New Packing Procedure at QAS ??

[M&M]

Hi, I'm going to ask anyone if they are now receiving their kits without the ice packets? I just got a shipment last week and although I was told they would be shipping them without ice packs - that it still would need to be refrigerated. So I stayed home one day last week and got my new shipment. I had 2 left over from my previous shipment.

Because the new shipment didn't come on ice pack - I decided to test the new test kit box against my previous test kits that did get shipped on ice and has been refrigerated.

Well they varied. I had the same machine - I put the new kit in the refrigerator and tested myself the next day - once I knew the kits had been refrigerated. Well, I tested one finger with the old (3 mos old) tenderlett, couvette and then tested my other finger right afterwards with the new shipment. The first time it was .5 difference.. I think it was 2.9 vs 2.4 - then I said - well 2.4 isn't that bad - I'll wait and test again before I call my coumadin clinic - as I might very well be 2.9 - so I waited a couple days and I did the testing again - previous shipment vs new shipment and once again it was 2.4 with the new kit and 2.8 on my old kit. So I did call me coumadin clinic and told them - I'm not sure which kit is right - but they definently vary and since I had the same machine - I have to say - its probably the kits. One shipment came on ice and the other didn't is the only difference. So, my coumadin clinic wants me to come in for blood work and bring my machine and test myself just before the blood draw. I only have 'new' shipment kits left.

Anyone had this happen? My coumadin clinic suggested I call QAS - which I did but have not heard back from them. I guess they are very busy. I don't know if I want to keep the ProTime machine - or just start to have the blood drawn all the time. I hate to be over medicated and yet - I don't want to be under medicated - but simply 'consistency' I would think is the main idea. They changed my coumadin doseage. I don't know why I test at home - if its not going to be accurate - I mean why bother...

Not feeling very confident with this 'new' shipment procedure - anyone else having problems. My coumadin clinic suggested I ask QAS to send me a new shipment and throw away the one I just got if the blood work at the lab varies from my home supplies. She said "they" (coumadin clinic) were still receiving their test strips 'ice packed'.. she was surprised I didn't..

Marilyn

 

[Ross]

Marilyn if you had tested the same day and same time back to back, then maybe I'd worry, but you gave it a couple days to retest and that cannot compare to the original. Follow what I'm saying or am I misunderstanding?

 

[Karlynn]

I highly doubt there's a problem. ProTime Cuvettes can be left unrefrigerated for 30 days. This is probably why, particularly at this time of year, they do not ship with ice. The last 2 shipments I received from another company had no ice packing and were fine. One was even shipped in the summer.

As far as getting different readings between the two cuvettes, that's could be just the nature of the beast. When I get a concerningly high or low INR, I always retest right away to make sure there isn't a problem with the machine or a fluke in the test. I have never gotten the same # back to back and from what I've read .5 (although it seems big) is close to acceptable. And now I know my machine is testing correctly because I tested my husband and his INR was .9.

Now as far as the 2 different batches testing consistently different from each other, that's a mystery. 2 different testing days isn't exactly a scientific sample. It still could be that the difference is explanable by acceptable norms. But a call to QAS would be worthwhile.

Do you have someone you can do the test on that doesn't use Coumadin. Do the dual test again with both batches. This will be a quick way of letting you know if the new batch is bad.

 

[M&M]

Hi Ross, well actually I did test back to back. I test twice on each day. One from the old set and one from the new set and they varied by .5 to .4 each day. I did test a couple days later - but once again - two tests and one from the old batch and the other from the new batch... So all in all I did two from the old batch which came delivered 'on ice' and the other two were not delivered on ice - but both were refrigerated. Does this sound 'normal' - I mean if you get a new batch - have you ever noticed a wide difference in your readings?

Thank You
Marilyn

 

[Karlynn]

Marilyn - you have two Member Names? Runner and Marilyn?

Supplies don't need to be delivered on ice. They have a 30 day shelf life outside the refrigerator.

Best, easiest way to check the strips would be to do the same comparison test on someone not on Coumadin and see if you get that much of a variation. Do the older strip first - to see if the test for the non-warfarin user comes in with an INR right around 1.0. If it doesn't and there is more than a .5 varience with the old strip, it may be the old strip (or your machine has the problem). Then test with the new strip to look at the same thing - does it come in around 1.0.

It's not unheard of to get a batch of strips that are "off". But since refrigeration during shipping isn't really needed (except for hot environments), then the question is - is it the old batch that's more correct, or the newer batch.

 

[Ross]

I meant to take care of that dual profile deal along time ago and never did. She had it before the rules and I knew about it, so we can't shoot her, maybe beat her with wet noodles though.

My suggestion was going to be what Karlynn is saying. Maybe you can use her husband as a control subject and jab his toe since Karlynn didn't do it last time.

 

[M&M]

Hi Karlynn, I'm sorry - I am the same person - Marilyn - Runner. I use to be a runner and then not so long ago - my chronic heart failure put an end to that and so I sign off as Marilyn now - I'm sorry.

I shall update my profile and stick with one name. How quickly we forget time goes by. I've been doing kind of lousey with this chronic heart failure - its a really tough disease as I know Joe has it and its terribly hard to control all the time.... My cooking is going very well and I'm cooking everything from scratch - but it takes alot of time. But I'm having fun with it..

You know I just thought of something - I did start a new 'ace inhibitor' medication about a week ago. Maybe my INR will change due to that..

I'm glad to hear that .5 or .4 is not a big variance from kit to kit. I wonder where my coumadin clinic gets their test kits - cause they said they got theirs on ice packs when delivered. Just curious - I'll have to ask when I go into their office on Friday.

I'm so tired - all these meds and boy I'm telling you - just filling my pill boxes takes me almost a half an hour !!! I take 7 in the morning and 7 at night. No, they're not the same 7... No wonder I'm so fatigued !!! I never took this many pills when I ran.. and I can't run now - my legs are to fatigued. I just got my ICD adjusted for 'potholes' in the road. As everytime I hit one driving - my machine thought I was exercising and gave me to many beats which caused me to be breathless. So last week - or maybe it was the week before my electrician gave my ICD a pothole program on my ICD !!!

Thanks all of you for listening to me - I just never know what to think anymore. They did switch my coumadin doseage and then I turned around and got Tuesday and Wednesday doseage's mixed up !!! I can't even remember what day it is... I have 3 doctor appts this Friday !!! I had over 40 visits to different doctors and various tests they ran last year. Yes, can you believe it - 40 visits and most of it was maintenance. Although several were to check my kidney's as they found a cyst on my left - thank goodness it was benign.. I wonder what is causing all my darn "hip" pain.

Oh well, its way past my bed time.. I still have one more day to work this week - before all my visits.. I'm just exhausted on the days I go to my doctors. Its a two hour drive - one way !!!

Good Night
Marilyn

 

[Karlynn]

I meant to take care of that dual profile deal along time ago and never did. She had it before the rules and I knew about it, so we can't shoot her, maybe beat her with wet noodles though.

Rats, we haven't had a good shooting in a while. Kill-joy!!!!

Marilyn, I was just confused by the two profiles, it seemed like the same person posting, but I wasn't sure.

The discrepency in tests is why so many of us like to keep our INR on the higher side of the range as a safety cushion.

My supplies used to be shipped on ice regularly too. The first one I got not on ice I called with the concern and was told about the change. May have been from directions from the manufacturer saying it wasn't necessary and it reduced the cost of shipping. (Although I'm sure we didn't see the reduction.)

 

[Blanche]

We have received supplies that were not on ice, the first in May 2005. We have seen no changes and have had no difficulties with those supplies. One package came in July when the temperature was over 100 degrees.
Regards,
Blanche...who lives in Arizona