Dick: This is probably it for me on this particular thread. (In answer to the original posting -- I still believe that it's useful to test every week -- but I don't see that Alere is providing much of a service -- you could get your own meter and call the doctor on your own, if you don't trust your ability to use the available dosage charts to decide if any change is necessary. You can probably jettison Alere and do it on your own - or with your doctor's help).
Dick: I wasn't arguing with your testing at the doctor's office -- that's a good idea. Having a doctor who is concerned enough to test the meter's accuracy EVERY DAY is also probably a good thing. And having a doctor who will give you a quick look for other problems is also good. I'm glad that it works for you.
Having a regular doctor and, as you do, being on Medicare so it doesn't matter as much how often you see a doctor, is also a good thing.
For me, the idea of having a doctor who I can see regularly, and who I can see affordably, is a distant memory. I make do with what I have.
For me, testing once a week is appropriate. Although I now have access to a public clinic, I really don't like having my taxes (and the taxes that others pay) paying for these services.
Finally, if the argument that monthly testing works well, as long as everything that you do is consistent - dosage, diet, wine consumption, etc., etc., etc. - and that monthly tests are all within range - then why not test every two months? Every four or six months? Hell, how about annual blood tests? If you're consistent from year to year, then it's easy to assume that for the ENTIRE YEAR, your INR was ALWAYS in range.
Personally, I am most comfortable with weekly self-testing. In my experience, I've caught changes that I wouldn't have caught with monthly testing. Perhaps if it required a visit to a doctor or lab to get an INR test, stretching the interval beyond once a week is usually safe -- but for those of us with meters, I think the likelihood that we'll be in range more of the time increases - as recently published papers report -with weekly testing.
I appreciate the opportunity to check the results of my meter against a monthly blood draw, but I still have faith in my meter for the weekly tests. (And even though, for the time being, I have access to monthly blood draws, I'm still committed to weekly self-testing, in addition to the lab tests).
Warfarin is not to be feared. I don't want anyone to get the impression that it's scary. Hell, gasoline is a lot scarier, but people are using it all the time. With warfarin, it's a matter of understanding how it works - how the effects aren't fully expressed for a few days - and how other things can effect your INR. For many of us, we trust the management of our anticoagulation to doctors or clinics. For others - many at this site - we trust ourselves to test (weekly? twice a month? monthly?), and to adjust our dosing (or ask for advice) when we get out of range. Without warfarin, there would probably be no mechanical heart valves in use; people with a-fib or DVT would be at more risk than they are now, and life for many of us would probably just not be possible. Warfarin is a good drug - not to be feared, but certainly afforded due respect.