Warfarin level Please help!!

[Jimmyk]

Ok, I'm fresh out of the hospital with a brand new mechanical Aortic valve.
I was started on warfarin about 4 days ago. The level the dr.'s are looking for is between 2.5 & 3.5 . Today I was at 3.4, which is in the higher good range. My problem is , I was sent home with 7.5 mg tablets, which I know if I had taken a whole one ,would have put me over 3.5.
The people at the warfarin clinic are home for the weekend but I got a last minute call from them regarding my concern.
I was told to cut a pill in half, take half today, a whole one tomorrow and half on Sunday . Then come in Monday to get tested again.
It can get expensive paying my 45.00 co pay every time getting tested. Especially being out of work now.
Question, the nurse that checked my blood using a machine I've seen on Amazon . I know that some insurances pay for this machine, but not until 90 days of being on warfarin .
If I'm not back to work in 90 days, I'll no longer have health insurance .
I'm seriously debating whether or not to buy one of these testing machines , it looks like a very good investment , considering I'll be doing this for the rest of my life .Not only will it relieve a lot of stress on this end, but will also save me 45.00 per test.
Can any of the forum members recommend the best one to buy? Possibly the best place to buy it?
Also, once I do get medically cleared to go back to work, this little machine can come with me, as I travel to different states quite often.
The different machines cost between 5 and 7 hundred dollars, I'm willing to buy it and be done with it.

 

[dick0236]

$45 is a LOT to pay for an INR test. One of the most used machines used by labs or home testers is the CoaguchekXS. The meter and strips are readily available on Ebay and other sites without a prescription from a doctor. The downside is few, if any, insurance plans will cover any part of this cost....but it will be a lot less than $45......more like $6 to $10 per test. The problem is many doctors may not accept the results of these tests and you may have to go to a lab monthly anyway. You may try to go thru a self-testing third party lab where they send you a meter, strips, lancets, etc. They charge about $25/test and most insurers will pay 80%($20) and you pay 20%($5). Normally you test weekly or bi-weekly. This requires a doctors prescription. I go thru this arrangement with Coaguchek Patient Services (800-780-0675) and have been very satisfied with this arrangement. I am on Medicare and self-testing is fully approved. If you want to consider this arrangement, call a third party service company (bunches on the internet) and they can help with getting the doctor prescription. Self testing normally requires you to go to a lab for the first 90 days following surgery and then start self-testing. Good luck

 

[Agian]

Yes, that little machine will relieve a lot of stress. Coaguchek xs is the most popular.
If you get scripts for tablets of different doses you can mix and match yourself.

Although, I have an on-x avr, I've decided to keep my inr above 2.5; standard is 2-3. Why does your guy suggest 2.5 - 3.5? What type of valve d'ya get?

 

[pellicle]

Hi Jimmy
glad you're "out and about" now

Ok, I'm fresh out of the hospital with a brand new mechanical Aortic valve.
I was started on warfarin about 4 days ago. The level the dr.'s are looking for is between 2.5 & 3.5 . Today I was at 3.4, which is in the higher good range.

just wanted to put it out there (as you already are on the money with range) that whatever your dose is now, it will likely increase as you recover.

My problem is , I was sent home with 7.5 mg tablets, which I know if I had taken a whole one ,would have put me over 3.5.

my first advice is to get a local doctor to give you another script for a few more variants in size, that will help you to dose better ... but I didn't see you mention the dose that you are on now ... to have the INR you are at now.

The people at the warfarin clinic are home for the weekend but I got a last minute call from them regarding my concern.
I was told to cut a pill in half, take half today, a whole one tomorrow and half on Sunday . Then come in Monday to get tested again.

seems reasonable and at this early stage I'd suggest that it doesn't matter if you yoyo a bit ... drop me a PM and I'll put together an Google sheet (you'll need a google account, which you'll have if you use android) to help you to get going on monitoring and self dosing (should you wish).

It can get expensive paying my 45.00 co pay every time getting tested. Especially being out of work now.

agreed...

I'm seriously debating whether or not to buy one of these testing machines , it looks like a very good investment , considering I'll be doing this for the rest of my life .Not only will it relieve a lot of stress on this end, but will also save me 45.00 per test.
Can any of the forum members recommend the best one to buy? Possibly the best place to buy it?

to my mind the Coagucheck XS is the best value and has the best price in "consumables" (strips). Buying in 24's you'll get them for about $6 each strip which is likely less than parking at the clinics.

I'd keep a keen eye on ebay and get the machine from there. They turn up for about $400 now and then...

Best Wishes

 

[Seeker]

Hi Jimmy,

For the first 3 months my INR was all over the board. My target range is between 2.0 and 3.0. To date my highest INR was around 4.5 and my lowest has been 1.6. Your body is recovering from the trauma of the surgery, processing new medications, and adjusting back to the food you typically ate prior to surgery. That was a lot for my body to handle. I felt ready to go back to work at 60 days but my body wasn't having any of that. I worried too much about my INR at first but later learned that as long as its in range I was good to go. I've nicked my hands and legs up many many times working around the house. It just take me about twice as long to stop bleeding. Not a big deal. Rest, take walks, nap, laugh. Eat as clean as you can while your healing and drink LOTS of water. Not sure if your a drinker. I waited 4 months before I drank a glass of wine. Because of the Warfarin, 2-3 drinks max for me these days just to be safe.

 

[MartinF]

I'm not sure what insurance you have but that sounds crazy to go to the doctor to draw blood. My Coumadin clinic sends me to a lab (no copay) and the next day the clinic nurse calls with the results, any change to my medications and the next test date. They bill the insurance. I have an HMO plan.

 

[bobmil58]

Hi every one, new to the site, and I have a Question about Coumadin clinics. My INR has been all over the place. last month was 3.9 doc said too high, then it was 2.3 4 days later. Then 6.2 on the 3th of July and 1.2 on july 7th.??? My question is how much is the normal charge after insurance at a clinic that uses the finger prick type of testing for INR? I have been using Quest Labs and it's $2.87 after insurance for the Blood test from the arm...

 

[jwinter]

Hi Jimmyk, and welcome to this side of your surgery. Fresh out of the hospital? I only can add that my INR was all over the place the first few weeks after surgery and I did not feel qualified to self test. I made a lot of phone calls and visits to coumadin clinic(didn't care if it was weekend or holiday, eventually someone will help) to get my numbers in line. They have been good after I had two further operations to drain the fluid off my heart.

I go to coumadin clinic once a month and my INR has been right where they want it. I am just now (8 months out) thinking of self testing. My primary care doc does not approve but will discuss with cardiologist at the end of this month. I will still monitor at the clinic for at least a year. We like to travel and I intend to keep in contact with the clinic.

Oh and my clinic charges are 105.00 per testing. No copay until I reach my 6,000.00 deductible.

Best wishes to you for a great recovery!

 

[ForeverThankful]

I'm seriously debating whether or not to buy one of these testing machines , it looks like a very good investment , considering I'll be doing this for the rest of my life .Not only will it relieve a lot of stress on this end, but will also save me 45.00 per test.
Can any of the forum members recommend the best one to buy? Possibly the best place to buy it?

I'm about a year and half out from my surgery and I bought my own Coaguchek XS about 4 months after surgery. I bought it on Amazon for about $500 and it's worth every penny! My only regret is that I didn't buy it the day I came home from surgery! I buy the strips on Ebay. I get the box of 48 and they're upwards of $200 a box making the strips only about $4 each, very reasonable.

 

[ClickityClack]

Although, I have an on-x avr, I've decided to keep my inr above 2.5; standard is 2-3. Why does your guy suggest 2.5 - 3.5? What type of valve d'ya get?

I also got a On-X AVR about 8 weeks ago. My surgeon wants me at 2.5 to 3.5 for the first three months. After that he said I can go to 1.5 to 2.

I'm not comfortable with such a small range that is so low and that's a big reason that I'm trying to get set up for self testing too. I got lucky and the VA clinic that I use (and especially the NP that monitors my INR and dosing) seems to have their stuff squared away. They do manage with weekly dose though and seem to be very reluctant to step outside SOP.