Self test virgin until last night ...

[Phil]

Hi All,

My CoaguChek XS arrived on Friday (free of charge). It stayed in the box over the weekend as I didn't want to deal with it. Yesterday I grab the bull by the horn, opened the package and with the help of my partner set up the meter and got it going in about 15 minutes. There were a few swear words along the way (more a comment about my technology skills or lack thereof) than the ease of the instructions. It took four strips to get my first reading as I didn't get the positioning of the blood right, but I know it will be easier next time around. My reading was point 1 lower than the reading I received from the path lab last night. All-in-all it was a positive experience which will be much easier and more convenient in the long run - when travelling, etc. Also, it took the lab 4 goes to find the vein yesterday. Arm is very bruised. Give me home testing any day. I'm converted!


Phil.

 

[Protimenow]

Welcome to the world of self-testers. So - from now on, you'll be testing every Monday. Right?

You will probably find that it is a lot more convenient - and in many ways, empowering - to be self-testing than having to rely on labs to do it. I don't know if you'll also be managing your dosing or having a clinic or doctor doing that for you, but if it's done right, you will probably have an INR that is IN RANGE more than others who don't self-test.

For my money, weekly testing is just about the right interval. Also - from personal experience, I recommend staying just a bit above the bottom of the range.

 

[Bina]

Hello Phil,
congrats on performing your first home test !
When I got my Coaguchek XS the pharmacist showed me how to use it to help avoid wasted strips, but I was a bit nervous anyway. Now, many years later, I still find testing a breeze.
My home results match up with my yearly blood lab draw so my doctor is equally pleased.
I have an INR that is rock steady and test about every 2 weeks, mark it down on my Agenda, and give results to my doc every few months.

 

[Agian]

Hope mine is 'rock steady' when it's my turn.

 

[Protimenow]

It can be considered 'rock steady' if you test every ten years and it's the same each decade. Even if my INR appears to be the same every two weeks, there are still possible variations from week to week (because the effective half-life of warfarin is 3-4 days) that might be missed by testing every two weeks. I am a lot more comfortable testing weekly (although I'm guilty of going 10 days to two weeks when I'm low on strips).

I would be a lot more comfortable if I was a bit less than Rock Steady, but within range, every week.

 

[pellicle]

Hi

And welcome to self testing

My CoaguChek XS arrived on Friday (free of charge).

If you register it you'll get training provided.

There were a few swear words along the way (more a comment about my technology skills or lack thereof) than the ease of the instructions.

Personally I had issue with the sprinkling of important steps out of sequence, and the quick start guide which had some errors. I sent a lengthy email to Roche about this, so maybe that's been looked at.

It took four strips to get my first reading as I didn't get the positioning of the blood right, but I know it will be easier next time around. My reading was point 1 lower than the reading I received from the path lab last night. All-in-all it was a positive experience which will be much easier and more convenient in the long run - when travelling, etc. Also, it took the lab 4 goes to find the vein yesterday. Arm is very bruised. Give me home testing any day. I'm converted!.

Was the lab QML ? your finding is consistent with my own.

A couple of points for you (Justin Case):
* observe the 15 second rule from lance to drop
(http://www.valvereplacement.org/forums/showthread.php?41136-the-15-second-rule)
* if you have trouble getting enough blood , rather than lance deeper, apply a light tourniquet using so,e cotton thread or dental floss above the second joint for a few seconds prior to lancing. You'll see the blood pooling in the fingertip. A shallower lance will then get your drop in short order
* lance the side of the finger not the tip or pad.
I lance here

* buy supplies online, I buy my strips from medshop . com . au and it saves a bundle over pharmacy prices. My last lot was about $140 (posted) for 24 strips

For your interest this is my year to date results of INR testing. My range is supposed to be 2.2 ~ 3, I "target" 2.6 but as long as I'm within that range I don't sweat it. There will be natural variations with responce such as when you are sick or on other medications.

The point being don't over do the tiller (dose) when the bow seems to head in another direction. Test weekly and document and eventually you'll get a feel for it


PS watch out for dose advice from our USA cousins, they often speak in mg dose per week, while in Australia we work in daily dose (as does most of the rest of the world)

 

[Protimenow]

In the U.S. they DO talk about total weekly dose -- and in some ways, it seems to go contrary to common sense. If I figure a weekly dose that is right for me, I try to divide it into seven EQUAL dose. Otherwise, because taking a different dose on different days will have a slightly different effect on INR depending on the day of the week that you test, you can get a somewhat inaccurate picture of your actual INR.

I've had advice from professionals to skip a dose one day a week (or perhaps to add 1/2 dose) one day a week, in order to hit the magic weekly dosing total. They didn't seem to realize (or care) that doing it this way would bring me over (or under) range just for a day or two and bring me back where I was before I made the change. (Bringing their weekly dosing theory to its ridiculous limits, if my weekly dose was 52.5 mg - 7.5 mg/day - why couldn't I take them all in one day and be sure to meet the weekly total?).

If possible, try to take the same dose every day.

 

[Phil]

Thanks heaps, Pellicle. Excellent advice as always.

Hope all is well.


Phil.

 

[pellicle]

Hi

Bringing their weekly dosing theory to its ridiculous limits, if my weekly dose was 52.5 mg - 7.5 mg/day - why couldn't I take them all in one day and be sure to meet the weekly total?

I have a mate who works in pathology out in the boonies (Katherine) and they have trouble with people doing
exactly that. Mainly they do it because they only remember to do it just before going in for a checkup. As here they are directed to take their dose daily. Seems to be too much for some people. So then they have to pump them full of vitamin K and treat them over the weekend.

 

[Protimenow]

Wow.
They have those daily pill things. It shouldn't be that difficult to check to see if you've taken you daily dose of pills.

It's pretty scary to think that someone would take a WEEK'S Dose of Warfarin without some major complications. (Of course, if they're used to the once monthly or once yearly stuff that's out there, perhaps the idea of a dose a week doesn't seem that crazy).

I guess that some of this comes down to basic education. Let the people know that it's a DOSE a DAY and that doing it otherwise can be life-threatening.

 

[Bina]

Hope mine is 'rock steady' when it's my turn.

It can easily be 'rock steady' if you test often enough and learn what will affect your INR readings.....(too much booze, some antibiotics, some herbal supplements, etc.)
My INR only has SLIGHT fluctations, that is what I consider 'rock steady'.
Best wishes.

 

[Protimenow]

I don't think that mine is 'rock steady,' either - but I like Bina's definition -- 'SLIGHT fluctuations.'

I've narrowed my testing to TWO meters - I'm not sure which one is most 'accurate,' but as long as both show that my INR is in range (or tickling the top of my range), I'm comfortable with my results. I will VERY RARELY make ANY adjustments to my INR, unless it's low. If I can confirm that it's around 2.0 (and the idiot doctors now think that my range should be 2.0-3.0 instead of 2.5-3.5), I may consider a slight (and I mean SLIGHT) increase for a couple days.

I'm pretty sure that, once your body is 'healed', and if your diet, activities, etc., are pretty consistent, your INR should become pretty darned steady.