for instance. eBay has many good sellers with the Roche Coaguchek regularly listed for around US$600, the strips are commonly US$99 for a pack of 24 strips. That works out to less than $5 per test.
...
I've had my Roche Coaguchek since late 2011 and its done more than one test per week (my blog will reveal some of the whys on that), which is about 400 weeks. Thus my machine (which still works fine) has come to cost an additional $1.5 per test in that (and it keeps getting smaller).
 

pellicle

Professional Dingbat
Joined
Nov 4, 2012
Messages
7,227
Location
Queensland, OzTrayLeeYa
There are many people who have trouble affording rent and food, much less lattes. They have valve replacements at the same frequency as the wealthy.
exactly, which is why being able to buy a meter and self test for what comes to $6 per week over time is critical to them having good health outcomes ... being uninsured would mean no other options for regular INR testing would it not?
 

Protimenow

Well-known member
Joined
Aug 10, 2010
Messages
3,600
Location
California
Pellicle and I are friends, but we have a bit of a lack of commitment as far as a meter of choice is concerned.

He made many good points about the CoaguChek XS. Its global distribution is much better than the Coag-Sense. You can buy it, and strips, in much of the world. Roche is selling an upgraded meter that takes the XS strips outside of the U.S. They have a meter that is only available if you use their testing services.

It operates by performing an electrical test on the blood, once it's deposited onto a strip and, based on the change in electrical impedance, and the code on the chip, it calculates an INR and prothrombin time. If you have certain blood issues (high hematocrit, for one), it either won't get a result, or will provide an erroneous result. Last year, they had a recall of a few batches of strips.

By contrast, the Coag-Sense meter actually detects the formation of a clot. It has a small wheel that spins during testing - deposit the blood, it mixes with the reagent, and the spinning wheel mixes blood and reagent. An optical sensor detects when the clot is formed (because the wheel stops spinning). The time is detected, and this time is divided by a value for the reagent (recorded as a barcode on the strip) to determine the INR.

The method of timing the formation of a clot is very similar to the method that labs use.

In 2013, I had a stroke because I put too much trust in a meter -- it was telling me my INR was 2.6 -- in the hospital, it was 1.7. I determined, after I got home, that I wanted to find the most accurate meter.

I tested many -- the ProTime, ProTIme 3, InRatio and InRatio 2, Coaguchek S (precursor to the XS), Coaguchek XS, and, finally the Coag-Sense. I also had tests at an anticoagulation clinic that used the Hemochron - a meter that was also used in surgeries and was reported to be as accurate as a lab test.

The InRatio was probably the worst. When my INR was high, the InRatio reported it WAY HIGH. At some times, the CoaguChek XS was also much higher than the lab (I'm talking about a full point or so higher).

The Coag-Sense was consistent. It seemed to be about .2 below the lab results. Many times, when I tested with Coag-Sense and CoaguChek XS, and also had a blood draw, the blood draw was almost an exact average of the two meters.

For me, the Coag-Sense was always around .1 - .2 below the lab results. In my mind, I'm more comfortable with a meter that may report SLIGHTLY LOWER than the labs than I am with a meter that reports SLIGHTLY HIGHER than the labs. (In other words, if both meters report 2.0, I can assume that the lab result may be between 2.0 - 2.2 or so (putting me in a fairly safe zone), but the CoaguChek XS result may mean that my INR may be as low as 1.8). FWIW, the meters are considered accurate if the INR reported is within 20% of the actual INR.

And, FWIW - I've had some really inaccurate results from labs over the past year or so. I'm trusting my meters more than I trust the labs.

Now -- a few more things:

I've seen some on this forum trying to make a big deal about 'extra steps' needed to do a test with the Coag-Sense. With the CoaguChek XS, you can touch the blood drop on the side or top of the strip. This IS easy. If you don't have the dexterity, you can use a capillary tube to collect the drop, then deposit it on the strip.

The Coag-Sense is a physical method of testing, so it's somewhat sensitive to air drops somehow mixing in with the blood sample. Their method requires a simple capillary tube to transfer the blood. Here's the terribly difficult method for testing with the Coag-Sense - incise finger, squeeze drop, place transfer tube onto blood drop. The blood will be brought into the tube, until it touches a tiny white obstruction - place the tip of the transfer tube into the well on the strip, and press the plunger on the transfer tube. This method assures that the right amount of blood is collected, and reduces the possibility that an air bubble is deposited onto the strip. It's really very simple. It doesn't feel like much of an 'extra step' and, in a way, it almost seems like fun.

Another thing -- CoaguChek XS strips are very sensitive to exposure to air. They come in a tube with a tight cap. Once you insert a strip into the meter, it expects a sample very soon - if you can't get an adequate drop of blood, the test fails, and the strip is toast.

The Coag-Sense is more robust. If you can't get a drop of blood onto the strip, you can put it into a plastic bag (and may not even have to do this), and use it later.

One final thing:
Cost.

There's a sexy new model called the PT2. It has lots of bells and whistles and seems to have been primarily designed for clinics, medical offices, and hospitals - it can store 2000 test results (at a test a week, that's around 40 years of tests), has WiFi, USB, an ethernet port, and NFC reader, USB, and an internal battery. It's a really nice meter. But, yes, it's not cheap (but neither are new CoaguChek XS meters).

I've seen the original Coag-Sense meter on eBay for less than $200. It's a very solid meter and, in some ways, better than the new model (it's better because it warms up faster, if that's important to you, and has no fancy features -- it just does the job). Both use the same strips. The meter for sale on eBay is supposedly new - it may be - I don't have one, so I can't speculate. I think Coagusense (the company that makes the Coag-Sense meter) may have discontinued this model (PT1) when it started shipping the new model (PT2) and may have sold off inventory --- but this is just a guess. I have no idea how the vendor got these 'new' meters.

I've seen strips for sale, retail, for about the same price as the CoaguChek XS strips. I've seen them on eBay for as little as $1 - $3 each.

I'm pretty confident that the manufacturer will be around for quite a while. You should be able to get strips for many years to come.

Roche should be around for MANY years. (A few years ago, they discontinued the CoaguChek S. There was plenty of warning in advance of its removal from the market -- it makes me wonder, just a bit, what will happen if Roche expects to phase out the XS?)

To me, what I perceive to be better accuracy - results equal to, or slightly lower, than an accurate lab argues for the Coag-Sense.

(I may have an extra, barely used, Coag-Sense, if you're interested).

As Pellicle noted, measuring INR isn't an exact science. Either meter should be fine for weekly testing. The strips cost about the same - and you may be able to get a deal on eBay. Either should do well for you until (or if) they find an alternate medication for valvers that doesn't require the weekly testing. (If they do, I wouldn't be surprised if it's around $8 a dose and dreadfully difficult to reverse - keeping warfarin as an attractive, affordable alternative).

I know that I went on a bit, describing some of the differences between the XS and the Coag-Sense. For me, I prefer the Coag-Sense and have little fear that the manufacturer won't be around for a long time.

I have no financial interests in Roche or Coagusense. These are just my opinions, based on my experience with the meters.

If you have any questions, feel free to send me a private message.
 

pellicle

Professional Dingbat
Joined
Nov 4, 2012
Messages
7,227
Location
Queensland, OzTrayLeeYa
Pellicle and I are friends
I think of it that way too ... I have many divergences from some of my friends. One rides "cruisers" while I prefer sport bikes, another is gay, I ride an electric scooter (and cop 5h1t for that from some of my cyclist mates who consider this a betrayal)

;-)
 

Heart_Fit

Member
Joined
Sep 2, 2017
Messages
15
Location
West hollywod CA
Heart_Fit -- INR management IS that easy for many of us here. You have to understand how warfarin works to most effectively manage it.
Post-op, you (or your doctors) will have to determine the appropriate dose - it often varies from individual to individual. It also takes a while, post-op, for your body to adjust to warfarin (maybe?).
Once you've determined the appropriate dose to keep your INR in range, you should commit to self-testing weekly -- get yourself a meter, get supplies. Depending on your insurance coverage, you may have to go to a clinic -- but there's nothing keeping you from buying your own meter and supplies -- some clinics are comfortable with testing every two weeks, or even less often.

It helps to be consistent with your diet -- this will help you keep your INR in range. Binging on greens if you don't normally eat a lot, or dropping them from your diet if you do normally have a lot, can change your INR. For your INR to be off for a day or two is no big deal.

Remember -- if you're looking to adjust your dosage, you won't see results for two or three days. Don't think that, if your INR dropped, loading up on warfarin will change your INR the next day -- instead, it can cause your INR to spike in two or three days. If you remember that it takes a few days to see any results from changed doses (up or down), you'll be better able to maintain your INR.

I may have made this sound complicated. It isn't. It's simple. There are many on this site who can help you with dosing or refer you to dosing charts.

As far as your activity level -- it probably doesn't change much. You may actually be more active, and more able to do things that you didn't have strength for, because your heart will be operating more effectively.

It may make sense to avoid some activities where you get banged around - anticoagulation will result in bigger bruises - but if you read through more stuff on this site, you'll see that people are doing all kinds of athletic activities -- even full contact.

Having a mechanical valve WILL change your life -- but for the better. I wouldn't fear anticoagulation if I were you.

(There's also the possibility that, before your 90th birthday, a new medication would have been developed to replace warfarin and eliminate the need for drug testing. It's also possible (perhaps) for a new type of mechanical valve to come on the market that doesn't require anticoagulants and that may even be an easy to install replacement or enhancement to the mechanical. I'll probably see neither of these, and if there's still a livable planet, you might)

thank you so much!
 

Heart_Fit

Member
Joined
Sep 2, 2017
Messages
15
Location
West hollywod CA
Pellicle and I are friends, but we have a bit of a lack of commitment as far as a meter of choice is concerned.

He made many good points about the CoaguChek XS. Its global distribution is much better than the Coag-Sense. You can buy it, and strips, in much of the world. Roche is selling an upgraded meter that takes the XS strips outside of the U.S. They have a meter that is only available if you use their testing services.

It operates by performing an electrical test on the blood, once it's deposited onto a strip and, based on the change in electrical impedance, and the code on the chip, it calculates an INR and prothrombin time. If you have certain blood issues (high hematocrit, for one), it either won't get a result, or will provide an erroneous result. Last year, they had a recall of a few batches of strips.

By contrast, the Coag-Sense meter actually detects the formation of a clot. It has a small wheel that spins during testing - deposit the blood, it mixes with the reagent, and the spinning wheel mixes blood and reagent. An optical sensor detects when the clot is formed (because the wheel stops spinning). The time is detected, and this time is divided by a value for the reagent (recorded as a barcode on the strip) to determine the INR.

The method of timing the formation of a clot is very similar to the method that labs use.

In 2013, I had a stroke because I put too much trust in a meter -- it was telling me my INR was 2.6 -- in the hospital, it was 1.7. I determined, after I got home, that I wanted to find the most accurate meter.

I tested many -- the ProTime, ProTIme 3, InRatio and InRatio 2, Coaguchek S (precursor to the XS), Coaguchek XS, and, finally the Coag-Sense. I also had tests at an anticoagulation clinic that used the Hemochron - a meter that was also used in surgeries and was reported to be as accurate as a lab test.

The InRatio was probably the worst. When my INR was high, the InRatio reported it WAY HIGH. At some times, the CoaguChek XS was also much higher than the lab (I'm talking about a full point or so higher).

The Coag-Sense was consistent. It seemed to be about .2 below the lab results. Many times, when I tested with Coag-Sense and CoaguChek XS, and also had a blood draw, the blood draw was almost an exact average of the two meters.

For me, the Coag-Sense was always around .1 - .2 below the lab results. In my mind, I'm more comfortable with a meter that may report SLIGHTLY LOWER than the labs than I am with a meter that reports SLIGHTLY HIGHER than the labs. (In other words, if both meters report 2.0, I can assume that the lab result may be between 2.0 - 2.2 or so (putting me in a fairly safe zone), but the CoaguChek XS result may mean that my INR may be as low as 1.8). FWIW, the meters are considered accurate if the INR reported is within 20% of the actual INR.

And, FWIW - I've had some really inaccurate results from labs over the past year or so. I'm trusting my meters more than I trust the labs.

Now -- a few more things:

I've seen some on this forum trying to make a big deal about 'extra steps' needed to do a test with the Coag-Sense. With the CoaguChek XS, you can touch the blood drop on the side or top of the strip. This IS easy. If you don't have the dexterity, you can use a capillary tube to collect the drop, then deposit it on the strip.

The Coag-Sense is a physical method of testing, so it's somewhat sensitive to air drops somehow mixing in with the blood sample. Their method requires a simple capillary tube to transfer the blood. Here's the terribly difficult method for testing with the Coag-Sense - incise finger, squeeze drop, place transfer tube onto blood drop. The blood will be brought into the tube, until it touches a tiny white obstruction - place the tip of the transfer tube into the well on the strip, and press the plunger on the transfer tube. This method assures that the right amount of blood is collected, and reduces the possibility that an air bubble is deposited onto the strip. It's really very simple. It doesn't feel like much of an 'extra step' and, in a way, it almost seems like fun.

Another thing -- CoaguChek XS strips are very sensitive to exposure to air. They come in a tube with a tight cap. Once you insert a strip into the meter, it expects a sample very soon - if you can't get an adequate drop of blood, the test fails, and the strip is toast.

The Coag-Sense is more robust. If you can't get a drop of blood onto the strip, you can put it into a plastic bag (and may not even have to do this), and use it later.

One final thing:
Cost.

There's a sexy new model called the PT2. It has lots of bells and whistles and seems to have been primarily designed for clinics, medical offices, and hospitals - it can store 2000 test results (at a test a week, that's around 40 years of tests), has WiFi, USB, an ethernet port, and NFC reader, USB, and an internal battery. It's a really nice meter. But, yes, it's not cheap (but neither are new CoaguChek XS meters).

I've seen the original Coag-Sense meter on eBay for less than $200. It's a very solid meter and, in some ways, better than the new model (it's better because it warms up faster, if that's important to you, and has no fancy features -- it just does the job). Both use the same strips. The meter for sale on eBay is supposedly new - it may be - I don't have one, so I can't speculate. I think Coagusense (the company that makes the Coag-Sense meter) may have discontinued this model (PT1) when it started shipping the new model (PT2) and may have sold off inventory --- but this is just a guess. I have no idea how the vendor got these 'new' meters.

I've seen strips for sale, retail, for about the same price as the CoaguChek XS strips. I've seen them on eBay for as little as $1 - $3 each.

I'm pretty confident that the manufacturer will be around for quite a while. You should be able to get strips for many years to come.

Roche should be around for MANY years. (A few years ago, they discontinued the CoaguChek S. There was plenty of warning in advance of its removal from the market -- it makes me wonder, just a bit, what will happen if Roche expects to phase out the XS?)

To me, what I perceive to be better accuracy - results equal to, or slightly lower, than an accurate lab argues for the Coag-Sense.

(I may have an extra, barely used, Coag-Sense, if you're interested).

As Pellicle noted, measuring INR isn't an exact science. Either meter should be fine for weekly testing. The strips cost about the same - and you may be able to get a deal on eBay. Either should do well for you until (or if) they find an alternate medication for valvers that doesn't require the weekly testing. (If they do, I wouldn't be surprised if it's around $8 a dose and dreadfully difficult to reverse - keeping warfarin as an attractive, affordable alternative).

I know that I went on a bit, describing some of the differences between the XS and the Coag-Sense. For me, I prefer the Coag-Sense and have little fear that the manufacturer won't be around for a long time.

I have no financial interests in Roche or Coagusense. These are just my opinions, based on my experience with the meters.

If you have any questions, feel free to send me a private message.

Thank you so much for writing all this! I'm going to start looking the ones you listed up and see what they're all about. I'm a bit OCD so I'm thinking i may try to get two different ones and work with averages.
 

pellicle

Professional Dingbat
Joined
Nov 4, 2012
Messages
7,227
Location
Queensland, OzTrayLeeYa
I'm a bit OCD so I'm thinking i may try to get two different ones and work with averages.
firstly read up on stuff, you know, proper readings like peer reviewed journals (not mens health dot com)

before you run out and get multiple meters (I mean if you have the money to throw around then great) I recommend you understand what INR is and what its measuring and how its measured and the roles that reagents have in determining INR.

Here are a few sources which I think make good reading just to kick you off:
https://www.medscape.com/viewarticle/731176

https://www.ncbi.nlm.nih.gov/pubmed/18550476

https://ashpublications.org/blood/a...-Reliability-of-Point-of-Care-POC-Prothrombin

The point of doing a literature review is to get a position, not to start with a conclusion and find literature to support your position.

PS: another very important thing to grasp is "clinically significant" difference. While to someone with a maths background who's obsessive a difference of 0.2 may seem something its not "clinically significant" ... which is also why we work now on Target INR rather than Ranges

Do read through my blog post on managing INR as its a good starting point for pretty much everything you need to know.
 
Last edited:

Protimenow

Well-known member
Joined
Aug 10, 2010
Messages
3,600
Location
California
If I wasn't concerned about getting the 'most accurate' meter, I wouldn't have multiple meters. I only test with one meter, most of the time. I use the Coag-Sense, but, really, if this meter hadn't been developed, or was unavailable where I am, I'd be fine with the CoaguChek XS. If I lived in a country that couldn't get the Coag-Sense and strips, I'd be fine with the CoaguChek XS.

Based on my testing, reported variance from lab results, and some papers comparing the XS to lab results, the XS can ge thought to report higher results than some labs. Assuming this to be the case, it's probably no big deal to be fine with a reported INR above 2.3 or 2.4 - this would suggest that, if the reported INR WAS .2 to .3 lower - that the actual INR would still be above 2.0. Medical conditions that can effect the accuracy of a reading using an XS are not common.

For me, I prefer the Coag-Sense. It's the meter that I use. I believe it to be more accurate than the XS.

That said, there's really no test for an EXACT INR. I've had some very inaccurate results from labs recently. My trust in the labs is lower than my trust in meters.

Test results from meters also aren't exact - to be considered 'accurate,' there's an acceptable variation of 20% from 'actual' (whatever that is).

When I had strips for te XS, the results were usually (it's been a while since I tested with an XS, so I'm not sure) within the 20% variance of each other.

The Coag-Sense is easy to learn - once you've done a test or two. To me, it's almost 'fun' to get the drop into the capillary tube, then drop it onto the strip. You get proof that an actual clot formed by looking at the wheel on the strip - the clot is right there.

But, really, I don't see a good reason to have two meters and do parallel testing. In most cases, the results should be within .3 or .4 of each other (maybe slightly more, maybe slightly less), but should be in range, if possible.

If you want to test with both meters, go for it. You'll probably see a slight difference from one meter to the other. These differences probably won't matter much -- unless your technique was wrong, or you've got a blood condition that would make the XS inaccurate or make it fail a test.

I'm down to one meter. If I can afford some XS strips, I'd give my XS a try -- but only out of curiosity, rather than a medical need to compare the results of two meters.

Either meter should give you a good, usable result.
 

Latest posts

Top