Question about Home Monitor !!

[Braveheart]

Hi Folks

Jonathan here! I've now got my CoaguChek 'S' INR monitor. However, I'm a bit worried and confused
because the readings I am getting indicate I am out of my therapeutic range(2.5-3.5) and the blood test I had at the hospital yesterday lunchtime showed me to be within my desired range. Which am I to believe?

Below are the results:

Date/Time INR Result System

15-12-01 / 00:14hrs INR 2.2 CoaguChek 'S'

16-12-01 / 20:10hrs INR 2.0 CoaguChek 'S'

17-12-01 / 12:15hrs INR 2.9 Hospital Lab.

18-12-01 / 13.25hrs INR 2.4 CoaguChek 'S'

I'm pretty disappointed actually. I expected a +/- deviation of say 1 or 2 points, but was amazed that the hospital test came back as 2.9.

I have called Roche Diagnostics and informed them of the results and they are sending me another CoaguChek system with some test strips to run in parallel as a test of the systems. I wonder if
there may be a fault with my system, although the Control Test I performed indicated normal range/accuracy.

I am due to go to the hospital this Friday for another blood test. I think I shall perform a test on each system in the morning and record the results. Then see what the hospital blood test comes out at.

Does anyone out there have any ideas? or is anyone using the CoaguChek and experienced similar problems?

Regards

Jonathan

 

[RobThatsMe]

Hi J,

You really need to run a test comparing the lab and your home monitor within 1 hour of each other.

I bring mine to the lab, and have them run their test, then right after I run my own test. They really do need to be compared within the same time frame if possible. INR levels change as we eat, time between doses, and on and on.

It is also best to check your INR levels at the same time or as close to it as possible when you do test. For example, If you check in the mornings around 9:00 am, then you should try and continue to try and check it during that same time each time you test. The amount of time that passes between your Coumadin dose will also cause a variation in your readings. So, if you take your Coumadin at night, and test at the same time in the morning, then you have done your best ro equalize the norm for your test.

There are so many variables with lab testing, that once you gain confedence in your home unit, I think you will feel much better about it. I trust my home test results more than the lab.

Happy Holidays,

Rob

 

[Marty]

? fo Dr. Jack Ansell

? fo Dr. Jack Ansell

Jonathon, When I had similar questions after I received my Coaguchek I referred them to Dr. Jack Ansell at Boston U. Medical School. He is a hematologist and is one of our national authorities in this area.Email your question to
[email protected] and you should receive a prompt reply. In my experience the Coaguchek has just as good a chance of being correct as the central lab.
I have regulated my dosage for over three years by the Coaguchek and I had no problems.

 

[Hank]

Home tester reliability

Home tester reliability

Hi Jonathan,

It is wise to at least want to verify your home machine with another home machine. That way you will gain the confidence you need in your machine.

I would be willing to bet however, that your machine is much more accurate than the lab is. That's just my own personal guess based on my experience with a home testing machine and my years working in a lab.

Do what is required for your confidence to be established, than you will have great comfort in what it tells you.

 

[Braveheart]

Thank You for Your Replies

Thank You for Your Replies

Thanks Rob, Marty and Heyring for your prompt replies. The information has helped very much indeed.

Firstly, your comments Rob were helpful. I shall try take my INR reading at the same time of day each time I test. Is morning better? or any particular time? On Friday I shall test with my CoaguChek within 1 hour of the hospital test as suggested.

Marty, I have just emailed Dr. Ansell and will let you know what he has to say on the matter. Thanks for his details.

Heyring, thanks for your input - you have given me more confidence. I just wonder if the hospital readings have been giving me inaccurate data perhaps this has something to do with my epsiodes (possible TIAs).

One other question, what part does alcohol have to play? Is it that big a deal? I say this because on Saturday I had one pint glass of beer and then Sunday evening a glass and a half of red wine. How long from taking a drink would it take to take affect and give a high INR reading or whatever? Just wondered if you knew the answer.

Many thanks again,

Jonathan

 

[cookie]

Jonathon,
Where did you get your Coaguchek monitor? I can't seem to find any info on this. Their web site is inactive.

 

[RobThatsMe]

Hi J,

I test in the mornings, and take my Coumadin in the evenings. That way, if my test results indicate that I have to adjust my medication, then I can do it that day with my evening dose.

If I already took my Coumadin in the morning, then tested, I would have to wait till the next day to adjust my dosage if it needed to be brought down.

You will find a routine that works for you, then everything will fall into place.

Good luck,

Rob

 

[Braveheart]

Replies

Replies

Cookie

The website address for Roche Diagnostics, who manufacture the CoaguChek 'S' is:

http://demapoc.mah.roche.com/servlets/MenuFrontServlet?ACTION=Frame&ID=937822422042&LANGUAGE=E

Hope this helps.

Rob,

Thanks so much for the info, I am going to try the same routine that you use.

Marty,

I had a great reply from Dr. Ansell. He basically said that it's best not to compare the CoaguChek with the hospital results, because unless they are performed more or less at the same time, side by side, under very strict conditions...there will be differences. He explained that I could depend upon the accuracy of the CoaguChek and that it would be good to use that as my tool for checking my INR etc.

Thanks again folks for the help. I shall keep you posted onmy progress with the new system.

Happy Holidays,

Jonathan