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Old clicker

Well-known member
Joined
Jun 9, 2004
Messages
129
Location
Atwood, Ontario Canada
I want to monitor my INR at home, and my GP doesn't think its a good idea. I need a good argument, any ideas what to use, or where to look? I havent searched the threads yet. That would probably be a good start thought.
 
Old clicker said:
I want to monitor my INR at home, and my GP doesn't think its a good idea. I need a good argument, any ideas what to use, or where to look? I havent searched the threads yet. That would probably be a good start thought.
Click to expand...

Does he make all his diabetic patients come in 2 or 3 times a day to get tested and then get their shots from him?????? Ask him if you became diabetic if he would require you to do that? If he says no, then ask him why he's requiring you to do it for your Coumadin management. Diabetics have much more to regulate and control than warfarin users and mismanagement by them has much more immediate result with significan consequences. Yet most diabetics are allowed to test and dose on their own. You may also ask him why he trusts you to take your medication daily without coming in to have it administered.

You're not even asking him to let you control your own dosing - just the ability to test. You can phone him your results and let him do the dosing. What is he afraid will happen, you'll slip and bleed to death from a finger stick?

A while ago, someone posted a report by some insurance group that showed that people who home test are less likely to have incidents involving their Coumadin. I have to see if I can find that.
 
Thanks Guys, this information should be enough.
Good point about the blood sugar checks Karlynn, because I am a Type II diabetic. It means my gut is too big LOL. I check my blood sugar once a day, but dont have to do insulin shots
 
Old clicker said:
Thanks Guys, this information should be enough.
Good point about the blood sugar checks Karlynn, because I am a Type II diabetic. It means my gut is too big LOL. I check my blood sugar once a day, but dont have to do insulin shots
Click to expand...

Then your doctor shying away from home testing is silly. You've already demonstrated that you have the ability. My guess is that if you meantion this and ask him exactly what his reservations are now, knowing that you already test blood sugar, he won't be able to give an answer that's satisfactory. It's his mental block and he needs to move past it.
 
Looks like an excellent reason to look around for another GP, your GP may well be as stubborn as he is ignorant and blinkered. Being a good medic is all about continuously updating ones knowledge - an art and a science.
 
I should also mention that every time I see your avatar I go "Ahhhhhhh". What a sweet picture!
 
Old clicker:

Perhaps your PCP has never dealt with someone your age (49) who has had valve replacement. It's possible that those patients of his who are on warfarin are much older and he doesn't believe they would be good candidates for home testing.
Or it could be that HE just doesn't understand warfarin and he doesn't see how anyone else could either.

I've discussed with my husband how it would be to "interview" a prospective new PCP -- should I have to find a new PCP -- and get one who would allow me to continue home-testing and adjusting my own dosage. I wonder what percentage of PCPs, GPs, internists are receptive to warfarin patients doing home testing?
 
catwoman said:
I wonder what percentage of PCPs, GPs, internists are receptive to warfarin patients doing home testing?
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A very small percentage. My PCP is a pretty sharp and a down to business type guy. He didn't even know that one could home test for INR. Then again, neither did. I quickly got to the point where I could dose adjust better than he could. Now I just call in an leave a message with my INR and what adjustments, if any, I'm making.
The hardest part was the running around in circles to get everyone on the same page to get the testing unit.
 
self testing? self dosing?

self testing? self dosing?

I have discussed home testing with PCP's and hematologists. Its interesting but they say it helps them only if the patient also self doses and does not bother the office by calling in results. My PCP does one blood draw a year and is happy not to hear about my INR the rest of the time. Last year I got 3.2 INR by Coaguchek and 3.2 from the central lab on the arm stick. Very unusual.However don't worry about the doctors office. self testing is a boon for the patient.
 
I wanted to self dose because I live about twenty mile from the nearest medical facilities. My PCP probably would have been the last to agree to this but my Cardiologist happens to be my son-in-law and he actively supported the idea. Now I don't have to waste two hours in the car, sit in a germ filled waiting room, and I can take the unit with me when I travel. I also self dose and email the INR and dosing changes in to my cardios Coumadin clinic. Self testers/self dosers are still pretty rare, but I don't know why they should be. Once you have experienced the freedom of doing this, you would never go back. I have a brother in law who still gets full blood draws and can't conceive of doing it himself - whatever. Several things need to change before the medical industry imbraces the idea fully: We have to convince the physicians that it is safe and doesn't threaten them (Some feel they are still responsible for the patient's INR and could be sued- maybe they could?) and secondly, the coumadin clinics would need to change their treatment model to allow for phone-in or email-in INR results, and to remind a patient if they haven't heard from them within a given guideline. The insurance industry would also need to agree to payment for the less active role of the coumadin clinic. Lastly, a more substantial education program would need to be available for the self doser so that they and their physician are comfortable that the skill is there. Hope this helps
 
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