Hi Ray:
If I remember correctly, the last time you were here, you were complaining about swellling in your legs, I suggested a vascular problem or a DVT, but suggested that something else (worse) was a possibility. Since you are look for INR monitoring, sounds like there was a clot. Am I correct?

Anyhow, I investigated remote monitoring a few years ago when I was on Coumadin. Its not as simple as you might like. The machines are very expensive (over $1000.00) There are also test strips (which are expensive). See if your insurance will pay. Medicare will pay only if you have been on Coumadin for over six months (I suspect you are not on Medicare). In this country you call in (or the machine calls in) the results of the test to the company that sells the machine. That company now informs your doctor and the doctor tells you how to adjest the dosage. This way they all get a cut. Kinda sucks. So your doctor needs to be hooked in the the machine provider. I suggest you talk to your doctor about in home monitoring and see who he is participating with (if anyone).

You may want to talk with these providers to get background information.

http://www.ptinr.com/
http://www.coaguchekpatientservices.com/

In Switzerland, where ATP lives (she may want to jump in here and correct any misstatements I may make), the government provides the machine, and the patient does their own monitoring and dosage adjustment. Limited kickbacks.

You may want to consider a NOAC. They are very expensive (approaching $1000.00 / quarter) but so much less aggravation. See if you insurance will pay for a NOAC. My insurance pays most of the cost of my Eliquis and there are programs from the NOAC manufactures that provide the drug at reduced cost.

I am on warfarin. I asked at my Doc;s office about getting a machine to check my INR and they told me that with a script from them I could get one for nothing. I could call in the results myself and they would advise me on adjusting the meds. I moved to only 3 mile away from him so I never followed through. It sounded simple, however that was
a few years ago.

I would check with your Doc, and possibly think about changing to one of the new bloodthinners. I am OK with the warfarin.

i am on warafin and go for once a month check in at the local lab ,my numbers run between 2.1 to 2.8
i decided against having ablation or even being cardioverted i have ahd the afib since 2011

Hi Ray,
Paul is right, here in Switzerland its a little easier. Insurance (the basic, mandatory insurance everyone has) pays for a new machine (Coaguchek) every 5 years and they pay for 72 testing strips a year. You have to take a course where they tell you about how the blood clots and how to self regulate. It wasnt difficult and self regulating is easier than I ever imagined you get a feel for it after a while. I can monitor whenever I want (I measure every Sunday morning) and adjust my weekly dosage accordingly. I have been in range 100% of the time this year so far! I dont think anyone gets any kickbacks on this over here.

What I especially like about self regulating is when I have to be on Plavix AND Warfarin (after a stent in my leg unfortunately that has happened often) I lower my range between 1.8 and 2.5 so I wont bleed to death if I cut myself while cooking, gardening or just playing with knives. The doctor told me to do that (not the playing with knives bit lowering the range) so hes not completely out of the picture. I dont think anything like that is possible with the NOACs.

A machine might bring you some peace of mind. Id check into it if I were you.

Carpe diem,
atp

I obtained a machine from Alere through my cardiologist's office. I pay a minimal fee each month and I have t to call in my results weekly. It's a nuisance but much better than having to go to Lab Corp and have them torture me once a week (not to mention the time I would have to take off from work).

Testing at home for 5 years weekly with a system called Remote Cardia Services. They provide machine and strips. My insurance covers and I pay $27.00 monthly. Keeps my anxiety at bay since I am not a regular eater in terms of amounts and concern of 2 high reading implications or too low for that matter. RCS reports my weekly INr to my doc.